From the Guidelines
Binge drinking with cocaine is significantly more dangerous than binge drinking alcohol alone, posing a substantially higher risk to morbidity, mortality, and quality of life. When considering the comparative health risks, it's crucial to understand that both binge drinking with alcohol alone and binge drinking with cocaine carry serious health implications. However, the combination of alcohol and cocaine introduces additional, severe risks. According to the most recent guidelines, such as those from 1, binge drinking itself is associated with significant cardiovascular morbidity and mortality, as well as physical and psychological injuries.
The addition of cocaine to binge drinking creates a compound called cocaethylene in the liver, which is known to increase the risk of sudden cardiac death by up to 25 times, as noted in various studies on substance abuse. This combination puts extreme stress on the cardiovascular system, potentially leading to heart attacks, strokes, and arrhythmias, even in young, otherwise healthy individuals. Furthermore, the mixture intensifies liver damage, masks alcohol's sedative effects (leading to the consumption of dangerous amounts), and significantly impairs decision-making.
Key points to consider include:
- The risk of sudden cardiac death is significantly increased with the combination of alcohol and cocaine.
- The mixture can lead to intensified liver damage and impaired decision-making.
- It increases aggression and violence risk while creating stronger addiction patterns than either substance alone.
- The financial and societal costs of binge drinking, as discussed in 1, are significant, and the addition of cocaine only exacerbates these issues.
Given the evidence, it is strongly advised to avoid binge drinking altogether, and especially to never combine alcohol with cocaine due to the drastically increased health risks. For individuals who engage in such behaviors, seeking immediate medical attention if symptoms like chest pain, irregular heartbeat, seizures, or breathing difficulties occur is crucial, as these can be signs of life-threatening conditions.
From the Research
Comparative Health Risks
The comparative health risks of binge drinking with alcohol alone versus binge drinking with cocaine are significant.
- Binge drinking with alcohol alone can lead to high morbidity and mortality, both in the long and short term, affecting essentially every organ system 2.
- It can cause neurologic, gastrointestinal, and hematological manifestations, and withdrawal is among the most common and dangerous sequela associated with alcohol use disorder 2.
- Binge drinking has also been linked to liver disease, and its consumption patterns have changed in recent years, making it a socio-sanitary problem with significant individual and third-party social impacts 3.
Combined Effects of Alcohol and Cocaine
- Concurrent use of cocaine and alcohol produces cocaethylene, a psychoactive substance with pharmacological properties similar to cocaine, but with a longer plasma half-life, making it an attractive drug for abuse 4.
- Cocaethylene has been associated with seizures, liver damage, and compromised functioning of the immune system, and carries an 18- to 25-fold increase over cocaine alone in risk for immediate death 4.
- The combination of alcohol and cocaine can also lead to cardiovascular toxicity, including myocardial ischemia and infarction, with the risk amplified by concomitant cigarette smoking and alcohol consumption 5.
Organ-Specific Effects
- Both alcohol and cocaine use can affect the liver, with alcohol causing liver cirrhosis and cocaine potentially inducing coronary artery spasm, leading to myocardial infarction 6, 5.
- The nervous system can also be affected, with alcohol causing mild anterograde amnesias, temporary cognitive deficits, and sleep problems, while cocaine can lead to indirect stimulation of the autonomic nervous system 6, 5.
- The immune system can be compromised by cocaethylene, and alcohol use disorders can lead to depressive episodes, severe anxiety, insomnia, and suicide 4, 6.