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Published: 15 November 2011

Cocaine and alcohol

Cocaine users commonly also use alcohol. Population surveys show that cocaine use and alcohol use — in particular heavy episodic drinking — are often associated. And two studies found that more than half of cocaine- dependent users in treatment were also alcohol dependent.

The popularity of this combination may be explained by context; both substances are strongly associated with nightlife and party scenes, but also by pharmacological factors. The ‘high’ achieved by combining these substances is perceived to be beyond that with either drug alone. In addition, cocaine can make the effects of alcohol inebriation less intense and may also counteract some of the behavioural and psychomotor deficits induced by alcohol. Alcohol is also used to temper the discomfort felt when coming down from a cocaine ‘high’. In this respect, the combination can lead to increased use of both substances.

There are documented risks and toxic effects associated with simultaneous use of alcohol and cocaine including increasing the heart rate, raising systolic blood pressure, which may result in cardiovascular complications, and impairment of cognitive and motor functions. However, retrospective studies show combined use does not appear to cause more cardiovascular problems than expected from the additive use of each drug (Pennings et al., 2002). In addition, combined use results in the formation of a new substance, cocaethylene, a metabolite formed in the liver. There is ongoing debate as to whether cocaethylene is responsible for increased heart rate and cardiotoxicity.

For more information see EMCDDA (2007).

EMCDDA (2007), Cocaine and crack cocaine: a growing public health issue, Selected issue, Publications Office of the European Union, Luxembourg.

Pennings, E.J., Leccese, A.P. and Wolff, F.A. (2002), 'Effects of concurrent use of alcohol and cocaine', Addiction 97(7), pp. 773-783.

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

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Page last updated: Friday, 28 October 2011