Cocaethylene is the name of a unique chemical that forms in the liver when people simultaneously use cocaine and alcohol (known chemically as ethyl alcohol or ethanol). This formation occurs when the presence of ethyl alcohol interferes with the body’s attempts to eliminate cocaine circulating in the bloodstream. According to several different scientific studies published in the 2000s, the presence of cocaethylene produces a feeling of euphoria more powerful and longer lasting than that produced by cocaine alone. In addition, the chemical can apparently trigger a number of serious or potentially fatal health risks, including increased chances of experiencing a heart attack, increased chances of dying suddenly, and indirect encouragement of excessive short-term alcohol intake.
Your liver acts as your body’s main organ of detoxification. When you use substances that can accumulate in your system and either kill you or seriously degrade your health, they get passed through your bloodstream to your liver tissue, where natural processing (metabolism) gradually breaks them down so they can eventually be eliminated in your urine. Alcohol and cocaine both qualify as toxic substances that can kill you in high concentrations; therefore, when they build up in your body, they get sent to your liver for metabolic processing. As stated previously, chemists refer to alcohol as ethanol or ethyl alcohol; cocaine is known chemically as benzoylmethylecgonine. Cocaethylene, known chemically as ethylbenzoylecgonine, forms when the natural metabolic processing of cocaine in the liver is altered by the presence of ethyl alcohol. Roughly 20 percent of cocaine processing gets disrupted by alcohol; in turn, when the liver tries to eliminate cocaethylene, the presence of alcohol also slows down this processing by roughly 20 percent. Typically, the liver starts producing cocaethylene within roughly two hours after the combined use of cocaine and alcohol. When consumption of alcohol disrupts cocaethylene elimination, significant amounts of the chemical pass from the liver, enter the bloodstream and eventually reach the brain. Inside the brain, the chemical accesses the same receptor sites on individual brain cells that also respond to the presence of cocaine. According to experts at Medscape Reference, brain analysis shows that triggering of these receptors by cocaethylene and cocaine produces roughly the same euphoric effects. However, in combination with the intoxicating effects of alcohol, cocaethylene can produce overall effects that feel much stronger to the user than alcohol alone or cocaine alone.
Unfortunately, when your liver processes toxic substances, the end product of this processing is sometimes more toxic than the original substance; this situation appears to hold true for comparisons between cocaethylene and cocaine. No one knows for sure exactly how toxic cocaethylene is to the human body, but laboratory studies of dogs and mice indicate that it may have a toxicity level as much as 30 percent higher than cocaine itself. Once cocaethylene production starts, the liver keeps pumping out the chemical for a number of hours; in addition, after it forms, it stays in the body approximately three times longer than cocaine. Some researchers believe that cocaethylene toxicity probably accounts for a significant percentage of the sudden, unexplained fatalities that sometimes occur in cocaine users. Cocaethylene toxicity may also play a significant role as an underlying cause of many cocaine-related heart attacks, but reputable researchers disagree on this point. For instance, researchers at the U.S. government’s Substance Abuse and Mental Health Services Administration point to cocaethylene as a major potential cause of cardiovascular damage in young cocaine users. However, research reported in the “American Journal of Emergency Medicine” contradicts this finding.
Encouragement of Increased Alcohol Consumption
The presence of cocaethylene appears to encourage a “more is better” approach to alcohol consumption. For example, according to a study published in 2006 in the magazine Druglink, people who snort cocaine and then consume alcohol often end up drinking for longer periods of time than they normally do, and also significantly increase their overall alcohol intake. In fact, nearly half of the study participants took part in cocaine-fueled drinking sessions that lasted for 12 hours or longer. This kind of excessive alcohol consumption, known as binge drinking, can trigger health consequences that include accidental injuries, self-inflicted injuries, alcohol poisoning, liver damage, nerve damage, heart disease, high blood pressure, uncontrolled blood glucose, and impotence or other forms of sexual dysfunction. Potential social and legal consequences of binge drinking include acts of intentional violence, unwanted pregnancy, and arrest and incarceration for driving while intoxicated. Some cocaine users understand the link between cocaine use and an increased capacity for alcohol consumption; as a result, they purposefully use cocaine before and during a night of drinking.