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Cocaine and alcohol


Alcohol and cocaine are opposites in many ways but are often used together.

Whilst alcohol initially causes the heart rate to speed up and often makes people more talkative and sociable, in quantity, alcohol is a depressant that slows down the central nervous system, mind and body. 

Meanwhile, cocaine is a stimulant that speeds up the messages between the brain and body.

There are many increased risks by taking the two together.

Mixing cocaine and alcohol

It is not at all unusual for people to develop issues with both alcohol and illegal substances,  including cocaine. 

A 2018 Public Health England report said of all the people entering treatment with an alcohol problem, a third also had an issue with another substance.

Cocaine is often viewed as a party drug and may be quite widely present in some social circles, but that does not diminish the risks associated with it.

Cocaine users, especially those who snort the powdered form, may combine it with a night of drinking in a bid to create a sense of euphoria, but it does increase the risk of both. Cognitive processes will be further impaired by using alcohol and cocaine together and poor decision making and overdose risk are increased.

A 2016 American study said simultaneous use of cocaine and alcohol was linked to increased risk of suicide. A coroner issued a specific warning around this after the death of Love Island star Sophie Gradon who died by hanging and was found to have both alcohol and cocaine in her system. The coroner said people could be 16 times more likely to kill themselves when cocaine and alcohol were taken together and the combination had caused Sophie to behave irrationally.

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Combined cocaine and alcohol effects

There is evidence that combined cocaine and alcohol use increases the effect on the heart of the two substances. 

It appears to lead to the formation of the chemical cocaethylene which may increase the likelihood of heart dysfunction or damage.

Research also suggests the combination of cocaine and alcohol can increase a tendency toward violent behaviour.

Businessman struggling with cocaine use

How to tell if someone is sniffing coke

Powder forms of cocaine may be snorted, injected or smoked. 

The effects of cocaine are usually short-lived, which means users often snort regularly during the course of one session to sustain the high.

When someone is high they are likely to be full of energy, chatty, have a reduced appetite and seem wide awake and energetic, even euphoric. Their pupils may dilate. They may have a higher pain tolerance and an increased sex drive. 

Less pleasant effects may include irritability, anxiety, restlessness, erratic behaviour, increased sensitivity to sound and light and the shakes. They may become violent or aggressive, paranoid, experience chest pain or a sense of panic.

Signs someone is snorting cocaine may include visible white residue around the nose or sudden display of the effects of having taken cocaine, perhaps after they have just disappeared to the toilet or somewhere private that they might have used. 

Someone who has been snorting cocaine regularly over a period of time may start to suffer nose bleeds, a reduced sense of smell and have a runny nose often.

In the days after cocaine use people may be tense or depressed, exhausted or display mood swings. The euphoric mood of being under the influence of cocaine is often the polar opposite of the mood of someone who is coming down.

Treatment for cocaine and alcohol addiction

Signs of addiction can include someone spending less time with established friendship groups and perhaps changing friends regularly. They may start taking less care of themselves, have relationship or work issues or fail to meet their responsibilities and perhaps become less interested in things they used to value and enjoy.

Cocaine is highly addictive, but not everyone who uses it will become addicted. Regularly using more cocaine than planned, wishing cocaine use had never started, feeling guilt or remorse over use or beginning to fail to fulfil responsibilities are indicators that addiction has taken hold.

Recovery rates from powder cocaine addiction are very good. Though there is no cocaine replacement medication, prescription drugs may be offered to assist with related problems such as sleep difficulties.

People who are addicted to alcohol and cocaine may be prescribed disulfiram. Disulfiram is a medication given to alcoholics. It is used to deter people from drinking by causing unpleasant effects if they do, such as sickness. There has been some evidence to suggest disulfiram helps people to reduce their cocaine consumption too.

Talking therapies, such as counselling, group therapy and cognitive behaviour therapy, are used widely in the treatment of cocaine and alcohol addiction. 

Residential rehab is the most effective form of treatment for addiction, allowing an opportunity to step outside of usual routines, habits and responsibilities and a period of intense support and focus on recovery.

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