How to Make Informed Choices: The Risks of Mixing Cocaine and Alcohol

According to the UN, the global supply of cocaine has reached record levels in 2023. When we couple this alarming fact with the statistic that over half of UK adults consume alcohol at least once a week, it wouldn’t be absurd to speculate that these two substances are being used simultaneously by some portion of that statistic.

In today’s help guide, we delve into the hazardous effects that can arise from combining alcohol and cocaine, impacting both your physical well-being and mental health. Additionally, we offer guidance for those struggling with issues related to cocaine, alcohol, or both.

Why do people mix cocaine and alcohol?

The combination of cocaine and alcohol is often sought after for its perceived enhancement of the effects of both substances. Cocaine can produce intense feelings of euphoria and increased energy. When paired with alcohol, a depressant, users may believe that the combination balances the stimulating effects of cocaine with the relaxing qualities of alcohol.

Here are some other factors that can be taken into consideration:

Social settings

The combination of cocaine and alcohol is often associated with social settings, such as parties and nightlife. Peer pressure, a desire to fit in, or societal norms within certain social circles may contribute to the co-use of these substances.

Misconceptions about safety

Some individuals may be unaware of or underestimate the health risks associated with mixing cocaine and alcohol. They might believe that they can handle the combination without experiencing severe consequences.


Individuals who are addicted to one or both substances may find it difficult to resist combining them. Addiction can lead to compulsive behaviour, even in the face of known risks.

Impaired judgement

Both cocaine and alcohol can impair judgement, leading individuals to make decisions they might not otherwise consider when sober. This impaired judgement can contribute to risky behaviours, such as wanting cocaine when drunk from alcohol or wanting alcohol when high from cocaine.

The dangers of mixing cocaine and alcohol

In this section, we take a closer look at how the short-term and long-term risks of combining cocaine and alcohol can have adverse effects on your health.

Short-term risks of mixing cocaine and alcohol

The short-term risks of combining cocaine and alcohol are considerable. Firstly, both substances individually elevate heart rate and blood pressure. When used together, they place additional strain on the cardiovascular system, increasing the risk of adverse events such as heart palpitations and arrhythmias.

The impairing effects of cocaine on judgement can also be exacerbated when paired with alcohol, leading to an increased likelihood of engaging in risky behaviours.

The simultaneous use of cocaine and alcohol results in the formation of cocaethylene, a metabolite with its own set of toxic effects on the heart and liver.


Other short-term effects include:

  • Compromised cognitive function: The combination can impair cognitive functions, including attention, memory, and reaction time. This can increase the risk of accidents and injuries.
  • Increased anxiety and agitation: Combining stimulants like cocaine with a depressant like alcohol can result in heightened anxiety, restlessness, and agitation.
  • Gastrointestinal issues: Cocaine and alcohol can both irritate the gastrointestinal tract. Combining them may increase the risk of stomach bleeding and other gastrointestinal problems.
  • Sleep disturbances: The combination of a stimulant and a depressant can disrupt normal sleep patterns, leading to difficulty falling or staying asleep.

Long-term risks of mixing cocaine and alcohol

Prolonged use of both cocaine and alcohol amplifies the risks to a person’s health. Chronic cardiovascular issues, including an elevated risk of heart attacks and strokes, may manifest.

The reinforcing nature of these substances increases the susceptibility to alcohol addiction, cocaine addiction and co-occurring addiction, potentially leading to a cycle of dependence that is more challenging to break.

The long-term combination of cocaine and alcohol use can have severe implications for both physical and mental health, necessitating a comprehensive understanding of the potential consequences.

Overdose risk when mixing cocaine and alcohol

The risk of overdose is significantly heightened when cocaine and alcohol are combined. The formation of cocaethylene, a substance more toxic than either cocaine or alcohol alone, increases the likelihood of life-threatening complications.

Overdose symptoms may include seizures, respiratory distress, and cardiac arrest. Understanding the gravity of this risk is crucial for individuals who may be tempted to mix these substances, as the consequences can be severe and potentially fatal.

What is cocaethylene?

Cocaethylene is formed when cocaine and alcohol are combined in the body and pose serious health risks. It increases heart rate and blood pressure more than cocaine alone, being over ten times more harmful to the heart, according to research.

The substance has a longer-lasting effect due to its extended half-life, intensifying the psychoactive impact when cocaine and alcohol are used together.

Surprisingly, despite being known for decades by scientists, cocaethylene has not been extensively studied, and its metabolic pathways still need to be fully understood. However, what researchers do understand is that cocaethylene is exclusively formed within the body through the interaction of cocaine and ethanol, making it the only known substance to do so when combined.

How mixing cocaine and alcohol can affect your mental health

Here are facts regarding mental health and cocaine, alcohol and co-occurring to give you an idea of how detrimental the two substances can be to your health:

  • Cocaine use is linked to a nearly twofold increase in the likelihood of depression.
  • The co-occurrence of anxiety disorders and alcohol use disorders is prevalent and holds clinical significance.
  • Higher doses or increased frequency of cocaine use elevate the risk of adverse psychological or physiological effects, manifesting as heightened irritability, restlessness, panic attacks, paranoia, and even full-blown psychosis characterised by a detachment from reality and auditory hallucinations.
  • Combined alcohol and cocaine use may increase violent thoughts and threats, potentially leading to an escalation of violent behaviours.
  • Both cocaine and cocaethylene elevate levels of dopamine and serotonin in the brain while reducing their reuptake, creating low mood after usage. This explains the commonly experienced ‘comedown’ after using these substances.

A cocaine ‘comedown’ vs an alcohol ‘hangover’

The ‘comedown’ period is when the effects of a drug, like cocaine, wear off and can be known as cocaine withdrawal. Cocaine often produces intense but short-lived euphoria, but when the effects wear off, users enter the ‘comedown’ (withdrawal) phase.

An alcohol hangover, on the other hand, results from the body’s reaction to the toxic byproducts of alcohol metabolism, making recovery challenging after excessive drinking.

Below, we see a deeper look at the effects of both a ‘comedown’ and a ‘hangover’ in a side-by-side comparison table:


Mental health aspects Alcohol ‘hangover’ Cocaine ‘comedown’
Depression/dysphoria Potential feelings of sadness or depression Depletion of dopamine leading to depression and dysphoria
Anxiety/restlessness Heightened anxiety during the hangover Increased anxiety and restlessness
Irritability Potential for increased irritability. Proneness to irritability and mood swings
Fatigue Feelings of fatigue and lethargy Extreme fatigue and tiredness
Difficulty concentrating Impaired cognitive function, difficulty concentrating Impaired cognitive function, difficulty maintaining focus
Cravings May crave relief through more alcohol Strong cravings for more cocaine
Paranoia Not typically associated with hangovers, but can happen Heightened feelings of paranoia
Social withdrawal Some individuals may prefer isolation Social withdrawal due to exhaustion and anxiety


As we can see from the table, both comedowns and hangovers share very similar symptoms. Combining cocaine with alcohol would exacerbate the negative mental health effects of the comedown from the cocaine and the hangover from the alcohol. The presence of both substances can intensify feelings of unease, potentially leading to a more challenging and distressing experience for the user.

What should I do if I have already consumed cocaine and alcohol together?

If someone has already consumed cocaine and alcohol together and experiences adverse effects, seeking medical attention is crucial.

The potential for serious complications and potentially overdose necessitates professional intervention. Staying hydrated by drinking water can help mitigate some of the dehydrating effects of these substances, but it won’t reverse the toxic effects of cocaethylene.

The most important thing is to immediately stop using more cocaine or alcohol to avoid making things worse and give the body a chance to recover.

I’m worried about my cocaine and alcohol intake- what can I do?

If you or a loved one is struggling with cocaine addiction, alcohol addiction, or an addiction to both, taking the crucial step towards seeking help is imperative. At UKAT, we understand the challenges you face and are here to support you on your journey to recovery. By reaching out to us today, you open the door to a compassionate and effective rehab treatment process that includes:

Contact us to learn more about how UKAT can guide you towards overcoming these challenges and reclaiming a healthier, happier life.

Call us now for help