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Cocaethylene, is formed in the liver through a process called hepatic transesterification when cocaine and alcohol are taken simultaneously. In short, the two drugs form a third drug in the liver that is more toxic than if either drug is taken alone.

Drugs- Cocaine & Alcohol

Drug category- Stimulant

Chemical Compound – Ethylbenzoylecgonine

Street/Brand names – Due to the lack of awareness around cocaethylene there are no known slang names for it

Cocaine has been under legal control in the UK since 1917 and is now considered a class A drug under the Misuse of Drugs Act 1971 making it illegal to possess or supply.  Supplying class A drugs can land someone a life sentence behind bars and/or a unlimited fine.

Cocaethylene produces similar effects to cocaine; 

  • increased heart rate

  • blood pressure

  • body temperature

  • increased energy

  • sharpened attention span and perception

  • intensified mood/feelings-typically euphoria

  • (sometimes) increased libido 

However, because of cocaethylene’s longer ‘half life’ these effects are prolonged.


Routes of Administration
As cocaethylene is formed in the body, anyone sniffing, injecting or smoking cocaine (crack) and drinking alcohol will probably be under the influence of cocaethylene.


Cocaethylene can raise you heartbeat by up to 33 bpm (beats per minute) compared to 12 bpm with cocaine alone so anyone with heart problems could suffer from severe consequences.  Also, a lot of people are not aware they have pre-existing heart conditions until it is too late.  Furthermore, studies have suggested that the combination of cocaine and alcohol can increase the chance of cerebral infarction (stroke), intracranial haemorrhage (bleeding in the brain), myocardial infarction (heart attack), cardiomyopathy (enlarged heart) and cardiac arrhythmias (irregular heartbeat)
Whilst cocaine can increase self-confidence and alcohol reduces inhibitions, the combination could lead people to do things they normally wouldn’t.  Getting into trouble with the law through violent or aggressive behaviour or engaging in risky sexual activity are just some of the potential consequences.
Not to mention the increased risk of transmitting blood borne viruses such as hepatitis C through sharing straws or notes to sniff cocaine, and HIV through sharing injecting equipment or paraphernalia.   These viruses can also be transmitted through unprotected sex.   

Keeping Safe/Harm Reduction
The obvious advice around mixing cocaine with alcohol is Don’t Do It . However, if you are going to do it then here are some simple steps to help you stay safe;

  • Try to use a known dealer to ascertain the quality, remember ‘you can always take more but you can never take less.
  • Always chop the cocaine powder as fine as possible to avoid damage to the lining of your nose.
  • DO NOT share bank notes or snorting tubes with other users to avoid catching infections or blood borne viruses like hepatitis
  • After a few ‘lines’ of cocaine wash out your nose with water or use a nasal douche to avoid damage to your nasal membranes
  • Avoid mixing cocaine with other drugs, especially uppers like whizz or downers like diazepam to ease the comedown. 
  • Apart from developing other habits you are confusing your body, especially your heart.

If things go wrong, call 999 and stay with the person this could be the difference between life and death. 
Visit your local drug service for advice, you can call Lifeline on 0191 565 8070 (Sunderland)  we would be more than happy to help.

Check out the hi way for more information in local services. 

Special thanks to Mark Roberts from Lifeline Sunderland for working on this content.

 If you would like to raise awareness of Cocaethylene in your local area the hi team can work with you to get the message out there. Check out our posters in Supporting Documents. 


Roweena Russell, E: , T: 079 57 57 6305
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