Effects of concurrent use of alcohol and cocaine

Abstract

The combination of alcohol and cocaine is popular among drug users, perhaps because of more intense feelings of 'high' beyond that perceived with either drug alone, less intense feelings of alcohol-induced inebriation and tempering of discomfort when coming down from a cocaine 'high'. A review is presented of the medical literature on psychological and somatic effects and consequences of combined use of alcohol and cocaine in man. The search was carried out with Medline, the Science Citation Index/Web of Science and Toxline. Exclusion and inclusion criteria for this search are identified. There is generally no evidence that the combination of the two drugs does more than enhance additively the already strong tendency of each drug to induce a variety of physical and psychological disorders. A few exceptions must be noted. Cocaine consistently antagonizes the learning deficits, psychomotor performance deficits and driving deficits induced by alcohol. The combination of alcohol and cocaine tends to have greater-than-additive effects on heart rate, concomitant with up to 30% increased blood cocaine levels. Both prospective and retrospective data further reveal that co-use leads to the formation of cocaethylene, which may potentiate the cardiotoxic effects of cocaine or alcohol alone. More importantly, retrospective data suggest that the combination can potentiate the tendency towards violent thoughts and threats, which may lead to an increase of violent behaviours.

Caracterização da cultura de crack na cidade de São Paulo: padrão de uso controlado

“…Alcohol has been used as a palliative for the negative effects of crack, 14,18,19,20 as illustrated by the following quotation:…”

Gender differences with high-dose naltrexone in patients with co-occurring cocaine and alcohol dependence

“…Commonly, the use of one substance leads to the use of the other (Dackis & O'Brien, 2001;Heil et al, 2001;Mengis et al, 2002). Additionally, concurrent use of cocaine and alcohol notably yields cocaethylene (McCance-Katz et al, 1993), an active transesterified metabolite associated with more lethality (Andrews, 1997;Jatlow et al, 1991;Katz, Terry, & Witkin, 1992) and toxicity (Cami, Farre, Gonzalez, Segura, & de la Torre, 1998;McCance-Katz, Kosten, & Jatlow, 1998;Pennings, Leccese, & Wolff, 2002;Wilson, Jeromin, Garvey, & Dorbandt, 2001) than cocaine alone. Postmortem studies link lethal overdose with cocaethylene (Jatlow et al, 1991), which has been estimated to increase the risk of sudden death by 18-25 fold when compared to cocaine alone (Andrews, 1997).…”

A double blind, placebo-controlled trial that combines disulfiram and naltrexone for treating co-occurring cocaine and alcohol dependence

“…Also, concurrent use of cocaine and alcohol produces cocaethylene (Gossop, Manning, & Ridge, 2006a;Harris, Everhart, Mendelson, & Jones, 2003), an active transesterified metabolite associated with more lethality than cocaine alone (Pennings, Leccese, & Wolff, 2002) and toxicity (Harris et al, 2003;Hearn, Rose, Wagner, Ciarleglio et al, 1991;Pennings, Leccese, & Wolff, 2002).…”