Skip to content

Using Alcohol And Cocaine Together

With over 55% of Americans age 12 or older being current alcohol drinkers, and 1.4 million Americans being current cocaine users, these substances are two of the most commonly abused substances in the United States. The numbers are similar in European countries. Using alcohol and cocaine at the same time is a common practice for those who abuse these drugs. One study demonstrated that the prevalence of concurrent alcohol and cocaine use was at 77%. Another study showed that among people who are cocaine dependent, a diagnosis of an alcohol use disorder may also be made in up to 90% of those people.

The reduced inhibitions that alcohol causes may influence some to use cocaine when they would otherwise not normally do so. Some believe that using cocaine will sober them up, and although the stimulant effects of cocaine cause increased alertness, this does nothing to reduce the blood alcohol concentration (BAC) in the body. Another myth is that using alcohol and cocaine together will eliminate withdrawal symptoms. These two substances can be very dangerous to use on their own but using them at the same time greatly increases the risk of heart attack, stroke, seizures, and a variety of other physical and psychological adverse effects.


Alcohol is used by people of all backgrounds across the world and can be a common and relatively harmless practice in moderation. However, excessive alcohol use including heavy drinking and binge drinking can have serious and deadly effects on the mind and body. There are 14.4 million American adults age 18 or older who have an alcohol use disorder (AUD). According to the National Institute on Alcohol Abuse and Alcoholism, an AUD is, “a chronic relapsing brain disorder characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.” Only an estimated 7.9% of adults with an AUD received treatment in the past year, a concerning number for those struggling with this powerful addiction.

Alcohol effects the organs like the brain, heart, liver, and pancreas. Damage to the heart can occur such as the development of an irregular heartbeat, cardiomyopathy, and high blood pressure. Alcoholic hepatitis, fatty liver, fibrosis, and cirrhosis can occur in the liver, and pancreatitis can develop over time in the pancreas. Long term heavy alcohol use can result in memory and learning problems, such as dementia and poor academic performance. Social problems, unemployment, depression, and anxiety may also occur.


Cocaine is a stimulant drug that is commonly inhaled through the nose, but can also be smoked, injected, and taken orally. When snorted, the user will feel effects within seconds to minutes and the effects last from about 15 to 30 minutes. Common effects include euphoria, energy, talkativeness, hypersensitivity, alertness, anxiety, restlessness, paranoia, dilated pupils, and increased heart rate and body temperature. Medical complications from cocaine use can occur with both short- and long-term use. In some rare cases, sudden death can occur with a person’s first use of cocaine. Frequent adverse effects include headaches, seizures, heart rhythm irregularities, and heart attacks.

Long term use of cocaine impacts the body and mind. When someone repeatedly snorts cocaine, this irritates the nasal septum resulting in an inflamed, runny nose. Loss of smell, swallowing problems, and nosebleeds may also occur. Cocaine use reduces blood flow in the gastrointestinal tract, leading to tears and ulcerations. Loss of appetite and extreme weight loss often occur in individuals who abuse cocaine. Over time, cocaine users can develop a tolerance to the drug, meaning that they will need to use more of it to produce the same effects. The brain changes with repeated use, and users will start to experience withdrawal symptoms and be unhappy unless they are continuing to use the drug. Adding alcohol to the mix only makes things worse, and can be even more dangerous as combining alcohol and cocaine leads to the production of a dangerous metabolite in the body.

What Is Cocathylene?

When someone uses alcohol and cocaine at the same time, the presence of ethanol and cocaine causes liver enzymes to produce cocathylene. Like cocaine, cocathylene blocks the reuptake of dopamine at receptor sites, furthering the stimulant effects of cocaine. This substance takes longer to leave the body than cocaine and is found in the blood longer than cocaine, making it more dangerous. Some studies have found that cocathylene, “carries an 18- to 25-fold increase over cocaine alone in risk for immediate death.” Cocathylene is more toxic to the heart and liver, increasing the risk for stroke, heart attack, and arrhythmia.

The increased euphoria that occurs from using alcohol and cocaine at the same time, compared to using the substances separately, makes it more likely that someone will use more of both substances over a longer period of time. The combination is also reported to increase the tendency towards violent thoughts and threats, leading to violent actions. Binge drinking and using large amounts of cocaine only furthers the chance of adverse effects occurring.

Alcohol and Cocaine Treatment

Using alcohol and cocaine separately is dangerous but using them at the same time is even more risky. Both substances are extremely addictive, meaning that treatment is oftentimes necessary to overcome the hold they have on those who use them. Fortunately, there are treatment options for both alcohol and cocaine. Patients can choose from inpatient and outpatient rehabilitation facilities that offer supervised detox, treatment medications, counseling and behavioral therapies, and an aftercare plan to help them maintain sobriety. After treatment, patients can join groups like Alcoholics Anonymous and Cocaine Anonymous to find a sense of community and understanding. To get started on discovering available treatment options, contact a treatment provider today.