Cocaethylene – a personal account and commentary

This blog was provided as an education piece by the person who experienced health problems from the combination of cocaine and alcohol and discovered a worrying lack of knowledge on it in health practitioners.

In 2023, the potentially catastrophic consequences of mixing alcohol and cocaine became very real to me, when I made this error myself. Amongst other historically well documented, near universally known dangers of alcohol and cocaine as individual substances, knowledge of the effect they have when combined is much less common. I made this discovery when the paramedics treating me that night admitted they didn't know this information when I flagged it up as relevant. This is extremely concerning in light of just how dangerous this particular presentation is, suggesting a thorough programme of education and committed public discussion is needed on the issue if standards are to be improved. 

The research context and empirical certainty on cocaethylene 

The specific narcotic combination of alcohol and cocaine is so dangerous because they fuse in the body to create a potent new compound, cocaethylene. Current scientific consensus forms around the fact cocaethylene, and its level of concentration in the bloodstream, makes adverse, life changing, often fatal outcomes more likely, by a  significant extent. In effect, cocaethylene is a longer lasting and therefore more harmful variant of cocaine This is conclusively evidenced by research, in various disciplinary fields concerned with the study of drugs and their effects, the dangers of cocaethylene now being an accepted fact of empirical knowledge.

Because these disciplines and their research intersect, they collectively develop a versatile range of possible advisory insights based on the data and insights they supply. This has potentially vast beneficial applications, both socially and for individuals. Where policy, guidelines and practice are adapted in adherence to evidence, and with the objective of maximising positive outcomes, a cumulative social improvement is set in motion, one that that saves lives and makes medical care better.

The specific issue I aim to advocate for here is improving the level of education of health care professionals on the effects of cocaethylene, based on aforementioned experiences of being treated by paramedics who just didn't know. Their willingness to listen to and absorb what I had to say to them, their thanks and appreciation for being told, made an impression on me that made me think there is an opportunity to make this common knowledge, sadly being missed.

Why cocaethylene education matters 

How education of health professionals is organised and implemented is obviously a complex, multifaceted operation, and rolling out a comprehensive education on cocaethylene would take careful and detailed planning. Despite the logistical complexity, it would be still be a purposeful and worthwhile undertaking. 

Public administration can only benefit from shifting to an evidence led direction. In the case of the dangers of cocaethylene, it begins with attention to designing education pathways that shape and build better treatment and better outcomes. Spheres of policy pertaining to drugs and the treatment of those affected by them stands to gain huge improvements from such an approach. Restricted knowledge of the effects of specific narcotic interactions seems like a problem that an embrace of empiricism could address.

At the same time as numbers of people mix substances and go blind into battle with the consequences, the people providing critical medical care are not guaranteed to know what they need to. There is significant potential to save lives, prognoses and outcomes in emergency care and critical intervention in cocaethylene related overdoses. Even with the conscientiousness and impressive training of paramedics, total possession of facts is not guaranteed, and it is the conscientiousness of the paramedics that has inspired me to think more about what can be done to help people. 

Conclusion

To conclude, there is a clearly identifiable need for a proper educational pathway for carrying full understanding of the effects of cocaethylene to health care professionals and frontline responders. Such an undertaking could be a powerful form of action to improve health care education with potential for massively beneficial clinical results. As well as the obvious medical outcomes, the existing context of policymaking, with a significant lobby for evidence led policy, makes cocaethylene education an issue that can address multiple issues.