February 2019: Cocaine Addiction

Effects of Cocaine & Alcohol

Mixing alcohol and Cocaine is common and very dangerous. The estimated prevalence of simultaneous and concurrent alcohol use among cocaine users was 74% and 77%, respectively. 

There a various reasons why people mix cocaine, a stimulant, with alcohol, a depressant. Sometimes people mix the two drugs to try to “balance out” or counter-act the negative effects of the other drug. It could be to feel less intoxicated or reduce the anxiety of the Cocaine crash. Yet more often mixing the two drugs occurs because of the social situation. Whether at a party, club, etc. Cocaine is often used in social situations where alcohol is present. A 2003 study by scientists at the University of California’s Drug Dependence Research Center noted: “The combined use of alcohol and cocaine can produce a sense of increased and prolonged euphoria, compared with the use of either substance on its own.”

However, combining Cocaine and alcohol is more dangerous and lethal than using Cocaine alone. A study funded by the National Institute of Mental Health found people who abused both alcohol and cocaine were 2.4 times more likely to kill themselves than other people with suicidal tendencies. It’s been reported that the risk of sudden death is 20 times greater for use of cocaine and alcohol together than it is for cocaine alone (Kinney, 2009). Some individuals will consume greater quantities of alcohol over longer periods of time because they do not feel its affects, as Cocaine sharpens alertness. This can lead to alcohol poisoning and subsequent death. Additionally, it’s reported that combining both drugs can cause an overdose death at much lower Cocaine levels (only one-tenth of the Cocaine levels known to be fatal from Cocaine alone). The reason combining these drugs is so dangerous, beyond their individual effects, is a substance called cocaethylene


Cocaethylene is produced by the liver in the presence of both cocaine and alcohol. It’s synthesized in a reaction that replaces the methyl group of Cocaine with an ethyl group. While Cocaethylene results in a longer experience of euphoria, it increases the strain on the cardiovascular system and significantly increases the risk of overdose. Cocaethylene can be fatal up to twelve hours after consumption of Cocaine and alcohol. This compound is found to increase the risk of immediate death by 18 to 25 times than Cocaine alone. Cocaethylene has also been associated with seizures, liver damage, and can compromise the function of the immune system. 

    Quick Facts on Cocaine

    2017 reported Cocaine use in the past month (0.8%), and lifetime use (14.9%) in the U.S. both increased compared to 2016 data. (SAMHSA)

    There were 13,942 overdoses involving Cocaine in 2017, more than double the 6,512 overdoses in 2007. (NIDA)

    In 2017, an estimated 2.2 million people aged 12 or older were current users of cocaine. (SAMHSA)

    Almost 15% of people ages 12 and older have tried Cocaine in their lifetime according to the National Survey on Drug Use and Health in 2017. 

    Signs of Cocaine Use

    Cocaine is a strong central nervous system stimulant which interferes with the re-absorption of dopamine to create a “high” from the surplus of positive chemicals in the brain. Normally dopamine is self-regulated in the brain and is recycled back into the cells that released it. When that re-absorption is disrupted by Cocaine, the flood of positive “feel-good” chemicals reinforces drug-taking behaviors. 

    There are numerous studies and articles that talk about how Cocaine is highly addictive. Some may have read about the study where rats chose cocaine over food.  While it’s true that Cocaine produces an immediate euphoria, the drug affects other parts of the brain in ways that imprint the euphoria into memory. Cocaine affects the limbic system, which includes the area of the brain that acts as memory centers. Studies have shown, “when someone experiences a cocaine high, these regions imprint memories of the intense pleasure as well as the people, places, and things associated with the drug. From then on, returning to a place where one has taken cocaine or merely seeing images of cocaine-related paraphernalia triggers emotionally loaded memories and desire to repeat the experience.” 

    Long-Term Brain Damage

    Long-term Cocaine use has been linked to accelerated age-related decreases in grey matter in the brain – essentially accelerating the natural deterioration that occurs over time. 

    Cocaine users may risk brain hemorrhage 20 years earlier than non-drug users. 

    Abusing Cocaine may increase the risk of developing Parkinson’s Disease. 

    NIDA supported researchers completed a study which found that Cocaine abuse resulted in long-term impaired mental and physical functioning including delayed memory, reaction time, and calculation ability. 

    Frequently Asked Questions

    What is Cocaine?

    Cocaine refers to a drug derived from the coca plant native to South America. For thousands of years native people in South America would chew the coca leaves for their therapeutic stimulant properties. In the 1900’s Cocaine was used and developed as a painkiller. Today, Cocaine is a Schedule II drug which the DEA describes as highly addictive with use potentially leading to severe psychological or physical dependence. Schedule II drugs are considered dangerous and are highly regulated, used only for legitimate medical purposes. 

    Either in powder or crystal form, Cocaine is often mixed with additives (some of which can be incredibly dangerous). It has become a common illegal drug with various street names including: blow, coke, crack, flake, icing, nose clams, snow, snow white, tardust, and white powder. “Crack” is the crystal form of Cocaine, which is normally a white powder. It is heated then smoked and received its street name from the crackling sound heard when heated. The differences between crack and cocaine are minor, although crack is generally viewed as more potent as it impacts the bloodstream more quickly resulting in a more potent although shorter lived high. This difference is due to how the drug enters the body, as opposed to chemical composition.

    How does Cocaine affect the brain?

    Cocaine is a strong central nervous system stimulant which interferes with the re-absorption of dopamine to create a “high” from the surplus of positive chemicals in the brain. Normally dopamine is self-regulated in the brain and is recycled back into the cells that released it. When that re-absorption is disrupted by Cocaine, the flood of positive “feel-good” chemicals reinforces drug-taking behaviors

    Long-term cocaine use has significant negative impacts on the brain including accelerated grey matter degradation, greater risk of brain hemorrhage, risk of developing Parkinson’s disease, and long-term mental and physical deficits.

    How addictive is Cocaine?

    The Center for Substance Abuse Research very clearly states that when it comes to smoking crack cocaine, a person can become addicted after his or her first time trying the drug. While there are no shortage of articles about how cocaine is addictive, it primarily has this affect because of how the drug affects the limbic system in the brain. The limbic system contains the parts of our brian that hold the memory centers, and the euphoria experienced during the high is imprinted in the mind. Thereafter, returning to a place or even seeing images of cocaine can trigger memories and cravings.

    How is Cocaine addiction treated?

    The majority of individuals seeking addiction treatment for cocaine are polydrug users meaning they use cocaine and additional drugs. While there are not currently any FDA approved drugs to treat cocaine addiction, therapy and clinical interventions can be effective. It’s also important to understand that frequent cocaine use has the affect of altering the mind and body, in some cases permanently. Specialized addiction treatment centers can help address individual, family, and social components, and provide treatment in a safe and sober environment which may be helpful for individuals who have tried to get clean on their own unsuccessfully in the past. Comprehensive addiction treatment centers also have the capability to address any co-occurring mental health disorder that may be contributing to drug use.

    Cocaine Use On The Rise

    Cocaine use in the United States has seen a recent resurgence that broke records in 2015 and has continued to rise. The greatest contribution to Cocaine’s increase in use and popularity may in fact simply be its availability. In terms of Cocaine’s use, the 2015 NSDUH survey estimated a 26% increase in people aged 12 and older who tried Cocaine for the first time compared with 2014, and a 61% increase compared with 2013. In 2015, just under one million people in the United States (0.4% of the population) tried Cocaine.

    Over the same period, Columbia’s Cocaine crop yield doubled between 2013 and 2015 to a total almost twice as much as the second and third largest producers. The production has since continued to break records annually. In 2017, there was enough cultivation to produce 1,520 tons of Cocaine which was a 31% increase compared to 2016.

    The increase in Cocaine use has also resulted in an increase in Cocaine overdoses over the last five and ten years. In 2017 there were 13,942 overdoses involving Cocaine use compared to only 6,512 in 2007, a more than 100% increase over the decade. Cocaine addiction is dangerous and has lasting negative effects on the body. It’s important if you have a cocaine addiction to receive treatment quickly to avoid the long-term negative effects Cocaine has on the lungs, heart, and brain.

    Risks of Cut Cocaine

    Cocaine is one of the most expensive illicit drugs. It can be altered or “cut” with other drugs or substances. The additive allows the seller to increase their profit and this can occur at any and all stages of the drug supply. The average purity of English Cocaine is reported to be no more than 20% to 30%

    While some additives can be seen as diluents, others are adulterants which themselves have an effect and cause a mental or physical bodily reaction. Some of these adulterants can be incredibly harmful and have caused deathsOne of more dangerous and common adulterants is Levamisole, a drug used by farmers to deworm livestock. The drug underwent clinical trials for treating cancer and autoimmune disorders and approximately 10% of patients patients in the trial developed agranulocytosis – a condition which has an effect similar to AIDS where the immune system is crashed catastrophically. A simple infection can become life-threatening without an effective immune system.  

    In 2011, U.S. Drug Enforcement Administration (DEA) estimated that 82% of seized cocaine contained levamisole, an increase from 1.9% in 2005.

    Other additivies include: acetaminophen, amphetamine or methamphetamine, caffeine, corn starch, fentanyl, lead, lidocaine, phenacetin, sodium bicarbonate, and sugar.


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