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February 26, 1992

Cocaine, Alcohol Mix in Body to Form Even Longer Lasting, More Lethal Drug

JAMA. 1992;267(8):1043-1044. doi:10.1001/jama.1992.03480080013002

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RESEARCHERS have demonstrated probably for the first time that, in the presence of two drugs, the body creates a third.

The discovery is not just an interesting pharmacologic phenomenon, however, but a serious health concern because of the two drugs involved—cocaine and alcohol. And for the 12 million people who combine these drugs every year, it is sobering news.

In the presence of cocaine and ethanol, the liver metabolizes cocaine to its ethyl homologue, called cocaethylene. That much has been known since 1978. But what wasn't known is that cocaethylene is a neurologically active compound that provides the same feelings of euphoria and well-being as cocaine, only more intensely and for longer periods. It is probably more addictive than the parent drug, and it is certainly more lethal.

Dopamine Mediates the Hook  Previous studies have shown that cocaine acts on the central nervous system (CNS) by blocking the reuptake of

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