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MDMA, street names include Mandy, Molly and ecstasy, is an Class A synthetic drug that has both stimulant and hallucinogenic properties

MDMA used to be heavily associated with the party scene, in particular the British rave scene, and was most commonly used as a recreational drug. However, in more recent years, MDMA has appealed to a much broader spectrum of drug users.

Cocaine is a Class A drug that produces very powerful and almost immediate stimulant and euphoric effects. Cocaine is well known for its addictive properties and associated dangers.

The purity of cocaine is currently at an all time high. This has led to deaths associated with cocaine in the UK to rise every year for the past 7 years. In 2018, The Office for National Statistics (ONS) reported that Cocaine was responsible for 637 deaths in England and Wales (1)

MDMA, whilst considered a much less dangerous drug than Cocaine, was still responsible for 92 deaths in England and Wales in 2018. This is almost double the number recorded in the preceding 4 years, of 50 MDMA associated deaths in 2014 (2)

The consistent rise in deaths for both Cocaine and MDMA tells us that both drugs are being abused more frequently and that both drugs are now purer and more dangerous than ever before.

MDMA is predominantly used by the younger generation (16-24) year olds and is the third most commonly used drug after cannabis and cocaine (3)

Mixing both Cocaine and MDMA together, as opposed to using either alone, more than doubles your chances of suffering a drug related death. It also presents a large number of associated risks and dangers.

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0 deaths in England and Wales where cocaine was responsible
0 deaths in England and Wales in 2018 where MDMA was responsible

The effects of mixing cocaine and MDMA – What it feels like

Both Cocaine and MDMA have stimulant properties and produce a very pronounced euphoric high. To some, this may seem like the ideal mix. However, many users report that the substances cancel each other out and only increase the risk of suffering harmful effects, especially to the heart.

a mixture of pills including MDMA

Whilst the effects of cocaine can be felt almost immediately but are relatively short lived (approximately 15 to 30 minutes), MDMA takes around 35 to 45 minutes for its effects to be felt and lasts anything between 3 to 6 hours (4)

There are users who take both MDMA and Cocaine at the same time, simultaneously. By the time cocaine’s effects have worn off, the effects of MDMA start to be felt. Doing this is very dangerous in itself for a number of reasons. Mixing the two together becomes extremely lethal when users then start to bump cocaine as a top up to the effects of MDMA.

So what does mixing cocaine and ecstacy feel like? Mixing Cocaine and ecstacy, a user would hope to feel increased euphoric effects of both drugs. However, ecstasy’s effects tend to override cocaine’s effects, once it has kicked in. Many poly drug users report that taking both drugs together is a waste of time and a waste of drugs.

This begs the question – Why would someone take Cocaine and MDMA together? We can only answer this in respect of why a drug user would mix any drug with alcohol, prescription medications or another drug – They are seeking the ultimate high!

Whether or not a user achieves the high they are seeking, it is very much a case of experimentation; during which time they are putting their life at great risk.

Poly drug users (where individuals abuse more than one substance) are considered the drug users most likely to suffer from an overdose or adverse reaction.

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The dangers associated with mixing cocaine and MDMA

Mixing cocaine with ANY drug, or with alcohol, has the potential to lead to disaster. Cocaine is already considered one of the most dangerous drugs available.

If you are taking cocaine or mixing cocaine with MDMA or with anything else, it is important to seek advice around harm reduction measures.

Whilst harm reduction measures still do not guarantee you will not overdose, it is better to be armed with as much information as possible.

There are also the long term health implications to consider. Even if you do not immediately suffer any adverse effects, the additional build up of toxins can only be considered a greater risk to your mental and physical health in the long run (5)

Young man lies with head in hands

The short-term risks of mixing Cocaine and MDMA

Mixing cocaine and MDMA together carries both short term/immediate risks and long-term health risks to the user. Both drugs have stimulant properties which puts the user at immediate risk of damage to the heart, other major organs and their mental health.

Short-term physical risks of mixing Cocaine and MDMA include:

  • Cardiac disturbances. Both Cocaine and MDMA can induce tachycardia (increased heart rate) as a result of their powerful stimulant effects. Mixing them together increases the already substantial risk of a heart attack, especially in those with underlying heart conditions.
  • Overdose. Taking MDMA with cocaine can put a user at risk of immediate overdose, especially if they continue to top up with cocaine whilst still under the influence of MDMA
  • Stroke. Both Cocaine and MDMA can increase your risk of having a stroke. Taking them together increases this risk further. A stroke occurs when the blood flow/supply to the brain is compromised. The consequences can be long lasting and even lead to death
  • Hyperthermia. Mixing cocaine and MDMA increases the risk of a drug overdose. MDMA increases the body temperature and a cocaine overdose also increases body temperature. Hyperthermia, where the body becomes severely overheated, can cause kidney damage/failure and electrolyte disturbances which can affect the heart and cause subsequent swelling in the brain. All of these symptoms of hyperthermia can be fatal.

Short-term psychological risks of mixing Cocaine and MDMA include:

  • Significantly impaired decision making and judgement. MDMA has hallucinogenic properties, both MDMA and Cocaine can cause feelings of impulsiveness, increased confidence and invincibility. An individual who is mixing both drugs together is more likely to suffer an accident, self-harm or place themselves in a risky situation
  • Severe anxiety, depression and paranoia. Both Cocaine and MDMA can cause severe psychological problems including anxiety, depression and paranoia. Taking both together increases the risk of suffering short-term and long-term mental health conditions including psychosis.
  • Increased comedown effects. Following the high of cocaine and MDMA comes the crash, also known as the ‘comedown’. Mixing cocaine and MDMA together will worsen the symptoms of a comedown and extend their duration. Symptoms of a cocaine and MDMA comedown include: severe depression, anxiety, paranoia, sleep disturbances, drug cravings and in some cases suicidal thoughts and intent.

The long term risks of mixing Cocaine with MDMA

In addition to the short term immediate risks to a person’s health, mixing Cocaine and MDMA together can also cause long term damage both physically and mentally.

Long term physical risks of mixing cocaine and MDMA include:

  • Liver damage and disease. MDMA and Cocaine can cause damage to the liver. In some cases even once the drugs have been stopped, the damaged liver will not be able to repair itself once past a certain stage.
  • Brain damage. Repeatedly taking both Cocaine and MDMA destroy brain cells and tissue. This can result in reduced cognitive function and memory impairment.
  • Long term kidney damage. Due to the effects of overheating that both substances can cause. A long term/ frequent user can sustain serious kidney damage as a result of hyperthermia and repeat dehydration.

Long term psychological risks of mixing Cocaine and MDMA include:

  • Increased risk of developing a dual addiction to both substances. Using both cocaine and MDMA together floods the brain with rewarding chemicals. Some users may associate this enhanced euphoria with taking both at the same time (even if only one is really having a predominant effect). They are therefore at higher risk of becoming compulsive users of both substances.
  • Mental health illnesses and dual diagnosis. Regularly taking Cocaine and ecstasy together can result in the development of long term health issues that are not resolved by stopping the drugs. Mental health illnesses including depression and generalised anxiety disorder (GAD) may require ongoing treatment medically and/or therapeutically.
  • Increased risk of using other harmful substances. As both MDMA and Cocaine are stimulants with very unpleasant withdrawal symptoms, a frequent user will be more inclined to use a third substance that acts as a depressant to counteract the effect of the two combined drugs. Common depressant drugs used to counteract the effects of stimulant drugs include alcohol, heroin and prescription benzodiazepines/opioids. This can result in multiple drug dependencies, that are not only extremely dangerous but also very complex to treat

Treatment for Cocaine and MDMA abuse and addiction

If you or a loved one have an addiction to Cocaine, MDMA or both, it is vital that you seek professional drug addiction treatment. Dual drug addictions and poly drug addictions are often complex to treat and difficult to withdraw from.

To help diminish and safely control the withdrawal symptoms of Cocaine mixed with MDMA, a full medical inpatient detox is recommended as the most effective course of treatment.

Following on from any drug detox, a comprehensive drug rehabilitation programme should then be undertaken in order to help the individual recover, heal and grow.

For more information on how Delamere’ s innovative and holistic approach to addiction treatment can help you or a loved one, call for a free and confidential addiction treatment assessment today.

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  1. Cocaine related deaths in England and Wales 2018
  2. MDMA related deaths in England and Wales 2018
  3. Home office Drug Misuse Survey 2017/18 for England and Wales
  4. Pharmacological effects of MDMA, onset and duration
    Freye E (28 July 2009). “Pharmacological Effects of MDMA in Man”. Pharmacology and Abuse of Cocaine, Amphetamines, Ecstasy and Related Designer Drugs. Springer Netherlands. pp. 151–160.
  5. The confounding problem of polydrug use in recreational Ecstasy/MDMA users: Gouzoulis-Mayfrank, E. (2006). Journal of Psychopharmacology 20(2), 188-193.