Using Cocaine with Alcohol

It is common knowledge that using cocaine with alcohol can cause significant health problems. Regular use of alcohol builds up and causes damage to the liver and kidneys while even an one-time, experimental use of cocaine can result in an overdose, heart attack or seizures. Unfortunately, when cocaine and alcohol are combined, the resulting damage is much worse than the effects of either drug alone.

Cocaethylene is a chemical that is created by the combination of the two chemicals cocaine and alcohol. Cocaethylene is a psychoactive ethyl homologue of cocaine, and is formed exclusively when using cocaine with alcohol. Not a natural alkaloid of the coca leaf, cocaethylene can be identified in the urine, blood, hair, and neurological and liver tissue samples of individuals who have consumed both cocaine and alcohol. With a pharmacologic profile similar to cocaine, it can block the dopamine transporter on dopaminergic presynaptic nerve terminals in the brain. It increases dopamine synaptic content, provoking enhanced postsynaptic receptor stimulation, resulting in euphoria, reinforcement, and self-administration.

Over time, with continued use of both drugs simultaneously, this chemical builds up in the liver and remains, causing extensive damage to multiple body systems. This is the only known case in which two drugs combine in the body to form a third drug, and few people know about it, let alone realize the devastating effects. Unfortunately, many who experience health problems due to cocaethylene build up don’t do so until long after their days of using cocaine with alcohol are over. Many never considered themselves addicts during their use and still don’t. In fact, many of the people who are having problems with the chemical buildup in their body now describe their cocaine abuse as merely a tool to help them drink more.

Not only does cocaethylene have an adverse and toxic effect on the liver, it may also be the reason why some under the age of 40 experience heart attacks. The full effects of the drug are not known due to the fact that so little is known about the drug at all. Studies are being undertaken to better determine the nature of the chemical and its effects upon users of alcohol and cocaine, including how much is too much and how long is too long.

The current statistics on alcohol addiction and cocaine use are staggering. Cocaine use is on the rise and is indicated in an increasing number of emergency room visits: one person in the United States is admitted to the emergency room for issues related to cocaine overdose about once every 10 hours. The US National Household Drug Survey reports that alcohol and cocaine are used by about five million people every month.

Few today recognize this third drug and its effects as a risk. Most view their use as minimal or experimental; if they aren’t using every day, then they don’t think that the health concerns are relevant to them. For those who are using cocaine with alcohol on occasion view it as a lifestyle choice, not as an addiction or the medical problem that it is and can potentially become.

Unfortunately, denial doesn’t make it true. The fact of the matter is that even irregularly using cocaine with alcohol creates the drug, which then builds up over time in the liver and can cause heart problems years down the road.

A recent study has shown scientists that using cocaine with alcohol leads to more impulsive decision-making and to poorer performance on tests of learning and memory than does use of either cocaine or alcohol alone. The negative effects on the ability to think clearly persist for at least a month after the substance use stops.

"This study reveals important basic information about the way these substances interact," says NIDA Director Dr. Alan I. Leshner. "It also has significant implications for drug abuse treatment, which involves learning and remembering concepts that help recovering drug abusers to change behaviors and avoid situations where they might use drugs."

Dr. Jean Lud Cadet, of NIDA's Intramural Research Program in Baltimore, and Dr. Karen Bolla, of Johns Hopkins Medical Institutions in Baltimore, studied the interactive effects of cocaine and alcohol in 56 adult cocaine abusers. Roughly half the study participants also consumed at least 10 alcoholic drinks per week. All participants abstained from both cocaine and alcohol during the four-week study.

During the first three days of the study the participants were given a battery of tests to measure general intelligence, verbal memory and learning, and attention, planning, and mental flexibility. The tests were repeated during the fourth week of the study.

"The results of this study support the view that cocaine abuse can have a major negative impact on the brain and these effects are compounded by the concurrent use of alcohol," explained Dr. Cadet.

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