Health Effects & Dangers of Mixing Alcohol and Cocaine

Polysubstance use occurs when a person uses multiple substances at the same time or in close succession—such as alcohol and cocaine.¹ Some people combine these substances for recreational purposes without realizing the dangers, such as an increased risk of overdose and the formation of a toxic substance known as cocaethylene.²

Combining Alcohol and Cocaine

Alcohol is a depressant and cocaine is a highly addictive stimulant.^1,3 People combine alcohol and cocaine for various reasons, including to:^1,2

• Enhance or prolong the effects of a single substance.
• Counteract the effects of a substance with another (i.e., some people use alcohol to ease the sometimes abrupt “bumps” associated with cocaine use).
• Experience a new effect.
• Alleviate or prevent withdrawal symptoms.
• Escape from the stressors associated with daily life, health issues, or trauma.

Mixing alcohol and cocaine is relatively common. One study found the estimated prevalence of simultaneous and concurrent alcohol use among cocaine users was 74% and 77%, respectively.⁴ Another study found that people dependent on cocaine are 89% more likely to use alcohol than those who are not.⁵ This may be because combining the two enhances feelings of pleasure and reward more than using either alone.⁵

Dangers of Mixing Alcohol and Cocaine

What happens if you take alcohol and cocaine? While alcohol and cocaine each pose health risks on their own, mixing them is particularly dangerous.^1,3 Alone, cocaine can increase blood pressure and heart rate, leading to potentially life-threatening cardiovascular effects.² When alcohol is mixed with cocaine, the additive and cumulative effects are stronger, increasing a person’s risk of experiencing these effects, including heart attack and stroke.⁶

Alcohol and cocaine mixed can also lead to the formation of a toxic substance in the liver called cocaethylene.⁶ Cocaethylene stays in the body longer than cocaine alone, making the effects more intense, but also more dangerous than either substance by itself.⁶

Research suggests that cocaethylene is over 10 times more toxic to the heart than cocaine alone.² It prolongs cocaine-related increases in blood pressure, which can increase the risk of brain injury from reduced blood flow to the brain or brain bleeds.^5,6 Its longer half-life can also increase a person’s risk of overdose.²

Other potential health effects of alcohol and cocaine include:^5-8

• An increased risk of sudden death.
• Hyperthermia (i.e., a condition that causes an imbalance between heat production and loss).
• An increased risk of liver fibrosis.
• Decreased cognitive functioning in areas such as intelligence, memory, and verbal learning.
• More severe psychological problems (i.e., homicidal and suicidal behavior).

Alcohol and Cocaine Addiction

Ongoing use of alcohol or cocaine can lead to the development of a substance use disorder (SUD), a chronic but treatable medical condition characterized by uncontrollable substance use despite the negative consequences.¹ Having an SUD can result in numerous physical and psychological consequences, which can be worse when a person has a concurrent SUD—sometimes referred to as a polysubstance use disorder.¹

Polysubstance use disorder occurs when a person chronically uses more than one substance, leading to uncontrollable use of both substances.¹ According to the Substance Abuse and Mental Health Services Administration (SAMHSA), among people with a cocaine addiction, known as stimulant use disorder, almost 60% also have an alcohol use disorder (AUD).¹

Some research shows that the combined effects of alcohol and cocaine are more rewarding and reinforcing than either substance alone.^4,5 This can cause people to want to continue using both substances together, increasing the risk of dependence and the development of an SUD.^5,9

Alcohol and Cocaine Addiction

Treatment If you or a loved one is struggling with polysubstance use, treatment is available. Because polysubstance use often comes with complex medical, psychological, and social challenges, individualized treatment that addresses both alcohol and cocaine use can result in better outcomes.¹

Treatment may begin with a period of medical detox, which can help keep you as comfortable and safe as possible during withdrawal.¹⁰ This is an important step in recovery as alcohol withdrawal can be life-threatening and lead to severe symptoms like delirium tremens (DTs) or seizures.¹⁰ Although cocaine withdrawal is not typically life-threatening, it may cause severe dysphoria that may lead to suicidal behavior.¹⁰ Medical detox provides monitoring and support while addressing complications that may arise.¹⁰

Following medical detox, you may transition to ongoing treatment, which will vary based on your unique needs. Treatment options include:¹¹

• Inpatient drug and alcohol rehab, where you live at a treatment facility and receive intensive, structured care, lasting anywhere from a month to a year, depending on the program.
• Outpatient addiction treatment programs, where you live at home but attend treatment during the day on a predetermined schedule.
• Intensive outpatient addiction treatment programs, which are more supportive forms of outpatient programs that offer 9-20 hours of weekly treatment.
• Partial hospitalization rehab programs, which are highly supportive outpatient programs offering 4-8 hours of daily treatment.
• Rehab aftercare, which involves different forms of ongoing support, such as attending 12-step meetings or living in a type of sober housing, which can help you maintain recovery and prevent relapse.

Your treatment plan will vary depending on your needs but may include a combination of behavioral therapies—such as cognitive behavioral therapy (CBT) and contingency management (CM)—as well as FDA-approved medications, and support groups.^3,12

There are no FDA-approved medications for cocaine addiction, but you may receive medication for alcohol use disorder (AUD), such as:¹²

• Naltrexone, which helps reduce cravings for alcohol.
• Acamprosate, which helps people maintain abstinence.
• Disulfiram, which causes unpleasant symptoms when a person drinks alcohol, thereby discouraging alcohol use.

Getting Help for Alcohol and Cocaine Addiction

If you or a loved one is ready to seek rehab for a substance use disorder, explore your options and reach out to a rehab center using our rehab directory tool today!