Cocaethylene—ethanol adding fuel to cocaine’s fire

Research output: Chapter in Book/Report/Conference proceedingChapter


Cocaethylene is formed by the transesterification of cocaine by liver carboxylesterase in the presence of ethanol and produces a stronger subjective euphoria compared to cocaine. However, animal and human studies have shown a much greater risk of toxicity associated with cocaethylene. Adverse effects of cocaethylene include increased hypertension and systemic vascular resistance, decreased myocardial function, slowed cardiac conduction, arrhythmias, and immunologic compromise. Herein, we present a case of a middle-aged female suffering from severe congestive heart failure and cocaine abuse who was suspected to have cocaethylene as a contributing factor to an acute heart failure exacerbation with pneumonia.

Original languageEnglish (US)
Title of host publicationToxicology Cases for the Clinical and Forensic Laboratory
Number of pages2
ISBN (Electronic)9780128158463
ISBN (Print)9780128163733
StatePublished - Jan 1 2020


  • Cocaethylene
  • arrhythmias
  • carboxylesterase
  • cocaine
  • congestive heart failure
  • hypertension
  • transesterification

ASJC Scopus subject areas

  • General Medicine


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