@article{ref1,
title="Proof and frequency of the combined use of cocaine and ethanol",
journal="Blutalkohol",
year="2000",
author="Toennes, Stefan W. and Kauert, Gerold F.",
volume="37",
number="6",
pages="434-439",
abstract="Epidemiological data about the combined use of cocaine and ethanol in Germany are not available. Over a period of 19 months, 2 461 blood samples related to traffic and 694 to criminal offenses were analyzed for medical drugs and drugs of abuse. Benzoylecgonine (BZE) as marker of a recent cocaine use was present in 537 samples (8 % of traffic and 54 % of criminal offenses), 182 of the cocaine users had also consumed ethanol (28 % of traffic and 40 % of criminal offenses, respectively). Only in the presence of ethanol, cocaine is metabolized in the liver to cocaethylene, which has nearly the same pharmacological properties as cocaine. Since cocaine and cocaethylene are almost completely hydrolyzed in unstabilized blood samples, the degradation products ecgoninemethylester (EME) and ecgonineethylester (EEE) are only detectable, the latter is considered to confirm the combined use of cocaine and ethanol. In 401 of the BZE-positive samples, EME (75 %) was present and in 181 also EEE, suggesting an incidence of 45 % for the combined use of cocaine and ethanol. In the 50 cases, where EEE was present but not ethanol, EEE can be considered as marker of alcohol use.<p />",
language="de",
issn="0006-5250",
doi="",
url="http://dx.doi.org/"
}