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Combining Cocaine with other Drugs – Interactions

Last updated on May 5th, 2023

The risks and effects of mixing Cocaine with other drugs varies. We’ve divided the risk factors into what we believe are three appropriate categories: “dangerous”, “unsafe”, and “caution”.

DANGEROUS:

  • αMT
  • Opioids: Stimulants (like cocaine) increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.
  • Tramadol: Tramadol and stimulants both increase the risk of seizures.
  • MAOIs: This combination is poorly explored.

UNSAFE:

  • Alcohol: Drinking while on stimulants (like cocaine) is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. Stimulants allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide combine, set an intake limit of how much you will drink each hour. Remember! You will feel the alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.
  • Dox: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic.
  • NBOMes and 2C-T-x: Cocaine and NBOMes/2C-T-x, both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.
  • PCP: This combination can easily lead to hypermanic states.
  • 5-MeO-xxT: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.
  • DXM: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

CAUTION:

  • Mushrooms, LSD, DMT, 2C-x and Mescaline: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.
  • Cannabis: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences.
  • Ketamine: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.
  • Amphetamines: This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine.
  • MDMA: Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.
  • Caffeine: Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.
  • GHB/GBL: Stimulants (like cocaine) increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise GHB/GBL can wear off and leave a dangerous concentration of cocaine behind.
  • MXE: Stimulants (like cocaine) taken with MXE can lead to hypermanic states much more easily, especially if sleep deprived.
  • Dealers don’t always sell what they say they’re selling. The chances of a dangerous side effects or overdose/overamping is increased when substances are misrepresented.

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