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Forensic Drug Profile: Cocaethylene.

Alan Wayne Jones1

  • 1Department of Clinical Pharmacology, University of Linköping, Linköping, Sweden.

Journal of Analytical Toxicology
|February 24, 2019
PubMed
Summary
This summary is machine-generated.

Cocaethylene (CE), formed from cocaine and ethanol, is more toxic than cocaine and detectable longer. Forensic toxicology should combine CE and cocaine levels for accurate intoxication and overdose risk assessment.

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Area of Science:

  • Forensic Toxicology
  • Pharmacology
  • Drug Metabolism

Background:

  • Cocaethylene (CE) is a pharmacologically active metabolite formed from co-ingestion of ethanol and cocaine.
  • Information on CE is limited in standard forensic toxicology resources, despite its common presence in casework.
  • CE shares dopamine reuptake inhibition with cocaine, reinforcing stimulant effects.

Purpose of the Study:

  • To review the properties and toxicological significance of cocaethylene (CE).
  • To highlight the importance of considering CE in forensic blood sample analysis.
  • To advocate for the combined interpretation of cocaine and CE concentrations in intoxication cases.

Main Methods:

  • Literature review of existing studies on cocaethylene.
  • Comparison of pharmacological and toxicological profiles of CE and cocaine.
  • Analysis of CE and cocaine concentration-time dynamics in blood.

Main Results:

  • CE is equi-effective to cocaine in blocking dopamine reuptake.
  • CE exhibits lower LD50 values and greater toxicity to the heart and liver than cocaine in some animal models.
  • CE has a longer elimination half-life (~2 h) than cocaine (~1 h) and is detectable in blood for extended periods.

Conclusions:

  • The concentrations of CE in blood are variable and depend on ethanol and cocaine intake.
  • CE is detectable in blood for several hours longer than cocaine after acute co-ingestion.
  • Combining cocaine and CE blood concentrations is crucial for accurate interpretation of acute intoxication and overdose risk in forensic toxicology.