Combining drugs with opposite actions, like cocaine and alcohol, can lead to a fatal overdose.

Mixing alcohol and cocaine results in a dangerous byproduct that can increase the potential for toxic effects, liver damage, and other pressing issues.


Cocaine is a potent central nervous system stimulant that still has some medical uses in the United States, particularly as a vasodilator by dentists.

As a result, even though most people associate cocaine with other illicit drugs, it is classified as a Schedule II (C II) controlled substance by the U.S. Drug Enforcement Administration. This means cocaine retains some recognized medical uses, but it is at the same level of control as drugs like methamphetamine and most opioids.

Even though it does have medicinal uses, it would be very rare for someone to get a prescription for medicinal cocaine. Its medical use is limited to hospitals and clinics under the strict supervision of physicians.

Cocaine primarily exerts its effects by increasing the availability of excitatory neurotransmitters like dopamine.


Alcohol remains one of the most abused drugs in the world. It is legal for use in most areas of the country for individuals who are over age 21.

Alcohol has the opposite effects of cocaine. Its use suppresses or depresses the functions of the nervous system.

Because of its availability, alcohol is a common drug of abuse. Its abuse can occur in conjunction with the abuse of other drugs like prescription drugs and powerful stimulant drugs like cocaine.

Alcohol primarily exerts its effects in the brain by increasing the availability of inhibitory neurotransmitters like gamma-Aminobutyric acid (GABA) and decreasing the availability of excitatory neurotransmitters.

Use and Abuse Figures

According to data provided by the Substance Abuse and Mental Health Services Administration (SAMHSA):

  • In 2016, about 216 million Americans reported some lifetime use of alcohol. In 2017, this figure was 220 million.
  • In 2016, about 39 million Americans reported some lifetime use of cocaine. In 2017, this figure was about 40.5 million.
  • In 2016, about 16 million people admitted to heavy alcohol use within the month before taking the SAMHSA survey. In 2017, this figure was 16.7 million.
  • In 2016, about 1.9 million Americans admitted to using cocaine within the month before taking the survey. In 2017, this figure was 2.2 million.

Concurrent Use

Alcohol use disorders represent a significant proportion of all substance use disorders in the United States. It has long been observed that many people who use stimulants like cocaine recreationally use it with alcohol.

Most often, alcohol is consumed with cocaine to “take the edge off” the effects of cocaine or to reduce some of the undesirable effects of prolonged cocaine use, such as hyperactivity, jitteriness, and problems with attention.

Dangers of Mixing Alcohol and Cocaine

Mixing cocaine and alcohol can lead to serious interactions.

  • The effects of alcohol will decrease the effects of cocaine, resulting in the person using higher amounts of cocaine.
  • Cocaine use interferes with the effects of drinking alcohol, leading to the potential to drink significantly more alcohol than one can handle
  • The most likely scenario is that a person will use potentially dangerous levels of cocaine due to the suppressing effects of alcohol on cocaine
  • The combination of the two drugs can lead to an increased risk for neurological issues, such as problems with motor coordination and an increased potential for seizures or brain damage
  • Important cognitive functions like emotional control, impulse control, and judgment are even more compromised by the combination of alcohol and cocaine than they are with the use of either drug alone. This can lead to numerous potential problems.
  • Combining the two drugs, and using more of one (or both) both drugs due to the tendency of this combination to cancel out the effects of one another, can result in serious cardiovascular issues, including significant heart damage or the potential for heart attack
  • Other organs can be burdened as a result of combining these drugs, especially the liver (see below)
  • Long-term use of these drugs in combination may result in ulcers, liver damage, respiratory problems, cardiovascular problems, and brain damage.

Dangers of Cocaethylene

Scientific research has repeatedly documented that when people combine alcohol and cocaine, a toxic byproduct is produced in the liver: cocaethylene (ethylbenzoylecgonine).

Whenever you drink alcohol, your liver immediately prioritizes breaking it down and metabolizing it over all other substances.

Cocaethylene is a waste product that is nearly a third more toxic than cocaine. It is produced when you combine alcohol and cocaine. When you drink alcohol and cocaine, nearly 20 percent of the cocaine metabolism is disrupted, and this waste product builds up and remains in your system three times longer than cocaine does.

As A Result of Cocaethylene Remaining in Your System, You Can Experience:

  • Increased potential to develop liver damage over the long run
  • Decreased reuptake of dopamine in your system that can result in bingeing on cocaine more
  • Increased risk of developing a heart attack
  • Increased long-term risk of developing cancer or other diseases as a result of cocaethylene
  • Increased issues with psychosis, decreased mental functioning, and delirium
  • Significantly increased potential to get involved in the legal system as a result of committing a crime or being the victim of a crime

Cocaine and alcohol is one of the drug combinations that result in a significant number of fatalities, according to the National Institute on Drug Abuse.

Death occurs due to increased risk for heart attack, seizures, or stroke. Decreased judgment and risky behaviors may lead to serious or potentially fatal accidents or other life-changing situations.

Formal Addictions

snorting cocaine

Regularly combining alcohol and cocaine leads to a greater susceptibility for addiction.

Developing stimulant use disorder (from cocaine abuse) and/or alcohol use disorder is a life-changing event. You may need to spend years in recovery and experience numerous losses that cannot be reversed, such as issues with relationships, work, and school.

Combining alcohol and cocaine leads to a greater risk to become involved in the legal system and suffer serious consequences. If you are continually abusing alcohol and cocaine, you should consult with a licensed mental health care professional.

Is There a Safe Amount?

Cocaine is a controlled substance; therefore, using any amount of cocaine while not under the supervision of a physician is unsafe. By all professional and legal definitions, there is no safe amount of cocaine and alcohol you can use.

There are cases in the research where a person using cocaine for the first time suffered serious consequences, even with relatively minor amounts of cocaine. Combining cocaine with alcohol increases the risk for many of these potentially serious events.

According to these cases, there is, again, no safe amount of cocaine and alcohol that can be combined.

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