Urine Drug Tests Indicate Higher Prevalence of Combined Alcohol and Cocaine Use Compared to Alcohol Together with Cannabis or Amphetamine—A Possible Link to Cocaethylene

Helander, Anders; Villén, Tomás; Signell, Patrick

doi:10.1093/alcalc/agad009

Cited by 3 publications

(2 citation statements)

References 34 publications

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“…Notably, alcohol and cocaine form the active metabolite, cocaethylene, a transesterification product of both drugs. This metabolite is as potent as cocaine and has a longer elimination half-life, prolonging the drug effect [ 30 , 31 ]. Therefore, we could speculate that this potentiation of cocaine contributes to concurrent/simultaneous alcohol use.…”

Section: Discussionmentioning

confidence: 99%

Cocaine/crack and cannabis use among transgender women in Goiás, Central Brazil

Magalhães,

dos Santos,

Diniz e Silva

et al. 2024

PLoS ONE

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Introduction Illicit drug use is a significant public health problem. Studies have shown a high prevalence of cocaine and cannabis use in transgender women (TGW). Objective To describe the consumption patterns of cannabis and cocaine/crack use and variables associated with their use in TGW in Central Brazil. Methods A cross-sectional study was conducted on TGW in Goiás, Brazil. Participants were recruited using a respondent-driven sampling method and were interviewed face-to-face about cannabis and crack-cocaine and the variables associated with them. The Alcohol Smoking and Substance Involvement Screening Test was used to assess substance use. Unweighted logistic regression was used to identify variables associated with cannabis and crack cocaine use. P-values < 0.05 were considered statistically significant. Results A total of 440 transgender women participated in the study. Their median age was 25 years (interquartile range: 20.5–29.5 years). Most participants were single (85.5%) and had engaged in sex work in their lifetime (58.6%). Cannabis was reported by 68.9% and 53.4% of participants in their lifetime and in the past three months, respectively, and cocaine/crack use was reported by 59.8% and 44.1% of participants in their lifetime and the past three months, respectively. Of the participants, 10.2% reported high-risk cannabis use, and 9.1% reported high-risk cocaine/crack use. Furthermore, 35% of participants reported using both drugs. Previous physical violence (Adjusted Odds Ratio (AOR): 2.37), inconsistent condom uses during anal sex (AOR: 2.17), and moderate-/high-risk cocaine/crack use (AOR: 3.14) were associated with high-risk cannabis use. Previous sexual violence (AOR: 2.84), previous STI (AOR: 2.90), moderate-/high-risk cannabis (AOR: 3.82), and binge drinking (AOR; 3.28) were associated with high-risk cocaine/crack use. Conclusion Our study found a high frequency, significant overlap in the use of cannabis and cocaine/crack use and violence associated with these drugs consumption among TGW, highlighting the urgent need for health policies for drug disorders among this socially marginalized group.

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Section: Discussionmentioning

confidence: 99%

Cocaine/crack and cannabis use among transgender women in Goiás, Central Brazil

Magalhães,

dos Santos,

Diniz e Silva

et al. 2024

PLoS ONE

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“…A recent Spanish ED study performed between 2017 and 2019 reported that the co-ingestion of alcohol with either cocaine or cannabis was the most prevalent drug combination seen in ED admissions with 32.2% and 24.0% of all drug-related ED visits, respectively [ 23 ]. In Sweden, 60% of the 2627 cocaine-positive samples from acute drug-related poisonings (2010–2016) were also positive for alcohol [ 24 ]. Similarly, 72% of cocaine users who attended an ED in Colombia between 2016 and 2017 also tested positive for alcohol [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic Review

van Amsterdam,

Gresnigt,

van den Brink

2024

JCM

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Background: The simultaneous use of cocaine and alcohol is highly prevalent and is associated with high numbers of emergency department admissions, primarily due to cardiovascular complications. Aims: To answer the question of whether the co-use of cocaine and alcohol increases the cardiovascular risk compared to the use of cocaine alone. Method: A systematic review of human studies comparing the cardiovascular risk of co-used cocaine and alcohol with the use of cocaine alone. Results: Despite a higher myocardial workload induced by the co-use of cocaine and alcohol and the potentiation of cocaine’s cardiovascular effects by alcohol, the findings on the risk and severity of cardiovascular symptoms due to combined use are inconsistent. However, the co-use of cocaine and alcohol clearly leads to higher mortality. Interestingly, the presence of cocaethylene, a unique metabolite generated only via a pharmacokinetic interaction between alcohol and cocaine, carries an 18- to 25-fold increase over the absence of cocaethylene (cocaine-alone users) in the risk of sudden death and is associated with myocardial injury and cardiac arrest, probably due to the inhibition of cardiac ion channels by cocaethylene. Conclusion: Despite the inconsistency in some of the results, it is concluded that the co-use of cocaine and alcohol poses an additional risk of cardiovascular fatalities compared to the use of cocaine alone.

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Is there a relationship between abuse of alcohol and illicit drugs seen in hair results?

Pragst,

Niebel,

Thurmann

et al. 2024

Drug Testing and Analysis

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Combined use of alcohol and illicit drugs is a serious health and social problem. In this study, it was examined, whether a relationship between alcohol and drug abuse can be ascertained by comparison of alcohol marker and drug concentrations in hair. In the frame of a social support system for families with parental abuse of illicit drugs, hair samples were analyzed between 2011 and 2022 for methadone, heroin (6‐acetylmorphine), cocaine, amphetamine, ecstasy (MDMA), cannabinoids (THC), and the alcohol markers ethyl glucuronide (EtG) and ethyl palmitate (EtPa). For 1314 hair samples from adolescent and adult family members, the hair results show a prevalence of combined occasional or regular drug use and social or abusive alcohol use of 41%–60% except heroin (35%). The drug concentrations were statistically compared in the three categories of abstinence or moderate drinking, social drinking, and alcohol abuse. For the most frequently detected drug cocaine (n = 703), a significant increase of the concentrations with rising alcohol consumption was found. The frequent detection of cocaethylene proved the preferred simultaneous intake of both substances. For THC (n = 489), no significant difference between the alcohol consumer groups was seen. Concerning the less frequently detected methadone (n = 89), 6‐acetylmorphine (n = 92), amphetamine (n = 123), and MDMA (n = 105), no clear trend between drug and alcohol marker results was determined. It is concluded that the evaluation of hair results is an appropriate way to study the extent of combined drug–alcohol consumption and complements other studies based on acquisition of consumption data by interview or questionnaire.

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Urine Drug Tests Indicate Higher Prevalence of Combined Alcohol and Cocaine Use Compared to Alcohol Together with Cannabis or Amphetamine—A Possible Link to Cocaethylene

Cited by 3 publications

References 34 publications

Cocaine/crack and cannabis use among transgender women in Goiás, Central Brazil

Cocaine/crack and cannabis use among transgender women in Goiás, Central Brazil

Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic Review

Is there a relationship between abuse of alcohol and illicit drugs seen in hair results?

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