In this article
Dangerous heart risks come from mixing cocaine and alcohol; in the liver, ethanol and cocaine form cocaethylene, a metabolite that poses special risks to the heart.
What is cocaethylene and how is it formed?
Cocaethylene is a psychoactive compound produced when cocaine and ethanol are both in the liver at once. This metabolite is unique: it can only be produced when those two drugs interact.
When cocaine and alcohol both reach the liver, an interaction between the two can cause cocaethylene to form as a byproduct.
Why the heart risk rises when you mix cocaine and alcohol
The risk to the heart is higher when cocaine and alcohol are consumed together; some of the additional factors include how long the compound remains in the system, its specific effects on the heart, and the way cocaine changes the flow of blood to the heart.
Cocaethylene carries an 18- to 25-fold increase over cocaine alone in the risk of sudden death; alcohol seems to make the cocaine-related cardiac risk worse.
Cocaethylene is associated with myocardial injury and cardiac arrest; the danger is probably due to blocking cardiac ion channels.
What's more, cocaine increases heart rate, boosts blood pressure, and raises the workload on the myocardium - increasing demand on the heart for oxygen - and also constricts coronary arteries, which reduces the blood supply to the heart, to the heart's vessels.
Together, these two drugs, cocaine and alcohol, are a bad combination for your heart.
A number of serious heart issues are linked to cocaine and alcohol, including:
- In 84 of 107 cocaine-related deaths, no definitive cause of death was identified at autopsy, so deaths were presumed to be due to arrhythmias
- sudden deaths from cardiac arrest, myocardial infarction, coronary thrombosis or vasospasm, acute aortic or coronary dissection, systemic thrombosis, and ventricular fibrillation
##
##
What to do first: Emergency help for a suspected cocaethylene overdose If you or someone else has chest pain, trouble breathing, faints or collapses, or has a seizure or severe agitation after drinking alcohol and using cocaine, call 911 immediately. Do not wait for symptoms to get worse or to see if they go away.
If you're struggling with substance-use disorder, SAMHSA's free and confidential treatment referral and information service is also available 24/7 at 1-800-662-4357.
This guide is general health information, not medical or legal advice. Talk to a doctor or pharmacist about your situation. In an emergency call 911.
