It’s incredibly dangerous to use cocaine and alcohol at the same time, as the combination can cause a variety of life-threatening side effects.

Article at a Glance:

Cocaine and alcohol amplify the effects of one another, and combining them can lead to life-threatening consequences.

A hangover caused by cocaine and alcohol can be very uncomfortable and drive someone to use more of these substances to relieve the effects.

The combination of cocaine and alcohol is associated with a higher risk for suicidal thoughts and actions.

Cocaine can mask alcohol impairment and cause an intoxicated person to believe they are sober.

Mixing Cocaine and Alcohol

Some people use alcohol and cocaine simultaneously in order to increase the effects of both substances. However, this combination can easily lead to life-threatening consequences such as overdose or alcohol poisoning. Alcohol is a depressant while cocaine is a stimulant, and when these opposing substances are used at the same time, their side effects can quickly amplify to dangerous levels. Alcohol and cocaine should never be used together, as the risks greatly outweigh any potential reward.

The Hangover or Comedown

Taking alcohol and cocaine together means that you would experience the “hangover” or “comedown” effects of both as your body processes each substance. With cocaine, the hangover is often called a “crash” because of how bad it makes a person feel. Common symptoms of a cocaine crash include:

  • Anxiety
  • Extreme suspicion
  • Fatigue
  • Irritability
  • Lack of pleasure
  • Paranoia
  • Sleepiness
  • Strong cravings for cocaine

Symptoms of alcohol hangover often include:

  • Anxiety
  • Fatigue
  • Headache
  • Inflammation
  • Nausea
  • Stomach discomfort
  • Thirst
  • Poor sleep
  • Restlessness

When cocaine and alcohol are combined, the symptoms of dehydration become more profound. Both substances can increase urination, and this side effect is more severe when taking them together. In addition, the psychological effects of the cocaine crash and physical effects of an alcohol hangover are happening at the same time. These symptoms are very uncomfortable, often driving a person to get intoxicated in an attempt to relieve them.

Increased Suicide Risk

Combined alcohol and cocaine use is also linked to an increase in suicide, according to a study at Brown University. Researchers looked at over 800 patients who reported to the emergency department for suicidal thoughts or suicidal behaviors. The study found that only the combination of alcohol and cocaine was linked to an increased suicide risk. Specifically, the risk of another suicide attempt in people who used both substances was 2.4 times higher than those who did not.

Alcohol Poisoning Risk

Because both substances impair judgment and cognitive thinking, it is much harder for a person to track and monitor their intake and frequency of use. This creates a much higher risk for overdose and alcohol poisoning.

Alcohol poisoning can be fatal. If you suspect someone is experiencing alcohol poisoning, call 911 immediately. Do NOT be afraid to seek help. If you do not have access to a phone, contact Web Poison Control Services for online assistance.

Overdose Risk

According to the Centers for Disease Control and Prevention (CDC), cocaine is involved in approximately one in five drug overdose deaths in the United States. Often, these cocaine-related deaths occur due to cardiac arrest, which is when the heart stops beating. Cardiac arrest has no warning signs and can be sudden, and drinking alcohol can significantly increase this risk.

When mixing alcohol and cocaine, potential overdose symptoms include:

  • Chest pain
  • Extreme paranoia
  • Trouble breathing
  • Unconsciousness or coma

Cocaine and Alcohol Effects

Taking alcohol and cocaine together can amplify the individual side effects of each substance. Additionally, there are many long-term and short-term side effects associated with combining alcohol and cocaine, including:

  • Cardiotoxicity (heart toxicity)
  • Breathing problems
  • Increased heart rate
  • Cognitive impairment
  • Increased blood pressure
  • Loss of coordination and motor function
  • Violent thoughts and threats
  • Heart palpitations
  • Cerebral infarction (death of blood vessels and blood tissue)
  • Stroke
  • Death

What Happens When You Mix Cocaine and Alcohol?

When cocaine and alcohol are taken together, they metabolize in the liver and produce a substance called cocaethylene (See More: Cocaethylene), which temporarily enhances the highs associated with both drugs. This buildup is particularly dangerous, as it increases blood pressure and can lead to aggressive and violent behavior. It can also contribute to long-term liver damage and even create the potential for sudden death (See More: Can Cocaine Kill You Instantly?).

Does Cocaine “Sober” You Up?

Because cocaine can make someone feel less cognitively impaired, using it with alcohol can reduce how intoxicated they feel. However, even though a person taking these substances together may “feel” less impaired, they are still very intoxicated. Cocaine and alcohol have two significant drug interactions that make a person more impaired. First, cocaine slows down the metabolism of alcohol, which actually makes a person more intoxicated. Second, cocaine and alcohol combine into cocaethylene, a longer-acting version of cocaine that increases the toxicity to the heart. It is important to understand that combining these drugs is much more toxic to the body than using either by itself.

If you or a loved one are struggling with a cocaine or alcohol addiction, The Recovery Village is here to help. Contact us today to learn more about treatment plans and recovery programs that can work well for your needs.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

Pennings, Ed; et al. “Effects of concurrent use of alcohol and cocaine.” Addiction, June 25, 2002. Accessed August 22, 2021.

Farré, M., et al. “Alcohol and cocaine interactions in humans.” Journal of Pharmacology and Experimental Therapeutics, 1993. Accessed August 22, 2021.

National Institute on Alcohol Abuse and Alcoholism. “Hangovers.” March 2021. Accessed August 22, 2021.

National Institute on Drug Abuse. “What are the long-term effects of cocaine use?” May 2016. Accessed August 22, 2021.

Brown University. “Simultaneous cocaine, alcohol use linked to suicide risk.” ScienceDaily, April 8, 2016. Accessed August 22, 2021.

MedlinePlus. “Cocaine Withdrawal.” August 5, 2021. Accessed August 24, 2021.

National Institute on Drug Abuse. “Can you overdose or die if you use cocaine?” Accessed August 24, 2021.

Centers for Disease Control and Prevention. “Other Drugs.” January 26, 2021. Accessed August 24, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with 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 providers.