When people choose to take mind-altering substances, they usually decide what to take based on the desire to achieve a specific effect. This is why people may combine substances to enhance that desired effect. Many people take one substance to achieve a desired effect and then take another substance to counteract the effects of the first. For example, combining uppers and downers; stimulants and depressant drugs. To understand why people combine a stimulant drug with a depressant drug, let us explore the effects of cocaine (a stimulant) and alcohol (a depressant).

Understanding Alcohol Abuse

Millions of people in the United States drink alcohol. If you are 21, it is a legal way to relax and socialize, but just because it is legal doesn’t mean it is always the responsible way to relax. Unfortunately, many individuals in the United States become too dependent on alcohol and develop an alcohol use disorder (AUD). In 2012 alone, statistics showed that 17 million adults, ages 18 and older, suffered from an alcohol use disorder, formally called alcoholism. Alcohol use disorders are not the only way individuals can abuse alcohol. People who drink but do not develop an AUD may still be at risk of drinking heavily or binge drinking.

When another substance comes into play, especially one that counteracts certain effects of the drug, alcohol use disorder becomes even more dangerous. Many people use alcohol to let loose and feel carefree. The relaxing effect of alcohol is often blocked when a drinker uses cocaine and alcohol at the same time. Fortunately, the “abuse of cocaine and alcohol has been gradually decreasing” but “these two substances still affect thousands of people all over the United States.” Mixing cocaine and alcohol is a dangerous combination that is all too common among people in the United States who want to party all night while experiencing the effects of both drugs. Their interaction, however, does not work as well as that.

Understanding Cocaine Abuse

Before we can understand how cocaine interacts with alcohol, we first need to learn how cocaine impacts the body. Cocaine is a stimulant drug that is also overly abused by people in the United States. Unlike alcohol consumption, cocaine use is illegal. Cocaine can be used in a powdered form or as crack cocaine. The powdered form of cocaine is the street version of the drug and is a fine, white, crystal powder. To increase profits, many cocaine dealers mix the substance with things like “cornstarch, talcum powder, or flour” and may “also mix it with other drugs such as the stimulant amphetamine, or synthetic opioids including fentanyl.” These extra substances make a dangerous compound, as “adding synthetic opioids to cocaine is especially risky when people using cocaine don’t realize it contains this dangerous additive. Increasing numbers of overdose deaths among cocaine users might be related to this tampered cocaine.”

Whether the user knows if the cocaine has an additive or not, they most likely will proceed with its use. In most cases, people snort the powdered form through their noses or rub it into their gums. The powder can also be dissolved and injected into the bloodstream. Once cocaine is processed, it is called “freebase cocaine”. In the heating process, the crystal rock makes a crackling sound. The crystal is heated to create vapors that can be inhaled into the lungs. Cocaine can also be used with other substances. A stronger combination than cocaine and alcohol is cocaine and heroin, known as a speedball. Some users choose to smoke Crack by sprinkling it into marijuana or tobacco before smoking.

Cocaine users often binge, “taking the drug repeatedly within a short time, at increasingly higher doses – to maintain their high.” The need to binge on the drug shows how addictive cocaine is. Dopamine, the neurotransmitter associated with pleasure, floods into the brain after being exposed to the drug, controlling emotion and reward response. Then, “the brain’s reward circuit strongly reinforces drug taking behaviors.” The short-term symptoms of cocaine use include:

Extreme happiness
Extreme energy
Mental alertness
Hypersensitivity to light, sound, and touch
Irritability
Paranoia

Unlike alcohol, cocaine’s symptoms surface almost immediately and can dissolve anywhere within a few minutes to an hour. The duration of the effect of cocaine is affected by how it is used. A high from snorting cocaine lasts anywhere from 15 to 30 minutes, while a high from smoking cocaine lasts anywhere from 5 to 10 minutes.

Mixing Cocaine and Alcohol

In 2015, a CDC survey was conducted titled the Youth Risk Behavior Survey (YRBS). The YRBS found that 5.2% of people surveyed reported that they had used cocaine before. This percentage from 2015 “represents a slow, steady decrease, as the highest percentage reported since 1991 was 9.5 percent in 1999.” In 2016, the Monitoring the Future Survey published by the National Institute on Drug Abuse showed that just 2.3% of 12th graders had tried cocaine in any form in the prior year. It’s debatable if the survey’s sample size was large enough to be conclusive, or if all participants were truthful in their responses. These statistics show a positive trend of decreasing cocaine use in young adults in the United States.

Unfortunately, not all trends involving cocaine use are going in the right direction. According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), “over half of cocaine-dependent individuals also suffered from alcohol dependency, highlighting the close link between these two addictive substances.” The EMCDDA investigated the drug’s connection and why people used these particular drugs together. The EMCDDA found that while these drugs are often used together in social settings, these drugs go hand in hand even outside of social settings “because the self-reported high associated with both is more intense than either drug alone.” These findings are alarming, as both drugs are highly addictive and can lead to abuse, addiction, dependence, and many short-term and long-term health consequences.

Effects of Combining Cocaine and Alcohol

When combining cocaine and alcohol, one drug may be consumed first, followed by the other. Going out and drinking, for example, is a popular way to socialize. When you drink, you’re under the influence, and you might say yes to something you would otherwise decline when sober. This lack of inhibition can lead you to use cocaine, whether by peer pressure or choice. In other social situations, cocaine may increase physical energy after drinking too much alcohol (a depressant drug). Someone might also use alcohol to reduce the stimulating effects of cocaine, like twitching and anxiety. Once cocaine and alcohol are taken simultaneously, it is very difficult to stop.

A common reason people begin to use these drugs is to self-medicate and dull depressive mood or emotional anxiety. Alcohol and drug use is a common coping mechanism. When the coping mechanism becomes polydrug use, there are multiple diagnoses at play. In most cases, people begin self-medicating to avoid understanding their symptoms and lack an appropriate diagnosis.

In fact, “people who struggle with bipolar disorder and schizophrenia are especially susceptible to substance abuse and polydrug patterns.” Studies have shown that a particular demographic is more likely to develop an alcohol use disorder; people with bipolar disorder. Why? In an attempt to “modulate mania associated with the condition” individuals with bipolar disorder will use alcohol and are also “at an increased risk of developing cocaine addiction to modulate the effects of the depressive episodes.” While these people with either diagnosed or undiagnosed bipolar disorder use these drugs to alleviate their symptoms, the combinations of drug use make mood disorders like depression, anxiety, and bipolar worse for a variety of reasons.

Whatever the reason is for mixing cocaine and alcohol use, this cocktail of drugs can be not only dangerous, but addictive, and lead to multiple diagnoses. Polydrug use is, unfortunately, more common than we like to think, and one drug does enough harm to the body alone when abused. Both drugs can cause damage to the user’s body and social and emotional well-being, while also increasing their risk of long-term, chronic health issues or overdose. The health dangers of one drug are enhanced by polydrug use and dual disorder diagnoses.

The good news is that at Boardwalk Recovery Center, our staff specializes in dual diagnosis treatment, whether that be polydrug use or substance use disorders and comorbid mental health disorders. At our facility, we are committed to getting to the root of each diagnosis and eliminating any drug use to take care of our clients’ baseline health.

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