Why do I crave cocaine after a few pints?

These days in the UK, ordering a gram of coke is about as casual as making a cup of tea. Look around your standard pub on most nights, and everyone seems to be on it. People are talking at others, not with them. That’s the telltale sign of cocaine; everyone talking, nobody listening.

Most of us have been there, drinking after work with no plan to pick up. But you’re four pints deep and can’t help but notice that you’ve suddenly become the most-drunk person in the room. Then, that niggling thought: a line would really hit the spot right now.

So you end up with a £50 gram and scuttle off to the toilet for a line emerging with a confident strut, feeling pretty invincible. But then, within a blink of an eye, it’s 5AM and you’re simultaneously knackered but not tired at all, with the looming anxiety set to kick in any minute now.

You only went out for ​“a couple” on Thursday, and now you’ll feel like shit and live in abject poverty until Saturday. That’s when the idea of doing it again begins to circle above your mind, with an air of inevitable menace.

For many people, a mere trip to the pub can often elicit an unplanned coke sesh. ​“It’s always after about four drinks,” a 25-year-old artist told THE FACE. ​“Usually it’s after work, I haven’t had any dinner and I feel really drunk. There’s always a point when I feel a bit sick and think, ​‘Mmm, if I can just have a line of coke I’d feel more sober and could carry on with the evening.” This is familiar territory for a lot of people who take coke. ​“Alcohol and cocaine are like fish and chips,” a 35-year-old guy who works in the building trade told me. ​“You need one to balance out the other.”

Why does this happen? ​“Firstly, alcohol causes you to be relaxed and disinhibited,” Rayyan Zafar, a PhD Fellow specialising in neuropsychopharmacology and working for DrugScience told THE FACE. ​“The way it does this is by reducing activity in the front part of your brain which is involved in making rational decisions. The benefit of this is that you stop overthinking and stop being stressed, but the downside is that you also find it harder to say no.”

Zafar also said that when alcohol is mixed with cocaine it releases a lot more dopamine and for a lot longer than just alcohol alone. ​“Once you have tried that combination a few times,” he said, ​“it’s hard for your brain to forget that, because this craving can kick in.”

In fact, just being in the pub could be part of the problem. ​“Our brains are very good at remembering situations where lots of dopamine is released,” Zafar concludes. ​“This is for our survival. But as alcohol and cocaine causes that, the environments we are in when we use it such as a pub or being with certain mates are enough to trigger wanting to get it.”

According to the National Institute on Drug Abuse, being in the setting and context in which you have used coke in the past could be the most important factor, due to a process called ​“associative conditioning”. ​“There is some evidence that alcohol may increase cocaine craving but more research is needed,” they told THE FACE via email. ​“Repeated drug use under specific contexts or in the presence of certain cues can cause an association to form between the rewarding effects of the drug and the cue or context commonly paired with the drug”. They added, bleakly: ​“Drug-associated cues and contexts can elicit intense drug craving.”

A record number of people are dying from drugs in England and Wales. The latest figures from the Office of National Statistics were released last week. The report shows that ​“4,859 deaths related to drug poisoning were registered in 2021 in England and Wales”. This is 6.2 per cent higher than the rate recorded in 2020 and the highest number since records began in 1993. Some drug charities have attributed the rise to ​“the legacy of austerity” and the ways in which ​“vulnerable communities were affected by the pandemic”.

The steepest rise in deaths were related to powder and crack cocaine. A reported ​“840 deaths involved cocaine which is 8.1 per cent more than 2020 and more than seven times the amount recorded a decade ago (112 deaths in 2011).” The increase is thought to be in part driven by an increase in the drug’s purity and availability.

Alcohol and cocaine might feel like a palatable pairing, but it’s not a healthy one. According to the NHS, when you mix alcohol and coke it creates a third chemical in your liver – cocaethylene – which is more toxic and can increase the risk of permanent liver disease and heart attacks.

So, while you might want to extend that impromptu Thursday sesh rather than going to bed, it might actually be best to pick your battles, power up the Uber app and save the baggie for a special occasion.