Cocaine or alcohol, what’s worse?

Cocaine and alcohol both come with the potential for catastrophic health and social consequences, but their impacts vary depending on things like usage patterns, individual health and context.

Cocaine and alcohol affect the body and mind in very different ways. While cocaine is a stimulant, alcohol is a widely accepted depressant. The former inducesintence euphoria while the latter makes you feel relaxed and uninhibited.

We’re going to take a look at the distinct dangers of each substance as well as the unique health problems and social challenges that come along with both.

Overview of cocaine

Cocaine is an extremely powerful stimulant drug which is derived from the leaves of the coca plant. It is typically processed into two primary forms: cocaine hydrochloride, a white powder that can be snorted or injected, and crack cocaine, a solid, crystalline form that is usually smoked. Both forms are highly addictive and can significantly impact the brain and body.

Short-term effects:

When used, cocaine quite rapidly increases dopamine levels in the brain, which ultimately leads to:

• Intense feelings of euphoria
• Increased energy
• Heightened alertness

These effects come at a cost, however. Short-term use also triggers severe anxiety, paranoia and agitation. It’s very common to experience cardiovascular issues like elevated heart rate and blood pressure, which ultimately leads to an increased risk of heart attack and stroke.

Long-term effects:

Chronic cocaine use can have devastating health consequences. Long-term effects include

Chronic cocaine use can have quite devastating consequences on health. These include:

• Severe respiratory problems due to snorting (such as nasal damage and chronic sinus infections)
• Hypertension and heart disease
• Persistent anxiety
• Depression
• Social impairments

Overview of alcohol

Alcohol is typically consumed in a form which makes it more palatable for social engagements. This could be beer, wine or spirits. The drug is produced through the fermentation of sugars by yeast and is known for its psychoactive effects, which can alter mood, brain speed and behaviour. Despite being legal and socially acceptable, alcohol is highly addictive.

Short-term effects:

In the short term, alcohol induces a sense of euphoria and relaxation, often lowering social inhibitions and increasing sociability. However, it can also impair motor coordination and judgement, leading to poor decision-making and risky behaviour. This impairment can manifest in various ways, including difficulties with balance and coordination, slurred speech, and slowed reaction times. Additionally, alcohol can sometimes provoke aggressive or erratic behaviour, particularly when consumed in large amounts.

The immediate risks of alcohol consumption include a higher likelihood of accidents and injuries, such as falls, motor vehicle crashes, and other types of trauma.

Long-term effects:

Extended alcohol use can lead to severe long-term health problems. Liver cirrhosis is a common consequence of chronic drinking, resulting in permanent liver damage and impaired liver function. Gastrointestinal issues, such as gastritis and pancreatitis, are also prevalent among long-term users. Additionally, alcohol can cause neurological damage, leading to cognitive decline and memory problems. Long-term alcohol consumption is also linked to an increased risk of several cancers, including those of the mouth, throat, oesophagus, liver, and breast.

Addiction potential

Both drugs come with the potential for addiction, but with each drug, this potential manifests in different ways:

Cocaine addiction

Due to its intense and immediate effects on the brain’s reward system, cocaine comes with a very high risk of addiction. When the drug is used, it rapidly increases dopamine levels. This sudden increase in dopamine is what creates intense feelings of euphoria, which in turn reinforces the desire to repeat the experience. The powerful cravings that follow can and usually do lead to frequent use and subsequently, to addiction. Chronic cocaine use alters brain function, particularly in areas responsible for decision-making, impulse control, and emotional regulation, making it challenging for individuals to stop using the drug despite negative consequences.

Alcohol addiction

Alcohol addiction, or alcoholism, often develops gradually through regular consumption. Initially, alcohol use may start socially or as a coping mechanism, but over time, it can lead to physical and psychological dependence. Physical dependence manifests through tolerance (where increasing amounts are needed to achieve the same effects) and withdrawal symptoms when alcohol use is reduced or stopped. Psychological dependence involves a compulsive need to drink, often driven by emotional or situational factors.

Risk of overdose

In both drugs, the overdose manifests in different ways.

Cocaine overdose

A cocaine overdose is a serious and potentially fatal medical emergency. Symptoms of an overdose can include:

• Severe agitation
• Intense hallucinations
• Paranoia

Physiological effects often involve a rapid and irregular heartbeat, significantly elevated blood pressure, and elevated body temperature. These symptoms can escalate to severe complications such as:

• Seizures
• Stroke
• Heart attack

Immediate medical attention is very important in the event of a cocaine overdose, as the condition can rapidly deteriorate and lead to fatal outcomes if not promptly treated.

Alcohol overdose (alcohol poisoning)

Alcohol poisoning occurs when excessive amounts of alcohol are consumed in a short period, leading to dangerous levels of alcohol in the bloodstream. Symptoms include:

• Confusion
• Severe vomiting
• Seizures
• Slow or irregular breathing

Individuals may also become unconscious, with a risk of choking on vomit or experiencing respiratory failure. Alcohol poisoning is a life-threatening condition that requires urgent medical intervention.

Conclusion

Cocaine is generally considered worse than alcohol due to its immediate and severe health risks, such as heart attacks and strokes, and its highly addictive nature, which can lead to rapid physical and psychological deterioration. While alcohol poses significant long-term dangers, like liver disease and addiction, its effects typically accumulate over time. Cocaine’s potential for sudden fatal consequences, even with limited use, and its severe impact on mental health make it more dangerous in direct comparison. Therefore, while both substances are harmful, cocaine is more acutely dangerous than alcohol.

If you or someone you know is experiencing addiction to either drug, UKAT provides structured and supportive environments for alcohol and drug recovery.