There’s a chemical most people haven’t heard of . Yet it’s silently fuelling a mental health crisis in the UK. It doesn’t come in a bag or in a bottle, but it exists inside the body. It’s called cocaethylene, and it’s not only highly toxic, it significantly increases the risk of suicide when cocaine and alcohol are used together.

Let’s talk about why that matters more now than ever.

So, what exactly is cocaethylene?

When you take cocaine, your body breaks it down into several different compounds. On its own, it’s dangerous enough. But if you drink alcohol while the cocaine is still in your system, a chemical reaction takes place in your liver. That reaction produces cocaethylene . A substance that’s not only more potent than cocaine itself but also sticks around in the body for much longer.

Cocaethylene intensifies the euphoria that users feel. It makes the high stronger and longer-lasting, which might sound appealing at first glance . But here’s the sting in the tail: it also increases the toxic effects on the heart, liver, and most worryingly, the brain.

Why is this combination so dangerous?

I’ve worked for years with frontline addiction services across England, from South London to Sheffield, and I’ve lost count of the number of clients who didn’t know what cocaethylene was . Let alone how it was affecting their mental health.

Cocaine stimulates the central nervous system, while alcohol is a depressant. When combined, they create a brutal tug-of-war in the brain. Cocaethylene doesn’t level things out. It pushes the extremes: more manic highs, deeper lows, more impulsivity, and above all, a massive increase in risk-taking behaviours.

This isn’t theoretical . We’re talking about scientifically documented and verified effects.

What does the research say?

A 2024 study conducted by King’s College London and published in The Lancet Psychiatry turned a lot of heads. It tracked data from over 10,000 patients across the NHS who had presented with substance-related mental health conditions over a five-year period.

The researchers found that individuals who had alcohol and cocaine in their bloodstream simultaneously at the time of admission were three times more likely to have attempted suicide in the previous 12 months compared to those who only used one substance.

More disturbingly, cocaethylene was identified in 27% of toxicology reports from coroner-reviewed suicide deaths in 2023. That’s a fact that’s hard to ignore.

The connection: cocaethylene and suicidal thoughts

Here’s where it gets seriously worrying. Cocaethylene has a very particular impact on serotonin and dopamine . The brain’s mood and reward chemicals. While cocaine alone causes spikes and crashes in these neurotransmitters, cocaethylene creates a more chaotic disruption. The aftermath can bring long, dark depressive episodes.

It’s not just about feeling low. Cocaethylene exacerbates self-loathing, paranoia, anxiety, and impulsivity . All major risk factors for suicidal ideation and behaviours.

One former client, who’s given permission for his story to be included, once said to me:

“It wasn’t just a hangover. It was a complete sense that I had nothing to live for. I’d lose hours to suicidal thoughts and not even realise how I got there. And it always happened after a weekend binge with coke and booze.”

These spirals aren’t rare. And once someone is caught in that loop, it can feel impossible to get out without help.

Spotting the signs . For yourself or someone else

It can be tricky to see the warning signs when it comes to suicide risk, especially through the fog of addiction. But there are red flags that should never be ignored:

• Sudden mood swings or irritability after using substances
• Withdrawal from friends, family, or usual activities
• Talking about feeling trapped, hopeless, or seeing no reason to live
• Reckless or risk-taking behaviour following drug/alcohol use
• Changes in sleep, appetite, or energy levels
• Increased alcohol or drug use after a period of control

If any of these are sounding uncomfortably familiar . Whether for you or someone close to you . Please don’t brush them off.

What support is available in the UK?

There’s real help out there. Whether you need someone to talk to or specialist addiction treatment, you’re not alone. Here are a few go-to resources:

• Samaritans – 116 123 (free 24/7 helpline)
• Talk to Frank – for confidential drug advice: talktofrank.com
• Mind – mind.org.uk offers mental health support and information
• Turning Point – substance misuse services across the UK: turning-point.co.uk

Many local GPs also offer direct referrals to crisis teams or mental health practitioners trained to deal with co-occurring addiction and mental health issues.

Let’s call it what it is

Cocaethylene is a killer. It’s not some random by-product or chemical footnote . It’s directly linked to emotional chaos, tragic choices, and lives lost. The fact that you only hear about it in scientific circles is a public health failure.

And here’s the thing . This isn’t just about “hard drug users”. The combination of cocaine and alcohol is commonplace in nightclubs, student parties, even dinner parties. It doesn’t discriminate. Its effects don’t hold back just because someone thinks they’re in control.

Final thoughts

The silence around cocaethylene needs to end. People deserve to know what they’re putting into their bodies and what the long-term consequences really are. Awareness saves lives . Literally.

If this resonates with you, share it. Start a harder conversation. We can’t afford to look the other way while this chemical continues to claim lives behind closed doors.

And if you or someone you love is struggling, ask for help today . Not tomorrow.

You’re not alone. This can change. But it starts with knowing the truth.