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Mixing Cocaine With Alcohol, Heroin, and Other Drugs

Mixing Cocaine With Alcohol, Heroin, and Other Drugs

While cocaine alone can be dangerous enough, the mixing of cocaine with other drugs is not only common, it also makes cocaine use more dangerous. It is important to understand the problems that can arise when cocaine is mixed with other drugs.

What Happens When You Mix Cocaine With Other Drugs?

Cocaine is a stimulant that can make a person feel alert, energetic, and elated. Whether it’s snorted, smoked, or injected, there are a number of dangerous side effects that come along with using cocaine. These include significant health risks like cardiovascular problems and breathing issues. When cocaine is mixed with other drugs, these side effects are greatly increased.

Why Do People Mix Drugs?

Cocaine is a powerful stimulant that affects the central nervous system (CNS). It’s often used with a variety of other drugs, including a class of drugs called “club drugs.” These include MDMA, GHB, ketamine, meth, and LSD.1 Users mix drugs to intensify the feelings of euphoria that cocaine produces. No matter what type of drug is mixed with cocaine, there is the potential for serious side effects2

Mixing Cocaine with Alcohol

Even on its own, cocaine can negatively impact cardiovascular health. When consumed, cocaine leads to elevated heart rates and a spike in blood pressure. That’s because cocaine is a stimulant that excited the normal patterns of the body.8

When alcohol is consumed concurrent to cocaine use, the cardiovascular impact is much greater. It puts a person at greater risk for long-term cardiac diseases like heart attacks and permanent changes in heartbeat patterns. People who struggle with cocaine addiction might mix it with alcohol in an attempt to reduce cocaine’s negative effects like anxiety. Alcohol is a depressant, so it has the opposite effect of stimulant drugs like cocaine.3 Combining cocaine and alcohol creates a chemical called cocaethylene. It forms in the liver when cocaine and alcohol exist in the blood. This chemical can build up over time and cause sudden death.

Mixing alcohol and cocaine will cause different side effects in each person. However,  these can include the following:3

  • ComaWhen alcohol is consumed concurrent to cocaine use, the cardiovascular impact is much greater.
  • Chest pain
  • Confusion
  • Heart palpitations
  • HIV or hepatitis
  • Irritability
  • Malnutrition
  • Nausea and vomiting
  • Seizures
  • Stroke
  • Traumatic injuries due to violence

Recent research suggests that over half of cocaine-dependent people are also alcohol dependent. This shows the close link between these two substances. Both drugs are often associated with partying and nightlife activities, so they’re often mixed in social settings.10

 Mixing Heroin and Cocaine

Heroin and cocaine use has its own term within drug culture. It’s called speed balling.4 Cocaine might help decrease the uncomfortable withdrawal symptoms of opioid addiction.5 Ultimately, the combination greatly increases the chances of an overdose.4

Speedballing typically includes injecting both drugs right into the bloodstream, but sometimes they’re snorted together. Users claim that this increases the length and intensity of a high.

The side effects most commonly associated with using these drugs together primarily affects the brain. For those who use both cocaine and heroin concurrently, they will experience serious physical side effects Ultimately, combining these drugs has a very high risk for unpredictable side effects.3,4,5

Physical side effects include:

  • Confusion
  • Blurred vision
  • Drowsiness
  • Paranoia
  • Uncontrollable movements

Long-term side effects impact the major organs of the body and put a person at risk for respiratory failure, stroke, or heart attack. Frequent speed ball users will also often experience episodes of severe depression.

Avoid Any Drug Combinations

When combined with cocaine, most drugs will produce disastrous results. It’s exceptionally important to exercise caution when mixing drugs. Often, the mixture will lead to overdose and potentially death. There are always long-term ramifications of using drugs together, even if the effects aren’t immediately evident.7

Treatment for Addiction to Cocaine and Other Drugs

Group Therapy for cocaine addiction

When you’re prepared to take the first step to sober living, you might wonder what kind of services are offered in rehab centers. Most rehabs that treat cocaine and other substance abuse addiction will provide you with a comprehensive approach to getting clean. Each facility operates under its own standard order of procedures, but most will follow a pattern similar to this one.

  • Intake evaluation: This provides the treatment team with enough information to create an individualized treatment program designed specifically to suit your needs. They will evaluate the severity of the addiction, possible comorbid mental health disorders, and your physical condition.
  • Detoxification: The treatment facility can provide you with medically managed detoxification, if applicable, in order to alleviate unpleasant withdrawal symptoms, while providing you with around-the-clock medical care.
  • Psychiatric care: Many people who suffer from a substance addiction or poly-drug addiction also have a mental health disorder. The best recovery centers are experienced in treating mental health issues in addition to addiction.

There are generally four different types of rehabs, and depending on your particular situation, one will be best for you.

  • Inpatient rehab: Inpatient rehab centers allow you to live at the facility while receiving 24-hour medical and psychiatric care. This provides you with the opportunity to escape your everyday, stressful environment in order to focus solely on your addiction.
    • Luxury: Luxury treatment centers provide you with extra amenities, such as horseback riding, spa treatments, yoga, meditation, and private rooms, and more closely resemble resorts. These recovery centers typically cost more than traditional inpatient facilities due to the added services.
  • Outpatient treatment: Although not recommended for those suffering from a severe addiction, this type of recovery program allows you to live at home while receiving addiction treatment when it works best with your schedule. This option is valuable for those who have home, school, or work obligations to meet.
  • Sober living homes: Sober living homes are often part of an aftercare program designed by a treatment team. They are group homes that provide a substance-free environment for individuals in recovery. People often reside at sober living homes upon completing an inpatient treatment program. These homes allow the individual to come and go as they please, but they may have to abide by a curfew and agree to consistent drug tests to ensure sobriety.

If you have mixed cocaine with other drugs, it’s important to get the help you need to get back on track. Don’t put your health in danger.


  1. Parsons, J. T., Grov, C., Kelly, B.C. (2009). Club Drug Use and Dependence Among Young Adults Recruited Through Time-Space Sampling. Public Health Reports, 124(2), 246-54.
  2. Pennings, E.J., Leccese, A.P., Wolff, F.A. (2002). Effects of concurrent use of alcohol and cocaine. Addiction, 97(7), 773-783.
  3. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. (5th ed.). Washington, D.C.: American Psychiatric Publishing.
  4. National Institute of Drug Abuse. (2013). Cocaine.
  5. Leri, F., Bruneau, J., Stewart, J. (2003). Understanding Polydrug Use: Review of Heroin and Cocaine Co-use. Addiction, 98(1), 7-22.
  6. Jaffe, J. A., Kimmel, P.L. (2006). Chronic Nephropathies of Cocaine and Heroin Abuse: A Critical ReviewClinical Journal of the American Society of Nephrology 1(4), 655-667.
  7. Gouzoulis-Mayfrank, E. (2006). The Confounding Problem of Polydrug Use in Recreational Ecstasy/MDMA Users: A Brief OverviewJournal of Psychopharmacology 20(2), 188-193.
  8. Higgins, S.T., Rush, C.R., Hughes, J.R., Bickel, W.K., Lynn, M., Capeless, M.A. (1992). Effects of cocaine and alcohol, alone and in combination, on human learning and performanceJ Exp Anal Behav, 58(1):87–105.
  9. Pennings, E.J., Leccese, A.P., Wolff, F.A. (2002). Effects of concurrent use of alcohol and cocaine. Addiction, 97(7), 773-783.
  10. European Monitoring Center for Drugs and Drug Addiction.  European Drug Report 2019.

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