Harm Reduction information

This is the same harm reduction information we use in our drug & alcohol leaflets. Please feel free to use it in your own resources or websites. Alternatively, you can buy designed and printed versions of this information from the Substance shop.

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  • Only use for non-commercial purposes
  • Link to, or credit the Substance website
  • This email address is being protected from spambots. You need JavaScript enabled to view it. where you used the information


Cocaine and alcohol are increasingly being used together as a ‘straightener’ to keep the night going, allowing people to drink more alcohol and lessen the ‘comedown’ from cocaine. But when alcohol and cocaine are used together your body produces a third substance called Cocaethylene. The information in this booklet will help you minimise the risks caused by cocaethylene.

Cocaethylene effects

For some people, cocaethylene can increase the duration and the intensity of the ‘high’ caused by cocaine, but the downside, (yes, there always is one!) is that cocaethylene is also a toxic substance which can cause short-and long-term, physical and mental health problems for some people.

Cocaethylene risks


Cocaethylene can force your heart rate and blood pressure to higher levels than cocaine alone would. Even for perfectly healthy people, this can increase the chance of seizures, heart attacks and strokes. For anyone with an underlying heart condition, this is extremely risky. Cocaethylene increases the toxicity of cocaine in your body and slows down the rate at which your liver processes both cocaine and alcohol. This puts a greater strain on the liver and, over time, can cause serious damage.


The combination of the disinhibiting effect of alcohol and confidence inducing cocaine with the addition of cocaethylene leads to a heightened possibility of impulsive or reckless behaviour and even violence.


The combined effect of cocaine and alcohol can ruin sexual performance. It can make you feel horny but makes it more difficult for men to get hard and women to get lubricated. Both men and women will find it difficult to orgasm. As trying to climax can take longer, this can damage the penis, vagina and anus, leading to increased risk of sexually transmitted infections (STIs). Always use a condom and plenty of water-based lubricant like KY Jelly. Using a sexual stimulant like Viagra alongside cocaine and alcohol can put a massive strain on the heart. Not recommended!

Warning signs

There is nothing to suggest cocaethylene poses an increased risk of dependence than using either of the two substance on their own would. But you can become so used to using both together, that using one can start a craving for the other. As a result, a dependency for both can develop. Some of the warning signs are:           

  • Using larger amounts of alcohol and cocaine to get the same effect, or to cancel out the negative parts of either substance.
  • Spending time thinking about when you are going to use next.
  • Having problems at home, work or uni because of your behaviour or not doing what you should have.
  • Getting involved in violence or injuring yourself or others after a session.

Taking control

If you want to cut down or stop using alcohol and cocaine, the following advice may help.           

  • Use less alcohol and cocaine at each session and give yourself more time to recover between sessions.
  • Think about the negatives. These could be things like being skint and feeling crap all the time. Remind yourself of these when you feel the urge to use.
  • Avoid things that remind you of alcohol and cocaine. These could be a place or people you would normally use with. Take a break from your friends for a few weeks, avoid certain pubs and clubs. Do other things when you would normally be indulging.
  • Tell someone what you are doing or get a mate to join you. Having someone to talk to during your moments of weakness can make all the difference.
  • Don’t give up. It is possible to break the habit. If you don’t manage it the first time, don’t beat yourself up about it, you have taken the first step. Try again!

You can buy printed versions of this information in the Substance shop

You can commission the Substance graphic design studio to design a bespoke resource or public health campaign for your organisation.


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