Cocaine and alcohol are both dangerous substances when consumed on their own, particularly if consumed in large amounts or abused frequently. However, the individual dangers of cocaine and alcohol are significantly greater when the two drugs are taken together.

When combined, cocaine and alcohol can produce chemical reactions in the body that produce a substance called cocaethylene — a byproduct of cocaine. Cocaethylene can increase the power of the effects and the risks of each substance – and can cause an overdose or death.

What is Cocaethylene?

When alcohol and cocaine are ingested together, a chemical reaction occurs to produce a new substance, cocaethylene, which can have a toxic effect on the body. Cocaethylene is the substance that is produced once the cocaine metabolizes in the body.

Cocaethylene can stay in the body for much longer than cocaine. Risks of cocaethylene buildup include liver damage, immune system damage and seizures.

  • What are the risks of cocaethylene buildup?

    • Cocaethylene is one of the reasons pairing alcohol and coke can lead to alcohol poisoning and death.
    • Cocaethylene is toxic to the liver, and it’s often a contributing factor when heart attacks occur in young people. The production of this substance is what leads to the risk of a spontaneous heart attack when you combine alcohol and cocaine.
    • Not only can cocaethylene be produced when you use alcohol and coke only once together, but it also has the potential to build up in the body over time.

  • Why do people mix alcohol & coke?

    Cocaine and alcohol are often consumed together because they are frequently present together at parties or clubs. Mixing alcohol and coke is also common because people often want to amplify their feelings of intoxication, and they may believe that mixing the two will intensify the cocaine high they experience. There’s also some belief that combining alcohol and coke can help alleviate the negative side effects of coming down from the cocaine.

    Unfortunately, the risks of mixing alcohol with cocaine are incredibly dangerous and deadly. The risk of dying when you combine alcohol and coke is 20 times higher than it if you just use cocaine alone. 

    When you mix alcohol and coke, there is no way to know how you’ll be affected by this combination of substances. The combination will likely make you feel less intoxicated than you really are, which can increase the chances of alcohol poisoning or drug overdose.

    Many people who frequently abuse these substances will start to develop a tolerance for either one or both of the substances, and they will want to move onto something that will give them a more intense high.

    Research has shown that more than half of the people who are dependent on cocaine are also dependent on alcohol, and there is a very significant link between these two substances.

Side Effects of Cocaethylene

As a stimulant, cocaine has different effects on the body than alcohol (a depressant) does. Taking cocaine on its own causes a rush of energy, a high or feelings of euphoria. Although alcohol usually slows the body down, taking cocaine and alcohol together can make the effects and risks of cocaine more severe.

Cocaethylene has similar effects to cocaine, but the risk of toxicity is greater. Alcohol also prevents cocaine from being eliminated from the body, which can be toxic.

  • Other common side effects:

    • An increased risk of stroke
    • Chest pain or cardiac depression 
    • Increased heart rate
    • Sedation or coma
    • Increased perceived level of intoxication
    • Cocaethylene can cause damage to veins, arteries and nerve tissue, which can cause serious long-term effects or death.

Overdose Risks

Overdose is a serious risk when mixing alcohol and cocaine. Cocaethylene can also prevent adequate oxygen to the brain or bleeding of the brain. High levels of cocaethylene can cause various toxicity symptoms. The toxic effects of cocaethylene can cause long-term, irreversible damage to the heart and brain which can result in death.

  • Common symptoms of an overdose:

    • Irregular heartbeat
    • Seizures
    • High body temperature
    • Trouble breathing
    • Agitation
    • Anxiety

How Long Does Cocaethylene Stay In Your System?

How long cocaethylene stays in your system depends on various factors from overall health conditions to the frequency of drug use. If drug use is chronic, it may take longer for these substances to clear your system completely.

In general, however, cocaine has a relatively short half-life. The elimination half-life of cocaine metabolites like cocaethylene can range from 14.6 to 52.4 hours. This means it can take over a week for cocaethylene to leave one’s system completely.

The individual variability can also affect if cocaethylene shows up on a drug test and can depend on the method of testing.

  • Cocaethylene detection times by test method:

    • Hair: The use of cocaine and its metabolites like cocaethylene may show up on a 90-day hair test.
    • Urine: Cocaethylene can be detectable in urine up to 15 days
    • Blood: The drug usually stays in your blood for a short period of time (several hours) but can be detectable in plasma for several days.
    • Saliva: The average cocaethylene elimination time from is around 68.2 hours, which means the drug may be detectable for three days.

These are estimates, and cocaethylene may be detectable much longer if cocaine and alcohol are used frequently or in very high doses.

Finding Help for Addiction

Addiction to alcohol and cocaine can mean that cocaethylene is often present in the body. There is a serious risk that cocaethylene can permanently damage the heart or brain, causing long-term disability or even death. These risks are present every time you mix the two substances.

If you’re abusing alcohol and cocaine, or you’re addicted to both substances, it’s important that you seek the right kind of treatment. The consequences of continuing to mix alcohol and cocaine can be extremely damaging to your physical and mental health.

The kind of treatment that’s best suited to alcohol and cocaine addiction is one that can treat polysubstance abuse problems. Dual diagnosis care may also be beneficial. Seeking this care level means that you receive treatment for both your alcohol and cocaine use and any underlying mental disorders related to your addictions. Detoxing from alcohol and cocaine can allow cocaethylene to leave the system completely, which can ensure your safety through the recovery process.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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