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Author Topic: Cocaethylene [Cocaine+Alcohol]  (Read 10906 times)

Offline Chip (OP)

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Re: Cocaethylene [Cocaine+Alcohol]
« Reply #1 on: March 08, 2018, 02:22:09 PM »
I hate cocaethylene. Most days I take my ironic poor mans speedball of buprenorphine and coca tea. If I do not touch alcohol, the coca is great with no side effects or comedown, no habit forming reward behavior, could even sleep 90 minutes after a cuppa. However if I drink or even take alcohol base herbal tinctures, the cocaethylene will rock my world. Personally it is a problem becuz: 1)it lasts much longer than cocaine, ie hard to keep a good sleep cycle, also has somewhat of the psychostimulant comedown effect the next days 2)it is certainly habit forming and if I mix them more than once a week or so, my mind will stop enjoying stuff as much when not on cocaethylene, 3)I like to chain smoke tobacco (and sometimes hash) but buprenorphine isn't like morphine; where if you smoke half a pack and are feeling ill, a fix will cure it. Usually I would take alcohol to "comedown" and curb the edginess but now that I cant do that. 4)coca while tranquilizing at a lower dose, becomes slightly edgy around 6+ cups/day and again I can't use alcohol to chill out. I haven't taken benzos for almost 5 years now, horrible w/d, hope to never be caught in that hell again. Other than alcohol, benzo/gabaergics, gabapentinoids, what other chill out drugs/flora are there??
I usually end up drinking once a week or two anyway. Otherwise I would have to day drink to feed the hepatotoxic coke monkey...
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Offline Chip (OP)

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Re: Cocaethylene [Cocaine+Alcohol]
« Reply #2 on: May 25, 2023, 08:03:37 AM »
The last detox I went into (for alcohol) had to cocaethylene patients.

Cocaine is an extremely popular drug in Australia (no crack though) and as you know, alcohol is abundant.

Coke + alcohol use is quite socially acceptable.

Not for me - i don't like coke and can't drink alcohol.

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Offline Chip (OP)

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Re: More on the metabolite Cocaethylene [from Cocaine+Alcohol]
« Reply #3 on: September 08, 2023, 10:10:43 AM »
more on this at this source link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8956485/

Cocaethylene: When Cocaine and Alcohol Are Taken Together

Feb 22, 2022

Abstract

Cocaine is taken frequently together with ethanol and this combination produces a psychoactive metabolite called cocaethylene which has similar properties to the parent drug and may be more cardiotoxic. Cocaethylene has a longer half-life than cocaine, so that people who combine cocaine and ethanol may experience a longer-lasting, as well as more intense, psychoactive effect. Cocaethylene is the only known instance where a new psychoactive substance is formed entirely within the body. Although known to science for decades, cocaethylene has not been extensively studied and even its metabolic pathways are not entirely elucidated.

Like its parent drug, cocaethylene blocks the reuptake of dopamine and increases post-synaptic neuronal activity; the parent drug may also block reuptake of serotonin as well. Cocaethylene has been studied in animal models in terms of its pharmacology and its potential neurological effects. Since the combination of cocaine and alcohol is commonly used, it is important for clinicians to be aware of cocaethylene, its role in prolonging or intensifying cocaine intoxication, and how it may exacerbate cocaine-induced cardiovascular disorders.

Most cardiac-related risk assessment tools do not ask about cocaine use, which can prevent clinicians from making optimal therapeutic choices. Greater awareness of cocaethylene is needed for clinicians, and those who use cocaine should also be aware of the potential for polysubstance use of cocaine and ethanol to produce a potentially potent and long-lasting psychoactive metabolite.

Introduction and background

Cocaine is a sympathomimetic that affects a variety of receptors in the body, releasing specific catecholamine and blocking their reuptake at certain sites. In the short term, cocaine acts as a vasoconstrictor and subjects who use cocaine present with dilated pupils, elevated body temperatures, rapid heart rates, and high blood pressure. At higher doses, cocaine may induce behavioral changes including paranoia, aggression, and violence; cocaine has potentially life-threatening cardiotoxic effects.
When cocaine and ethanol are used together, a psychoactive metabolite is produced with similar pharmacological and psychoactive properties as cocaine. This metabolite, cocaethylene, is considered more toxic to the cardiovascular and hepatic systems than cocaine, the parent drug, and it has a longer plasma elimination half-life (about 2 hours) than cocaine (about 1 hour). There are other metabolites produced as well but they go beyond the scope of this review.

The serum concentration of cocaethylene is not readily predictable because it is based on the timing of the use of ethanol with cocaine and the quantities used. While cocaethylene is often encountered in clinical work, it has not been the subject of extensive investigation and there may be a lack of clinical understanding of this metabolite and its role in overdose toxicity, cocaine-induced heart disease, and drugged driving.

Polysubstance use disorder is prevalent among recreational drug users, including cocaine users, and ethanol is frequently combined with cocaine. Cocaine is a stimulant that can produce feelings of euphoria, but as it wears off anxiety may arise; alcohol is sometimes used with cocaine to enhance the effects of cocaine, prolong the cocaine high, or to soften the sometimes abrupt “bumps” in cocaine use. Some people using cocaine may take alcohol for no other reason than it is available at the time.

In a study of 2,016 intoxicated drivers who submitted to drug and alcohol testing, 6.0% (n=131) were polysubstance users and, of that group, 5.6% were using cocaine and alcohol concurrently. A prospective study of 417 trauma patients ≥13 years found that 8.9% had cocaethylene metabolites in their system, indicating the concurrent use of cocaine plus ethanol. In this study of people seeking medical care for trauma, the presence of cocaethylene significantly increased the probability of intensive care unit (ICU) admission (odds ratio 5.9). In another single-center study of 15 male trauma patients, 13/15 had detectable cocaethylene in their system upon admission.

While cocaethylene is detectable in many drug assays and is well known to forensic professionals, clinicians may be less aware of cocaethylene and its possible effects on the clinical outcomes of cocaine-using patients. The goal of our narrative review is to present a clinically relevant overview of the cocaethylene metabolite. The PubMed database of the National Institute of Medicine was searched in August 2021 for “cocaethylene” with 473 results. When using PubMed, we also used the “similar articles” feature, when available, to find related articles. When the search was narrowed to the past five years, there were 63 results. The Embase database was searched and presented 542 results. The Web of Science database was searched with two results. Although the Cochrane Library is included in PubMed, it was searched independently, and there were 17 meta-analyses. This search formed the basis of the literature used in this report. Emphasis was placed on newer (<5 years) research but some important research about cocaethylene was conducted 20 or more years ago.

The article continues at the source link at the top of this post
« Last Edit: September 08, 2023, 10:43:23 AM by Chip »
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