Cocaine and alcohol is one of the most common combinations on a night out or social gatherings in Ireland. It’s not uncommon for someone to bring out a bag, and another drink to be ordered not long after.
But when cocaine and alcohol are mixed, the liver produces a third substance called cocaethylene. It’s more toxic than either substance on its own, and it stays in the body for much longer.
Most people have never heard of cocaethylene, but it is still something that many can end up critically ill over.
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What happens in your body when you mix cocaine and alcohol?
Cocaine speeds your body up – It raises your heart rate, sharpens focus, floods your brain with dopamine, and gives you a rush of confidence.
Alcohol does the opposite; it slows your reactions, relaxes your muscles, dulls your thinking, and lowers your inhibitions. So, when used at the same time, the body has to process two drugs that are pulling it in opposite directions.
Your liver normally breaks cocaine down into inactive byproducts that your body can remove. But when alcohol is present at the same time, that process changes. Instead of breaking cocaine down safely, your liver produces a new substance called cocaethylene.
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What is cocaethylene?
Cocaethylene is a toxic compound that is only created when the liver tries to process cocaine and alcohol together.
Like cocaine, cocaethylene is psychoactive. It can make you feel more alert, impulsive, anxious, and paranoid. But cocaethylene is more toxic than cocaine, and it lasts far longer; taking three to five times longer to leave your system. It can stay in your body for days, or even weeks.
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Why is cocaethylene more dangerous than cocaine or alcohol alone?
Cocaethylene makes your heart and liver work harder than they should, and it’s been linked to seizures and damage to the immune system.
Dr Eamon Keenan, clinical director of HSE Addiction Services, has said that mixing cocaine and alcohol “creates cardiac abnormalities”.
Research published in the journal Drug and Alcohol Dependence found that it carries an 18 to 25-fold increase in the risk of immediate death compared to cocaine alone.
Cocaethylene also masks how drunk you feel. You might not realise how much you’ve taken, so you could take more of both. That’s when the risk of a cocaine and alcohol overdose goes up. Cocaine and alcohol overdose symptoms include your heart stopping, your breathing slowing dangerously, or loss of consciousness.
On top of that, alcohol increases cravings for cocaine, so more cocaine leads to more drinking, which produces more cocaethylene.
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Why do people mix cocaine and alcohol?
For a lot of people, it starts after a few drinks. Someone suggests getting a bag in, you might feel socially pressured to join in. Suddenly, cocaine becomes part of the evening without much thought behind it.
The chemical effects then reinforce the habit. Cocaine masks the depressant effects of alcohol, so you feel less drunk than you are and drink more than you normally would. Some people use alcohol to try to extend the high or to help with the comedown that night or the next morning.
Either way, it’s psychological; one substance makes you want more of the other.
Anthony Deegan, former patient and Recovery Advocate at Smar
“Everyone’s the same throughout it. The staff were absolutely lovely, you know, they were very kind, caring, and understanding. And I don’t think there’s anywhere in Ireland that has the same facilities as a Smarmore Castle. Not that it’s all about the facilities, but the programme that’s on over here, you know, it can be tailor-made, which is why we do the biopsychosocials and the assessments to where some therapies can be tailor-made, which I found very, very beneficial, which is what attracted me to when I first started looking around.”
How do you know if cocaine and alcohol use has become a problem?
Using coke and alcohol together can often start occasionally. But for some people, this becomes regular use and develops into an addiction. It’s not always obvious when that’s happening, but there are some questions to ask yourself.
- Are your weekends taking longer to recover from?
- Are you drinking more than you planned to when cocaine is involved?
- Are you finding it difficult to have one without the other?
- Are you spending more than you can afford or remember?
- Are people around you saying things you’re not quite ready to hear?
If any of that resonates, you can read more about cocaine addiction and alcohol addiction.
Getting help for cocaine and alcohol use in Ireland
Your GP is a good place to start. They can talk through what’s going on and refer you to the right support, including services provided by the HSE.
For people who need a more structured approach, residential treatment at Smarmore Castle is a good option. We treat cocaine and alcohol dependence as the connected problem it usually is. In clinical terms, this is called polysubstance use disorder.
Residential treatment takes you away from the environment where the triggers that make stopping so difficult are. Treatment begins with medical support during cocaine detox and alcohol detox, to make the process as safe as possible.
After detox, our programme includes individual and group therapies for addiction and aftercare planning as standard.
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Learn about Smarmore Castle’s addiction treatment programmes today.
If someone in your life is using cocaine and alcohol
Watching someone’s behaviour change and not knowing what to say can be hard. You may feel like you’re losing them gradually, or may not be sure whether raising the subject will help or make things worse.
Cocaine and alcohol can have a serious impact on the people around someone who is drinking or using a lot.
Smarmore Castle’s programme involves families in the treatment process from day one. We offer advice and somewhere to discuss their experiences, and help them provide better support during and after treatment.
Frequently Asked Questions
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Can mixing cocaine and alcohol cause psychosis?
Both cocaine and alcohol can cause psychotic symptoms on their own. Cocaine use is associated with cocaine-induced psychosis, which can include paranoia, hallucinations, and disordered thinking. Separately, alcohol psychosis can develop as a result of chronic alcohol use, producing delusions and hallucinations.
Cocaethylene adds to this. Because it shares cocaine’s psychoactive properties and stays in your system far longer, it compounds cocaine’s already-known risk of psychosis. Using both cocaine and alcohol together may amplify these risks. If you’re experiencing any of these symptoms, speak to your GP.
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What are the withdrawal symptoms when stopping cocaine and alcohol?
Stopping both at the same time can be complicated. Cocaine and alcohol withdrawal affects the body in two very different ways. Cocaine withdrawal tends to be less physically visible than alcohol withdrawal, but it can be psychologically intense. Symptoms include fatigue, low mood, agitation, vivid and unpleasant dreams, and strong cravings.
Alcohol withdrawal is more physically pronounced and it’s one of the few withdrawals that can be life-threatening. Symptoms include anxiety, trembling, sweating, nausea, and difficulty sleeping. They usually begin around eight hours after the last drink and can get worse over the following 24 to 48 hours. Seizures are possible within that window. In some cases, alcohol withdrawal can lead to a serious condition called delirium tremens, which requires immediate medical attention.
Smarmore Castle’s cocaine detox and alcohol detox programmes are medically managed to keep you safe throughout.
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What should I look for in a private treatment centre for cocaine and alcohol use in Ireland?
There are a few things to check. Does the centre understand how cocaine and alcohol dependence interact, or does it treat them as unrelated problems? Is there a medically supervised detox programme? Is the centre accredited? And does the aftercare plan extend beyond the point of discharge?
Smarmore Castle is an accredited residential treatment centre with a clinical team experienced in polysubstance use disorder. The programme includes medical detox, individual and group therapies for addiction, and structured aftercare.
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If you or a loved one are struggling, our team is here to help – contact us in confidence today.
