Concurrent use of cocaine and ethyl alcohol leads to the formation of cocaethylene. This substance has the same cardiotoxic effects as cocaine, while being eliminated three times slower, which prolongs the harmful effect on the heart. It is known that cocaine alone increases heart rate and blood pressure, but the alcohol-cocaine mixture increases them even more and the risk of sudden death from cardiac arrest is 22% greater.

We present herein the case of a 33-year-old young man who died suddenly from cardiac arrest. According to informations provided by the medical examiner, the deceases was addicted to cocaine and other unspecified narcotics. In order to confirm the toxic death, a toxicological screening is carried out by a gas chromatography-mass spectrometry method (GC-MS, Perkin Elmer), as well as a determination of the alcohol blood level by gas chromatography flame ionisation detector (GC-FID, Perkin Elmer).

The result of the alcohol blood level came back positive with a rate equal to 02.16g/L. The toxicological screening revealed the presence of cocaine, cocaethylene, methylecgonidine and cotinine. No other substance, toxic, medicinal or narcotic, was detected.

The results of the toxicological analysis carried out in our laboratory allowed the forensic experts to confirm the cause of death by the concomitant use of cocaine-ethyl alcohol mixture.