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What You Need to Know About Combining Cocaine and Alcohol

While common, the combination of the two drugs can be toxic and highly dangerous.
Lines of cocaine on a mirror sitting on a table next to a glass of whiskey
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About three-quarters of cocaine users also drink at the same time, studies suggest. As most people are aware, cocaine induces euphoric feelings that typically last between 5 and 30 minutes, and as users come down from that high, they often report feelings of anxiety. Likewise, people who use cocaine often drink to help offset those jitters, suggests research by Lori Knackstedt, an associate professor of psychology at the University of Florida.


Other times, people who use cocaine might be doing it to offset the performance-impairing, sedating effects of alcohol—in other words, they want to keep their night going, suggests research by Stephen T. Higgins, director of the Center on Behavior and Health at the University of Vermont.

No matter what the motivation is, combining cocaine and alcohol can carry serious risks. For one thing, Higgins says, “a likely downside is that cocaine is going to keep one awake and allow for more alcohol consumption without totally offsetting the impairing effects of alcohol.” That increases the likelihood of trouble with drunk driving or other negative consequences. We looked into what other risks people should know about combining the two drugs.

What happens to your body when you mix cocaine and alcohol?

Both alcohol and cocaine are hard on your body, and the combination of the two is extra dangerous, even for a casual user. (The same goes for the combination of alcohol and crack, the smoked version of cocaine.) As you metabolize the combination of cocaine and alcohol, a toxic substance called cocaethylene is created by your liver and travels through your bloodstream, increasing the risk of liver damage, immune system dysfunction, cardiac damage, and more. Cocaine is also hard on your heart because it speeds up your heart rate and spikes your blood pressure to potentially dangerous levels. The combination of cocaine and alcohol is even more cardiotoxic, and can elevate your heart rate and blood pressure more than cocaine would on its own, research suggests. The consequences could include a heart attack or cardiac arrest. High-purity cocaine, which has less fillers, gives you a higher dose of the drug with each hit, increasing the dangers to your body.


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To be blunt, the combination of cocaine and alcohol can kill. In 2015, Tommy Hanson, a former pitcher for the Atlanta Braves, died from complications of alcohol and cocaine toxicity at just 29 years old. In a recent study, emergency department patients who used a combination of alcohol and cocaine died more often than those who used cocaine alone. (The combination of weed and cocaine or weed, cocaine, and alcohol proved even deadlier.)

What are the long-term effects of combining cocaine and alcohol?

Even if you get through the night scot-free, your body still pays a price when you combine these drugs. Research suggest that regular use of cocaine can damage your heart even if you’re young and otherwise healthy.

This drug combination may also be especially difficult to leave behind. Drinking even moderate amounts of alcohol can make cocaine more appealing to users, research by Higgins shows. “This can undermine efforts to quit cocaine use among those trying to do so,” he says. When people in outpatient treatment for cocaine dependence are encouraged to reduce their drinking, they are more likely to quit using cocaine, his research suggests.

Studies have also found that people who are dependent on both alcohol and cocaine experience more accidental injuries, violence, and overdoses than people who are dependent on cocaine alone. What’s more, this combination could have a long-term impact on your brain. In one study, brain scans revealed that people who were dependent on both alcohol and cocaine had reduced white matter in their anterior cingulate cortex, a region of the brain responsible for emotional regulation.

The bottom line

Even if somebody is experienced with one of the two drugs, Knackstedt says, they should be very cautious about adding the other to the mix. More research on how these drugs—and others—interact is still needed, she says. “Historically, drugs have been studied by themselves. Because we just know how drugs act individually, that’s what we base our treatments on,” she says. We may be seeing evidence of the limitations of that approach: So far, medications tested for treatment of cocaine addiction have failed in clinical trials. That said, there are encouraging signs that could change: Thanks to a new grant from the National Institutes of Health, for instance, Knackstedt is now investigating the effects of alcohol and cocaine in animal models to help increase our knowledge of how the drugs affect humans.