Skip to main content
SpringerLink
Log in

Concurrent cocaine-ethanol ingestion in humans: pharmacology, physiology, behavior, and the role of cocaethylene

Psychopharmacology volume 111, pages 39–46 (1993)Cite this article

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, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  • Abelson HI, Miller JD (1988) A decade of trends in cocaine use in the household population. NIDA Res Monogr 61:35–49

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • Cregler LL, Herbert M (1986) Medical complications of cocaine abuse. N Engl J Med 315:1495–1500

    Google Scholar 

  • 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

    Google Scholar 

  • Fleming JA, Byck R, Barash PG (1990) Pharmacology and therapeutic applications of cocaine. Anesthesiology 73:518–531

    Google Scholar 

  • Foltin RW, Fischman MW (1989) Ethanol and cocaine interactions in humans: cardiovascular consequences. Pharmacol Biochem Behav 31:877–883

    Google Scholar 

  • Gawin FH, Ellinwood EH (1988) Cocaine and other stimulants-actions, abuse, and treatment. N Engl J Med 318:1173–1182

    Google Scholar 

  • Gradman AH (1988) Cardiac effects of cocaine. A review. Yale J Biol Med 61:137–147

    Google Scholar 

  • Grant BF, Harford TC (1990) Current and simultaneous use of alcohol with cocaine: results of a national survey. Drug Alcohol Depend 25:97–104

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • Jaffe J, Cascella NG, Kumor KM, Sherer MA (1989) Cocaine-induced cocaine craving. Psychopharmacology 97:59–64

    Google Scholar 

  • Jatlow P (1988) Cocaine: analysis, pharmacokinetics, and metabolic disposition. Yale J Biol Med 61:105–113

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • Kuhar MJ, Ritz MC, Boja JW (1990) The dopamine hypothesis of the reinforcing properties of cocaine. TINS 14:299–302

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • 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

    Google Scholar 

  • Statistical Consultants, Inc. (1986) PCNONLIN and NONLIN84: software for the statistical analysis of nonlinear models. Am Statist 40:52

    Google Scholar 

  • 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

    Google Scholar 

  • Weiss RD, Mirin SM, Griffin ML, Michael JL (1988) Psychopathology in cocaine abusers — changing trends. J Nerv Ment Dis 176:719–725

    Google Scholar 

  • Wilkinson P, Van Dyke C, Jatlow P, Barash P, Byck R (1980) Intranasal and oral cocaine kinetics. Clin Pharmacol Ther 27:386–394

    Google Scholar 

  • Zsoter TT, Sellers EM (1977) Effect of alcohol on cardiovascular reflexes. J Subst Abuse 38:1–10

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Neuroscience Research Unit, Abraham Ribicoff Research Facilities, 34 Park Street, 06 508, New Haven, CT, USA

    Elinore F. McCance-Katz, Lawrence H. Price, Christopher J. McDougle & Jed E. Black

  2. Substance Abuse Treatment Unit, Connecticut Mental Health Center, 34 Park Street, 06 508, New Haven, CT, USA

    Elinore F. McCance-Katz & Thomas R. Kosten

  3. Department of Psychiatry, Yale University School of Medicine, 333 Cedar Street, 06511, New Haven, CT, USA

    Elinore F. McCance-Katz, Lawrence H. Price, Christopher J. McDougle, Thomas R. Kosten, Jed E. Black & Peter I. Jatlow

  4. Laboratory Medicine, Yale University School of Medicine, 333 Cedar Street, 06511, New Haven, CT, USA

    Peter I. Jatlow

Authors
  1. Elinore F. McCance-Katz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lawrence H. Price
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christopher J. McDougle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas R. Kosten
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jed E. Black
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Peter I. Jatlow
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints 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

Download citation

  • Received:

  • Revised:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02257405

Key words

search

Navigation