The formation of cocaethylene and clinical presentation of ED patients testing positive for the use of cocaine and ethanol

Signs, Steven A.; Dickey-White, Howard; Vanek, Vincent W.; Perch, Steven J.; Schechter, Martin; Kulics, Albert T.

doi:10.1016/s0735-6757(96)90085-6

Cited by 25 publications

(13 citation statements)

References 35 publications

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“…Consistent with this, analysis of over 1000 toxicological screens for emergency room patients revealed that 88% of the people who tested positive for alcohol and cocaine had produced cocaethylene. Furthermore, plasma cocaethylene levels correlated well with plasma cocaine levels (Signs et al. 1996).…”

Section: Resultsmentioning

confidence: 99%

Effects of concurrent use of alcohol and cocaine

2002

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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.

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Section: Resultsmentioning

confidence: 99%

Effects of concurrent use of alcohol and cocaine

2002

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“…However, current findings have disputed previous claims of enhanced alterations of cardiovascular function induced by cocaethylene. In such studies, cocaethylene was consistently found to be less potent than cocaine in evoking cardiovascular effects regardless of the route of administration employed (e.g., intranasal, IV administration) or the type of population recruited (e.g., community versus clinical populations) (Hart et al, 2000;Perez-Reyes, 1994;Signs et al, 1996). Based on these mixed results, it is difficult to infer that combined use of cocaine and alcohol will produce greater neurocognitive disturbances than either drug used alone.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Efficiency in Stimulant Abusers With and Without Alcohol Dependence

Lawton-Craddock

Nixon

Tivis

2003

Alcoholism Clin & Exp Res

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As expected, substance abuse was associated with cognitive inefficiency. More importantly, these findings suggest that the cognitive effects of chronic stimulant abuse are not additive with those of alcohol abuse. That is, singly addicted stimulant abusers demonstrated similar or greater neurocognitive impairments than individuals who abuse alcohol and stimulants concurrently. The reason for this pattern is speculative but may be attributed to alcohol's opposing actions on cerebrovascular effects brought on by stimulant abuse.

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“…Speculations of increased risk for cardiovascular complications in combined cocaine and alcohol users have focused on the role of cocaethylene (Farre et al, 1993;McCance-Katz et al, 1993). However, more recent investigations of the effects of coca- ethylene in clinical populations (Signs et al, 1996), and healthy volunteers who ingested ethanol after cocaine snorting (Perez-Reyes, 1994) have not observed cardiotoxic effects from cocaethylene. In these samples, cocaethylene attained plasma concentrations that were comparable to those observed in the studies by McCance-Katz et al (1993) and Farre et al (1993), but did not alter cardiovascular effects of cocaine (Perez-Reyes, 1994) or had no effect on cardiovascular performance (Signs et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

“…However, more recent investigations of the effects of coca- ethylene in clinical populations (Signs et al, 1996), and healthy volunteers who ingested ethanol after cocaine snorting (Perez-Reyes, 1994) have not observed cardiotoxic effects from cocaethylene. In these samples, cocaethylene attained plasma concentrations that were comparable to those observed in the studies by McCance-Katz et al (1993) and Farre et al (1993), but did not alter cardiovascular effects of cocaine (Perez-Reyes, 1994) or had no effect on cardiovascular performance (Signs et al, 1996). Variations in the route of cocaine administration, the order and dose of cocaine or alcohol consumption, and the elapsed time since the last dose of either drug are factors that may contribute to contrasting findings on the effects of cocaethylene.…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological functioning in cocaine abusers with and without alcohol dependence

Robinson

Heaton

O’Malley

1999

J Int Neuropsychol Soc

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Thirty codependent cocaine and alcohol users were compared with age-, education-, race-, and sex-matched cocaine abusers (N 5 30) and normals (N 5 30) using an extended Halstead-Reitan Neuropsychological Test Battery to determine whether cocaine abusers with alcohol dependence were more cognitively impaired than singly addicted cocaine abusers. Tests were grouped and analyzed according to 8 major ability areas. Participants who abused both cocaine and alcohol did not differ from normals on the majority of test measures. An unexpected but consistent finding was the poorer performance of the cocaine sample relative to cocaine and alcohol abusers on measures of complex psychomotor and simple motor functioning ( ps , .001). Pure cocaine abusers, but not abusers of both cocaine and alcohol, also performed more poorly than normals on a measure of global neuropsychological functioning ( p , .01). These results are consistent with previous reports of generally mild cognitive dysfunction in cocaine abusers. The findings also suggest that cocaine and alcohol abusers of relatively young ages may be less cognitively impaired than demographically comparable cocaine abusers. Evidence from studies of vascular functioning in abusers of cocaine and alcohol alone and in combination is discussed as possible explanation for these findings. (JINS, 1999, 5, 10-19.)

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The formation of cocaethylene and clinical presentation of ED patients testing positive for the use of cocaine and ethanol

Cited by 25 publications

References 35 publications

Effects of concurrent use of alcohol and cocaine

Effects of concurrent use of alcohol and cocaine

Cognitive Efficiency in Stimulant Abusers With and Without Alcohol Dependence

Neuropsychological functioning in cocaine abusers with and without alcohol dependence

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