What is Cocaethylene: Dangers of Mixing Alcohol and Cocaine?

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Cocaethylene is the combination of two dangerous substances, alcohol and cocaine. Combined, it can stay in the system longer, putting people at risk for seizures, liver damage, and immune system impairment. You are also at an 18-25x increased risk of immediate death instead of using one of these substances alone.

Let’s learn more about cocaethylene, the associated risks, and how you can seek treatment for alcohol and drug use.

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What is Cocaethylene?

Cocaethylene is a substance that is created in the liver after a person has consumed alcohol and cocaine together. It is more potent than the individual substance and stays in the body much longer than if only alcohol or cocaine is used alone. Because of the increased toxicity and slow release from the body, people may be tempted to try this combination. However, there are significant lethal risks involved if mixing alcohol and cocaine.

Cocaine use in the United States:

  • In 2020, 1.9%, or 5.2 million people, reported using cocaine in the past 12 months.
  • .5% or 1.3 million people reported having a cocaine use disorder.
  • 19,447 people died from an overdose involving cocaine in 2020.

Alcohol use in the United States:

  • In 2019, 69.5% of those 18 and up reported using alcohol in the past 12 months.
  • Nearly 15 million people reported having an alcohol use disorder.
  • 95,000 deaths were attributed to alcohol use.

What are the Risks of Cocaethylene Buildup?

Because cocaine and alcohol are common substances, the potential risks associated with the combination are unknown to most people. Additionally, cocaethylene has a longer half-life than cocaine, which means it stays in the body much longer when alcohol is combined. When a substance stays in the body longer, the combination produces increased toxicity, often leading to a sudden overdose. To understand the risks associated with toxicity, we must look more closely at the role of the liver.

The liver regulates most chemical levels in the blood and excretes bile waste. All the blood leaving the stomach and intestines passes through the liver. The liver processes this blood, breaks down substances, balances and creates the nutrients, and metabolizes drugs into more accessible forms for the rest of the body.

When the liver has to process drugs such as alcohol and cocaine, it can put more strain on the liver to remove the toxins. So as you can imagine, combining two harmful substances increases the amount of stress on the liver when processing additional chemicals. Having other toxins in the body can lead to increased toxicity. Increased toxicity means alcohol enters your bloodstream faster, making you impaired more quickly.

Research indicates that it takes about 2 hours for cocaethylene to produce in the liver after alcohol and cocaine are consumed. Additionally, cocaine alone can last in the system for up to 2 weeks if a person uses it regularly. That means if alcohol is consumed within a week of cocaine use, a person is at increased risk of developing cocaethylene and may experience lethal side effects.

Why Do People Mix Alcohol & Coke?

Cocaine is a potent drug that can easily lead to addiction due to the intense euphoria and the fast dopamine rush a person may experience when using this drug alone. Additionally, a person may feel sudden anxiety and uncomfortable withdrawal when cocaine has left the body. So this increased desire to feel better drives a person to feel psychologically dependent on cocaine use. When a person combines alcohol and cocaine, these powerful feelings are more substantial and last longer in the system than with one substance alone. Therefore, the desire to feel the intense emotions and mitigate the withdrawal effects entices people to combine alcohol and cocaine.

Side Effects of Cocaethylene

Unfortunately, the side effects of cocaethylene are fast-acting and deadly. A person has an 18-25x greater risk of immediate death when cocaethylene is produced. Notably, a person has a greater chance of overdose due to toxicity and cardiotoxicity, which may lead to cardiac arrest.

Cocaethylene increases blood pressure and heart rate more than cocaine alone. In fact, Cocaethylene is thought to be 10x more toxic to the heart than cocaine alone.

Side Effects of Cocaethylene: 

  • Increased toxicity.
  • Increased risk of overdose.
  • Increased risk of stroke.
  • Increased impulsivity-violence, accident, assault.
  • Increased heart-related problems.
  • Increased liver damage.
  • Sudden death.

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Overdose Risks

Because this toxic combination can last in the system longer than individual substances, the chances of unintentional overdose are high. Most people are unaware of cocaethylene and do not know that overdose and sudden death can occur when combining alcohol and cocaine. According to this research article, cocaine use resulted in 500,000 emergency room visits annually. Of 199 patients brought in for cocaine use, 49 patients developed cocaethylene. With the patients who developed cocaethylene, cardiac arrest was significantly notable. Additionally, this article indicates that alcohol increases the body’s desire to use more cocaine when both substances are mixed. This combination of substances staying in the body, increasing potency, and the desire to use more cocaine increases the risk of overdose and the likelihood of emergency medical attention.

Common Symptoms of an Overdose

Symptoms of a drug overdose may change with each substance. Here are the common symptoms associated with cocaine overdose.

Common Symptoms of Cocaine Overdose: 

  • Fast or difficulty breathing.
  • Rapid, rambling speech.
  • Anxiety, agitation.
  • Confusion, restlessness.
  • Lack of awareness.
  • Muscle tremors in hands and face.
  • Dilated pupils.
  • Fast, irregular heartbeat.
  • Increased blood pressure.
  • Nausea, vomiting.
  • Lightheadedness.
  • Pale or blue-tinted skin.
  • Fever.
  • Excessive sweating.
  • Bladder incontinence.
  • Hallucinations.
  • Seizures.

How Long Does Cocaethylene Stay In Your System?

As mentioned, cocaethylene stays in the system longer than when alcohol or cocaine is used individually. In general, cocaethylene stays in the system for 14.6 to 54.4 hours. This can range from person to person based on how much alcohol and cocaine is consumed, frequency of use, and type of testing completed. Here are the following estimated periods for cocaethylene in the body.

Testing Hair for Cocaethylene

Traces of cocaethylene can be found in hair when drug-tested for up to 90 days.

Testing Urine for Cocaethylene

Traces of cocaethylene can be found in urine for up to 2-3 days. Only a little data corroborates the specific number of days cocaethylene can be found in urine.

Testing Blood for Cocaethylene

Cocaethylene can be found in the blood for up to 10 hours after the last use of cocaine.

Testing Saliva for Cocaethylene

It is still being determined how long cocaethylene can be found in saliva.

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Please contact us today if you are concerned about your health due to alcohol or substance use dependence. You don’t have to wait for your health to decline to prioritize your wellness. Focusing on recovery can improve health, repair relationships, and change your life.

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It can be frightening to reach out for help, and our goal is to ensure our streamlined process is stress-free from beginning to end. Contact us today to begin your new life in recovery.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://pubmed.ncbi.nlm.nih.gov/9243342/
  2. https://nida.nih.gov/publications/research-reports/cocaine/what-scope-cocaine-use-in-united-states
  3. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8956485/
  5. https://pubmed.ncbi.nlm.nih.gov/12133112/
  6. https://pubmed.ncbi.nlm.nih.gov/36000306/
  7. https://pubmed.ncbi.nlm.nih.gov/19631491/
  8. https://medlineplus.gov/ency/article/000946.htm
  9. https://www.gimitec.com/file/5989-7212EN.pdf
  10. https://www.scielo.br/j/bjps/a/y5rFVf96yzRSFr9XYM6Q6sL/?format=pdf&lang=en

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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