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Mixing Cocaine With Alcohol, Heroin, and Other Drugs

What Happens When You Mix Cocaine With Other Drugs?
Drugs people commonly use with cocaine include alcohol, heroin, ecstasy, and ketamine. People often mix the drugs to intensify the high, often at parties. Mixing cocaine with alcohol can lead to chest pain, heart palpitations, irritability, and seizures. Mixing cocaine with heroin can lead to nosebleeds, problems swallowing, severe itching, and depressed breathing. In both cases, the person may not be aware they are overdosing until it is too late.

Most people know cocaine is a stimulant that can make you feel alert, energetic, and elated. Whether you snort, smoke, or inject it, cocaine has a number of side effects and carries a number of health risks—from cardiovascular problems to the development of substance addiction. These effects are compounded and made more dangerous when mixed with other drugs.

Why Do People Mix Cocaine with Other Drugs?

Cocaine, which is a powerful central nervous stimulant, is commonly abused with other substances, including club drugs such as ecstasy or MDMA, gamma-Hydroxybutyrate (GHB), ketamine, methamphetamine, and LSD. Adolescents and young adults tend to abuse these drugs in rave or party settings.1 As many as 14% of young adults have reported cocaine use and about 15% have abused ecstasy or MDMA.1 In these cases, the drugs are mixed to enhance a euphoric effect in the party atmosphere.

Alcohol is another common drug combined with cocaine, and the reasons may include: 2

  • To intensify the cocaine high.
  • To reduce feeling of drunkenness.
  • To alleviate unwanted symptoms while coming down from cocaine.
If you want help for drug dependence or cocaine addiction for yourself or someone you know, we can assist you. Call our helpline at 1-888-744-0789 Who Answers? to speak to recovery support advisors about various forms of treatment.

Mixing Cocaine with Alcohol

Cocaine on its own can negatively impact your cardiovascular health, leading to dangerously elevated heart rate, vasospasm, and a spike in blood pressure. When you drink alcohol while using cocaine, the cardiovascular impact is compounded, and may hasten the onset of long-term cardiac disease such as cardiomyopathy, pathological arrhythmias, and even myocardial infarction (heart attack).

The National Institute on Drug Abuse explains that combining cocaine and alcohol causes your body to create a chemical called cocaethylene, which can build up over years of time or cause sudden death, and is more dangerous than either cocaine or alcohol on their own.

A 2009 Drug Abuse Warning Network report discovered that the numbers of those who mix alcohol and cocaine is high, reporting that more than 150,000 emergency department visits were associated with concurrent alcohol and cocaine use.

Mixing alcohol and cocaine may cause the following effects:3

  • Chest pain
  • Heart palpitations
  • Confusion
  • Stroke
  • Seizures
  • Coma
  • Nausea and vomiting
  • Irritability
  • HIV or hepatitis
  • Malnutrition
  • Traumatic injuries due to violence

Mixing Heroin and Cocaine

When heroin and cocaine are abused concurrently, this comorbid use is called “speed balling.”4 And while cocaine can decrease the uncomfortable withdrawal symptoms associated with opioid addiction (one reason people mix these drugs),5 the combination greatly increases the odds of a fatal overdose.4

Effects of concurrent heroin and cocaine use include:3,4,6

  • Renal disease.
  • Breakdown of muscle tissue.
  • Nosebleeds.
  • Problems swallowing.
  • Nasal septum perforation.
  • Contraction of hepatitis or HIV.
  • Abscesses.
  • Track lines.
  • Collapsed veins.
  • Anxieties.
  • Irritability.
  • Paranoia.
  • Depressed breathing.
  • Severe itching.
  • Coma.
  • Drowsiness.
  • Dizziness.

Heroin and cocaine cause many opposing effects in your body. Because of this, you might not realize you are overdosing on one of the drugs until it is too late.

In addition, snorting a combination of cocaine and heroin may lead to breathing problems, notably a condition called bronchial hyperreactivity, often an indicator of prolonged asthma.

Avoid Any Drug Combinations

Many other drugs not discussed here, when combined with cocaine, could still create serious physical problems. Be exceptionally cautious about mixing drugs since the mixture can affect your body differently than if you took each drug individually.

Mixing drugs frequently leads to overdose and potentially death. As previously mentioned, the combination of cocaine and alcohol, as well as that of cocaine and club drugs occurs frequently. Cocaine and MDMA is a particularly dangerous mix, capable of creating neurotoxicity and amplifying long-term ramifications.7

Treatment for Addiction to Cocaine and Other Drugs:

Group Therapy for cocaine addictionAny rehab that treats addictions to cocaine and another substance will provide you with the following services:

  • 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.
  • 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; call us today at 1-888-744-0789 Who Answers? for help finding a program that can treat your specific situation.


  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 Review. Clinical 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 Overview. Journal of Psychopharmacology 20(2), 188-193.