The Effects of Mixing Cocaine and Alcohol

Patients without pre-existing chronic sleep disturbances demonstrated lower ratings of sleep (Pittsburgh Sleep Quality Index [PSQI]) and daytime sleepiness (Epworth Sleepiness Scale [ESS]) compared to healthy sleepers. Oyefeso et al. [151] reported inadequate sleep quality and quantity as well as difficulty initiating and maintaining sleep in persons with opioid use disorders in early stages of methadone detoxification. Similar studies have shown some increased daytime drowsiness and below normal sleep measures in this patient population [113, 114, 134, 204]. After longer periods of MMT, however, there is some degree of tolerance to these effects [206], and sleep difficulty is shown to be present only in the first 6–12 months of MMT [158, 193]. Similar to clinical studies examining sleep latency and SWS, REM sleep measurements appear to be important in clinical outcomes, but with conflicting results.

The serum concentrations of cocaethylene depend on both the amount and timing of the two agents (cocaine and ethanol) consumed. People who use cocaine without any ethanol would have no measurable amount of cocaethylene in their system, but the ingestion of even small amounts of ethanol may result in production of cocaethylene [3]. Likewise, people who consume ethanol but take no cocaine or very little cocaine would not produce cocaethylene [40]. The greatest cocaethylene production would theoretically occur in a person who has a relatively high blood-alcohol level at the point in which they used cocaine [40]. In real-world clinical practice, it can be very difficult to predict cocaethylene concentrations in the blood, even when the exact amounts and timing of alcohol and cocaine use are known. The longer half-life of cocaethylene means that its measurable presence in the blood indicates that the person had used cocaine, even if cocaine is no longer detectable [3].


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. Most of this evidence comes from studies reporting results from the first few weeks of abstinence, including acute withdrawal [196], subacute withdrawal (i.e. days 8 and 12); [106] (Table 2), and beyond Top 5 Tips to Consider When Choosing a Sober House for Living [26, 69, 83, 127]. Several studies examining sleep in persons with alcohol use disorders also reported data on fragmentation of sleep. Sleep fragmentation reflects awakenings or switching from a deeper to a lighter stage of sleep, and is measured by the number of switches from one stage of sleep to another, the number of awakenings, and the time spent awake after sleep onset.

Cocaine is a profoundly addictive stimulant drug that produces euphoria, increased energy, and talkativeness. It is most often snorted or dissolved in water and injected into a vein. Due to the short duration of pleasurable effects, many users will binge on cocaine (repeatedly use the stimulant each time the effects begin to wear off). This pattern of binging leaves the user vulnerable to developing an addiction to cocaine.

Why do people use alcohol and cocaine together?

A few decades ago—when it was glamorized in the entertainment industry as the hot drug of choice—teens showed an extremely high level of interest in cocaine, but rates of use among teens are dropping. Despite dropping rates, nearly 40,000 adolescents were cocaine users in 2014, according to the CBHSQ. The National Institute on Drug Abuse estimates that there are 1.5 million current cocaine users in the United States. Adults aged 18 to 25 have the highest rate of cocaine use, compared to other age groups.

cocaine and drinking

The measurements of sleep fragmentation provide some insight into the objective quality of sleep. Results from these studies show consistent deficiencies in objective sleep quality, with an increase in sleep stage switches compared to healthy controls from day 2 of abstinence to as far out as 1–2 years of abstinence [2, 106, 196]. Although it is known that alcohol can decrease sleep latency when consumed by healthy persons [124], chronic use leads to increased sleep latency, consistent with individual self-report.

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