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Cocaine and Alcohol | What Are the Dangers of Mixing?

Since 2009, the usage of cocaine has remained relatively stable, according to the National Survey on Drug Use and Health (NSDUH). However, in 2014, there were an estimated 1.5 million (past-month) cocaine users over the age of 12, translating to 0.6 percent of the population. Adults between the ages of 18 and 25 have a higher rate of cocaine use than other age groups, with 1.4 percent of young adults using the drug in the previous month. 

According to a recent survey by the National Survey on Drug Use and Health, an estimated 85.6 percent of people over the age of 18 reported alcohol use at some point in their lives, while 69.5 percent said they drank in the past year. Another 54.9 percent admitted to drinking in the past month. 

In 2019, nearly 25.8 percent of individuals 18 or older admitted to engaging in binge drinking in the past month, and another 6.3 percent engaged in heavy alcohol use in the past month. Despite being legal, alcohol is a dangerous drug, and when you combine cocaine and alcohol, you might wonder what the dangers are of mixing. 

The Effects of Alcohol and Cocaine

Cocaine, both in freebase and powdered form, will cause stimulant effects and side effects, including:

  • Decreased appetite
  • Mental alertness and high energy
  • An intense and energetic high
  • Constricting blood vessels, which may lead to heart palpitations or high blood pressure
  • An increase in body temperature
  • Paranoia and anxiety
  • Increased risk-taking
  • Dilated pupils
  • Insomnia
  • Irritability, aggression, and restlessness
  • Intense drug cravings as cocaine wears off

Since alcohol is considered a depressant, it provides effects that are the complete opposite of stimulants like cocaine. The side effects of alcohol include:

  • Slowed speech
  • Loss of motor coordination
  • Slowed reflexes and reaction times
  • Blurred vision
  • Lowered inhibitions
  • Memory loss, and in some cases, blackouts
  • Impaired judgment
  • Depression
  • Anxiety, confusion, or restlessness
  • Slowed heart rate
  • Significantly reduced blood pressure
  • Increased sweating
  • Slowed heart rate
  • Increased sleepiness or fatigue
  • Dehydration
  • Nausea or vomiting
  • Upset stomach

Those who struggle with cocaine addiction often use alcohol in conjunction with the stimulant to combat the adverse side effects of cocaine, such as twitching or anxiety, by including a depressant. Oftentimes, mixing alcohol and cocaine occurs due to social situations. In other cases, a person who consumes too much alcohol may use cocaine to increase their physical energy. Although the reasons may vary for using these two drugs together, it can be hazardous to your health. 

When Alcohol and Cocaine Are Mixed Together

Mixing two recreational drugs is an unsafe practice, and it shows a problem with polydrug use. Unfortunately, mixing alcohol and cocaine is the most common form of polydrug abuse. The reason for this is because one reduces the adverse symptoms of the other. Alcohol enhances euphoric effects from various substances because it indirectly impacts GABA receptors, which increases the release of specific neurotransmitters. 

According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), an estimated 50 percent of cocaine-dependent individuals also admitted to alcohol dependency, which highlights the close link between the two addictive drugs. 

The EMCDDA also reported that both substances were linked to partying and nightlife, meaning they’re commonly used in social situations. However, those who continue using these drugs together, even outside of social scenarios, admit it’s because the high is more intense. This will lead to dependence, abuse, addiction, and other health consequences. 

Unfortunately, those who suffer from severe mental health conditions will self-medicate with alcohol or drugs before receiving an appropriate diagnosis. Those struggling with schizophrenia or bipolar disorder are more susceptible to substance use and polydrug patterns. Individuals with bipolar disorder are at higher risk of alcohol use disorder as a co-occurring disorder to put the mania associated with the condition at ease. 

Individuals with bipolar disorder are also more likely to develop cocaine addiction to reduce the effects of depressive episodes. Those with undiagnosed bipolar disorder might abuse both alcohol and cocaine to regulate their mood disorders. Unfortunately, alcohol and drug addiction are more likely to cause mood disorders like anxiety, depression, and bipolar disorder to worsen.

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Risks of Mixing Alcohol and Cocaine

On their own, both alcohol and cocaine abuse will cause severe damage to the body, including overdosing, to long-term or chronic health problems. When used together, these health dangers increase exponentially. 

One of the worst problems stemming from alcohol and cocaine abuse is when the two are metabolized through the liver. Our organ produces a chemical called cocaethylene, causing a build-up in the body and placing severe stress on major organs, particularly the liver and cardiovascular system. 

Cocaethylene is responsible for temporarily enhancing cocaine and alcohol effects, but the euphoria increases blood pressure, violent or aggressive thoughts, and poor judgment. It will also build up to toxic levels in the liver, and increased cocaethylene is linked to sudden death. 

Consequences of your body producing cocaethylene include:

  • Intracranial hemorrhage
  • Myocardial infarction
  • Heart attack with severe heart pain
  • Cerebral infarction
  • Death of blood vessels and brain tissue, which may lead to stroke, brain damage, or aneurysm
  • Cardiomyopathy
  • Heart disease
  • Cardiac arrhythmia, which may contribute to a heart attack later on

Other Short-Terms Issues from Mixing Alcohol and Cocaine

Both cocaine and alcohol increase risky and impulsive behaviors, which may decrease your ability to make judgments and reduce your cognitive functioning. Alcohol increases the likelihood of memory loss, so the individual may also not remember risky behaviors from the night before. 

Other side effects from using both alcohol and cocaine together include:

  • Heart palpitations
  • Breathing issues
  • Increased blood pressure
  • Cognitive impairment
  • Increased heart rate
  • Loss of coordination and motor function

Loss of inhibitions may cause risky sexual encounters or other dangerous behaviors. It can lead to lifelong infections such as herpes, HIV, hepatitis, and other bacterial infections. 

Cocaine and alcohol on a wooden table

Long-Term Effects of Cocaine and Alcohol Abuse

A study released by Brown University found that using cocaine in conjunction with alcohol increased the risk of suicide. Nearly 1,000 people admitted to the emergency room for substance abuse who mixed the two drugs were the most likely to attempt suicide within a year after emergency treatment. 

From the study of 874 people, 195 attempted suicide at least once, 298 of them struggled with alcohol abuse, 74 struggled with cocaine abuse, and 41 admitted to abusing both drugs. Those who used both were 2.4 times more likely to attempt suicide in comparison to the others in the study.


ScienceDaily (April 2016) Simultaneous Cocaine, Alcohol Use Linked to Suicide Risk. Retrieved from

NIDA (January 2021) What Is the Scope of Cocaine Use in The United States? Retrieved from

National Library of Medicine. (January 2021) Cocaethylene. Retrieved from

EMCDDA (September 2020) European Drug Report 2020. Retrieved from

CDC (January 2021) Alcohol and Public Health. Retrieved from

NIDA (January 2021) What Is Cocaine? Retrieved from

NIAAA (January 2021) Alcohol Use in the United States. Retrieved from

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