Cocaine and Alcohol: Risks and Effects of Mixing Them

The term polysubstance abuse can apply to the mixing of any number of substance combinations and is always dangerous. One of the most toxic blends is that of cocaine and alcohol.


While the mixing of cocaine & alcohol has decreased overall in recent years, the practice is still prevalent – and still deadly.


Effects of Cocaine

Cocaine is an illicit drug that people often seek for its powerful stimulating effects. People typically smoke, inject, or inhale it. Cocaine is often snorted in a powdered form, or smoked by using “crack rock” or “freebase” cocaine. Whether mixed with alcohol or not, cocaine use can seriously damage the body. It also comes with a high risk of death by overdose.


Long-term cocaine abuse can permanently increase blood pressure, leading to kidney failure.


Long-term cocaine abuse can permanently increase blood prssure, leading to kidney failure.


Cocaine’s influence comes on fast and is gone within a few minutes to a few hours. The length & intensity of the effects on a person depend on many factors. These include the form and amount used and how it’s taken. Typical effects include a person getting a “mood boost” from the dopamine & becoming:

  • more talkative
  • more mentally alert
  • highly reactive to lights, touch, and sounds


While cocaine is used for the purpose of a euphoric high, the following side effects also often accompany a “hit” or use:

  • anxiety, paranoia, or panic attacks
  • sudden aggressive or violent mood changes
  • irritability, restlessness, shakes
  • raised heart rate
  • heart palpitations and high blood pressure
  • increase in risk-taking
  • decreased appetite
  • insomnia
  • strong cravings as the drug wears off


Effects of Alcohol

Alcohol & cocaine have many side effects that overlap, such as:

  • Reduced inhibitions
  • Impaired judgment
  • Memory loss, even blackouts
  • Confusion, anxiety, and restlessness
  • Depression


As a depressant, however, alcohol’s effects on the body are more sedative in nature. They include:

  • Reduced blood pressure
  • Increased sweating
  • Nausea or vomiting
  • Dehydration
  • Slow breathing rate
  • Increased fatigue or sleepiness
  • Slowed heart rate
  • Blurred vision
  • Slowed reaction time and reflexes
  • Loss of motor coordination
  • Slow speech


Side effects of both alcohol and cocaine: Reduced inhibitions; impaired judgement; memory loss, even blackouts; confusion, anxiety, and restlessnes; depression.


Alcohol and cocaine are some of the most widely-abused substances in the world.


Each substance on its own has short and long-term effects that can result in injury or death. The combination increases the side effects – both desirable and painful – of both drugs. Consuming them together can also lead to co-occurring addiction. Their habit-forming properties can reinforce the addictiveness of the the other substance.


When Cocaine & Alcohol are Mixed Together

One of the most serious problems with mixing alcohol and cocaine is the production of  cocaethylene. The terrible irony is that the process for the body to rid itself of cocaine produces a substance even more toxic than the one it is purging.


Someone may attempt to "offset" the uncumfortable side effects of cocaine by drinking alcohol.


When the liver attempts to metabolize the cocaine, any alcohol in the body prevents this process. As a result, it releases built-up cocaethylene into the bloodstream. The buildup puts stress on multiple organs. This is particularly true for the cardiovascular system and the liver itself.


Why People Take Both

Since cocaine can produce uncomfortable side effects such as anxiety or twitching, someone may attempt to “offset” these hyper-active responses by drinking alcohol. The idea is that the depressive properties of alcohol will counteract the ill-effects of cocaine.


This is not always the case.


Much of the time, mixing cocaine and alcohol happens in social situations. People at a party setting will snort or smoke cocaine in order to get an energetic high. They then go on to consume alcohol simply because it is available in the same setting.


Alcohols’ effects on GABA receptors increases the release of some neurotransmitters.  This process can enhance the  many drugs’ euphoric effects.


On the flip side, a person in the same setting who has had too much alcohol & is experiencing its sedative effects may take cocaine to increase their physical energy.


Side Effects & Risks of Mixing Cocaine & Alcohol

Cocaethylene temporarily enhances the high associated with both cocaine and alcohol, but this euphoria has dangerous effects as well. Increased blood pressure, violent thoughts & even sudden death have all been linked to raised cocaethylene levels.


Cocaethylene production consequences include:

  • Myocardial infarction, or heart attack with heart pain
  • Cerebral infarction, or death of blood vessels and brain tissue, leading to brain damage, stroke, or aneurysm
  • Intracranial hemorrhage
  • Cardiomyopathy, or heart disease
  • Cardiac arrhythmia, which can contribute to a later heart attack


Both alcohol and cocaine reduce cognitive function, decrease decision-making ability, & increase impulsivity. Since memory problems usually accompany alcohol abuse, a person may not be able to recall risky behaviors they engaged in the night before.


This loss of inhibitions can lead to risky sexual encounters or needle-sharing – an activity closely tied to high infection rates. HIV, herpes, hepatitis, and bacterial infections are among the most common types transmitted this way.


It is important to seek help to prevent actions that may lead to permanent loss of quality of life.

A Brown University study of 1,000 people admitted to the emergency room for substance abuse recently found that those who mixed cocaine and alcohol were the most likely to attempt suicide within one year after treatment. Due to the ability of alcohol & cocaine to alter a person’s normal decision-making processes, it is important to seek help to prevent actions that may lead to permanent loss of quality of life.



If you or someone you know suffers from any type of substance abuse, seek professional guidance. A well-suited recovery program will address multiple layers of addition for long-term freedom.


For more information on Northern Arizona Center for Addiction and our personalized approach to recovery, explore our programs or give us a call.


To learn more about substance abuse and the science of addiction, view our resource pages.

Zara G

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