ALCOHOL PLUS COCAINE - THE WHOLE IS MORE THAN THE SUM OF ITS PARTS

Cocaethylene, an active metabolite that arises through hepatic transes terification of cocaine when cocaine and ethanol are used together, sh ares many neurochemical and pharmacological properties with cocaine. C ocaethylene is similar to cocaine in its properties as an indirect dop amine agonist, and human subjects cannot distinguish its effects from those of cocaine, Cocaethylene, and especially its isopropyl analog, a re more selective indirect dopamine agonists than cocaine, with relati vely weak potency at the serotonin transporter. Cocaethylene may contr ibute to the manifestations and consequences of combined cocaine and e thanol use, although its relative importance remains unclear.