Abstract
Simultaneous abuse of cocaine and ethanol is a common occurrence. Cocaethylene, the ethyl ester of benzoylecgonine, has been detected in the urine of patients reporting concurrent use of cocaine and ethanol, and high levels have been found in the blood of victims of fatal drug overdose. This placebo-controlled, double-blind study examined the pharmacokinetic, physiologic, and behavioral effects of dual cocaine and ethanol administration in humans (n=6). Cocaethylene was found in the plasma only after administration of both cocaine and ethanol, and appeared to be eliminated more slowly than cocaine. Plasma cocaine concentrations were significantly higher during cocaine/ethanol administration. Euphorigenic effects were both enhanced and prolonged, and heart rate was significantly increased, following cocaine/ethanol administration as compared to administration of cocaine or ethanol alone.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abelson HI, Miller JD (1988) A decade of trends in cocaine use in the household population. NIDA Res Monogr 61:35–49
Bradberry CW, Murphy E, Nobiletti J, Jatlow P, Roth RH (1991) Comparison of effects of cocaine and cocaethylene on dopamine and serotonin in vivo, using microdialysis. Soc Neurosci Abstr 348 [14]: 888
Cami J, de la Torre R, Farré M, Ortuno J, Segura J (1991) Cocainealcohol interaction in healthy volunteers: Plasma metabolic profile including cocaethylene. CPDD Annual Scientific Meeting Abstracts
Chiara GD, Imperato A (1990) Drugs abused by humans preferentially increase synaptic dopamine concentrations in the mesolimbic system of freely moving rats. Proc Natl Acad Sci USA 85:5274–5278
Cregler LL, Herbert M (1986) Medical complications of cocaine abuse. N Engl J Med 315:1495–1500
Fischman MW, Schuster CR, Hatano Y (1983) A comparison of the subjective and cardiovascular effects of cocaine and lidocaine in humans. Pharmacol Biochem Behav 18:123–127
Fleming JA, Byck R, Barash PG (1990) Pharmacology and therapeutic applications of cocaine. Anesthesiology 73:518–531
Foltin RW, Fischman MW (1989) Ethanol and cocaine interactions in humans: cardiovascular consequences. Pharmacol Biochem Behav 31:877–883
Gawin FH, Ellinwood EH (1988) Cocaine and other stimulants-actions, abuse, and treatment. N Engl J Med 318:1173–1182
Gradman AH (1988) Cardiac effects of cocaine. A review. Yale J Biol Med 61:137–147
Grant BF, Harford TC (1990) Current and simultaneous use of alcohol with cocaine: results of a national survey. Drug Alcohol Depend 25:97–104
Hearn WL, Flynn DD, Hime GW, Rose S, Cofino JC, Mantero-Atienza E, Wetli C, Mash DC (1991) Cocaethylene: a unique cocaine metabolite displays high affinity for the dopamine transporter. J Neurochem 56:698–701
Higgins ST, Bickel WK, Hughes JR, Lynn M, Capeless MA, Fenwick JW (1990) Effects of intranasal cocaine on human learning, performance and physiology. Psychopharmacology 102:451–458
Isner JM, Estes M, Thompson PD, Costanzo- Nordin MR, Subramanian R, Miller G, Kastas G, Sweeney K, Sturner WQ (1986). Acute cardiac events temporally related to cocaine abuse. N Engl J Med 315:1438–1443
Jaffe J, Cascella NG, Kumor KM, Sherer MA (1989) Cocaine-induced cocaine craving. Psychopharmacology 97:59–64
Jatlow P (1988) Cocaine: analysis, pharmacokinetics, and metabolic disposition. Yale J Biol Med 61:105–113
Jatlow P, Elsworth JD, Bradberry CW, Winger G, Taylor JR, Russell R, Roth RH (1991) Cocaethylene: a neuropharmacologically active metabolite associated with concurrent cocaineethanol ingestion. Life Sci 48:1787–1794
Javaid JI, Fischman MW, Schuster CR, DeKirmenjian H, Davis JM (1978) Cocaine plasma concentrations: relation to physiological and subjective effects in humans. Science 202:227–228
Jeffcoat AR, Perez-Reyes M, Hill JM, Sadler BM, Cook CE (1989) Cocaine disposition in humans after intravenous injection, nasal insufflation (snorting), or smoking. Drug Metab Dispos 17:153–159
Johnson RH, Eisenhofer G, Lambie GH (1986) The effects of acute and chronic ingestion of ethanol on the autonomic nervous system. Drug Alcohol Depend 18:319–328
Kuhar MJ, Ritz MC, Boja JW (1990) The dopamine hypothesis of the reinforcing properties of cocaine. TINS 14:299–302
Pettit HO, Ettenberg A, Bloom FE, Koob GF (1984) Destruction of dopamine in the nucleus accumbens selectively attenuates cocaine but not heroin self-administration in rats. Psychopharmacology 84:167–173
Rafla FK, Epstein RL (1979) Identification of cocaine and its metabolites in human urine in the presence of ethyl alcohol. J Anal Toxicol 3:59–63
Ritchie JM (1980) The aliphatic alcohols. In: Gilman AG, Goodman LS, Gilman A (eds) The pharmacological basis of therapeutics. Macmillan, New York, pp 376–386
Roberts DC, Corcoran ME, Fibiger HC (1977) On the role of ascending catecholaminergic systems in intravenous self-administration of cocaine. Pharmacol Biochem Behav 6:615–620
Roberts DC, Koob GF, Klonoff P, Fibiger HC (1980) Extinction and recovery of cocaine self-administration following 6-hydroxydopamine lesions of the nucleus accumbens. Pharmacol Biochem Behav 12:781–787
Rounsaville BJ, Anton SF, Carroll K, Budde D, Prusoff BA, Gawin F (1991) Psychiatric diagnoses of treatment-seeking cocaine abusers. Arch Gen Psychiatry 48:43–51
Smith RM (1984) Ethyl esters of arylhydroxy- and arylhydroxy-methoxycocaines in the urines of simultaneous cocaine and ethanol users. J Anal Toxicol 8:38–42
Statistical Consultants, Inc. (1986) PCNONLIN and NONLIN84: software for the statistical analysis of nonlinear models. Am Statist 40:52
Van Dyke C, Ungerer J, Jatlow P, Barash P, Byck R (1982) Intranasal cocaine: Dose relationships of psychological effects and plasma levels. Int J Psychiatry Med 12:1–13
Weiss RD, Mirin SM, Griffin ML, Michael JL (1988) Psychopathology in cocaine abusers — changing trends. J Nerv Ment Dis 176:719–725
Wilkinson P, Van Dyke C, Jatlow P, Barash P, Byck R (1980) Intranasal and oral cocaine kinetics. Clin Pharmacol Ther 27:386–394
Zsoter TT, Sellers EM (1977) Effect of alcohol on cardiovascular reflexes. J Subst Abuse 38:1–10
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
McCance-Katz, E.F., Price, L.H., McDougle, C.J. et al. Concurrent cocaine-ethanol ingestion in humans: pharmacology, physiology, behavior, and the role of cocaethylene. Psychopharmacology 111, 39–46 (1993). https://doi.org/10.1007/BF02257405
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF02257405