The Cocaethylene Cocktail – the Deadly Mix of Cocaine and Alcohol

In 2018, 637 people died in England and Wales after taking cocaine. That’s twice the number of cocaine deaths than in 2015 and the highest rate since records began. Why is cocaine killing so many people? Purity and availability of cocaine have risen in recent years – but there are also major risks of mixing cocaine and alcohol. Cocaethylene is formed in the liver when cocaine and alcohol are taken together – a highly toxic and psychoactive compound that increases the risks of serious illness, addiction and death.

In this blog, we’ll explain the facts about cocaethylene – what happens in the body when cocaine and alcohol are used together. We’ll also cover the common reasons people tell us they mix cocaine and alcohol.

The Chemistry of Cocaine and Alcohol – Cocaethylene Facts

When cocaine and alcohol enter the bloodstream together, it sets in motion a detoxification process in the body – cocaine and alcohol are removed from the blood into the liver, where these substances are metabolised. When the liver breaks down cocaine in the presence of alcohol (ethanol), cocaethylene is produced.

Cocaethylene is more toxic than cocaine and alcohol alone. Cocaethylene stays in the body up to five times longer than cocaine, as it takes more time to break down. This means cocaethylene can accumulate within the body – particularly with regular heavy use of cocaine and alcohol.

As a consequence, there’s a greater risk of serious ill health and death when using cocaine and alcohol together. Cocaethylene puts the body under prolonged periods of heightened stress. Major risks include cardiovascular damage, seizures, stroke, liver problems, respiratory failure and sudden death. Physically, cocaethylene’s effects include raised heart rate and blood pressure for extended periods of time, as well as disruption to sodium channels that regulate heart contractions. Mentally, cocaethylene has been linked to anxiety, paranoia, aggression, delusions and depression – before, during and after the ‘high’. In regular users of cocaine and alcohol, cocaethylene can build up and damage vital organs over time.

Cocaethylene is also a psychoactive substance – this means it alters neurological processes in the brain and produces mind-altering effects. Cocaethylene affects dopamine and serotonin re-uptake, for example, which heightens sensations of pleasure. For this reason, regular users of cocaine and alcohol are at a greater risk of addiction because of the additional potent effects of cocaethylene on the brain’s reward centre.

Why People Take Cocaine and Alcohol Together

At Addiction Helper, we speak to hundreds of people every day about addiction. Using cocaine and alcohol together is increasingly common. Why do people tell us they mix cocaine and alcohol? And what’s really going on?

  1. Using cocaine to negate side effects of alcohol

cocaine addiction how is it so widely spreadPeople often tell us they only use cocaine during heavy-drinking sessions. They start out drinking alcohol, then when they feel drunk or tired, they say that they take cocaine to feel more alert, charged or in control. Then, they drink more alcohol.

Cocaine and alcohol sessions often go on for many hours, all night or even days at a time – sometimes progressing to daily use. By the time people call Addiction Helper, there are usually mounting consequences in their life from repeatedly using cocaine and alcohol.

There’s a dangerous myth that we sometimes hear on confidential calls to our helpline. Some people believe that taking cocaine ‘sobers them up’. In fact, the opposite is true – using cocaine and alcohol together increases blood concentrations of both substances. More cocaine is absorbed into the bloodstream when you drink alcohol. And you’re more likely to drink alcohol over longer periods when using cocaine. Cocaethylene has its own intoxicating effects too.

So, whilst cocaine may initially mask your awareness of alcohol intoxication – it doesn’t mean your judgment, decision-making and self-control are unaffected. When mixing cocaine and alcohol, you’re at the same or greater risk of accidents, dangerous or impulsive behaviours, overdose and death.

  1. Using alcohol to negate side effects of cocaine

Many callers to Addiction Helper say they can’t stop drinking alcohol when they take cocaine. Feeling like you’re out of control of how much you drink is a trait of alcoholism – but why does cocaine exacerbate this?

One explanation is that cocaine purity is at an all-time high in Britain. Taking even moderate amounts of cocaine can have very sudden and shocking effects. You may feel very high, very quickly. You may become agitated or even paranoid after taking cocaine. If so, alcohol may be the quickest way to take the edge off the high.

People also tell us they use alcohol to manage cocaine comedowns. They say that cocaine withdrawal symptoms are too uncomfortable or distressing without using a depressant like alcohol. However, when cocaine and alcohol are used together, cocaethylene is also building up in your body. This means your withdrawal symptoms will be worse and last longer – because cocaethylene takes more time to break down. This dangerous cocktail can lead to a serious addiction – because you’re always taking one drug to counteract the downsides of another.

  1. Cocaine, alcohol and sex

Some cocaine and alcohol users describe heightened sexual arousal and decreased sexual inhibitions. They have sex under the influence of cocaine and alcohol, which initially makes it appealing to use more.

However, cocaine and alcohol use during sex increases the risk of reckless sexual behaviours, STI transmissions, sexual assault and unwanted pregnancies. In the longer term, cocaine and alcohol abuse are linked to sexual dysfunction and infertility in men and women.

  1. Everyone around me uses cocaine and alcohol

When people call Addiction Helper about cocaine and alcohol addiction, they often tell us that everyone they know uses like they do. They say all their friends take cocaine on nights out, at football, on holiday, sometimes at work too – so it’s hard to imagine a life without their addiction.

pathways to recovery imageThere’s a simple explanation for this. In addiction, most people gravitate towards friends who use in the way they do. It’s part of the way people normalise or justify an addictive habit. This can happen very quickly over a few months – or over many years.

In addiction treatment and recovery, people are often surprised to discover that most people don’t use cocaine and alcohol like they do.

For advice on cocaine and alcohol addiction – including the best treatment options – please contact Addiction Helper.

Who am I contacting?

Calls and contact requests are answered by admissions at

UK Addiction Treatment Group.

We look forward to helping you take your first step.

0800 024 1476calling