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About CO-ALC Alliance

Cocaine and Alcohol taken together metabolises in the liver to create Cocaethylene (abbreviate to Co-alc). 
The Co-alc Alliance is an independent task group set up in January 2021 to increase awareness of increased risk of suicide in persons taking alcohol and cocaine together and tackle the complex issues that currently prevent public health campaigns.

Set up and led by former Samaritan Volunteer , Maggie Cee, and bereaved mothers and leading campaigners Nicola Abraham of the Jacob Abraham Foundation and Nicola Smerdon of 4Tom Organisation in South Wales, and recently joined by Nadine and Mandy of the Ginger Heart Foundation in Lancashire. 


This group, which originated in South East Wales, is supported by over 50 engagement partners from public services, third sector organisations, and health services, who have attended meetings and shared their understanding and knowledge.

We have identified several barriers that currently prevents wider understanding of the links between suicide and cocaethylene. 

  • Cocaine

    • Is a Class 1 illegal ​drug, therefore it is difficult to obtain accurate information in consumption in users. 

    • Cocaine is generally taken recreationally/socially and is not seen as classic substance misuse ie mental health coping. 

    • Resultant Cocaethylene is far more potent than taking cocaine or alcohol separately and appears to increase suicidal behaviour. 

  • Coroner's reporting

    • There have been inconsistencies found in different areas relating to toxicology reports and cause of death, ie suicide or accidental death which effects the outcome of inquests and consequently national statistics. 

  • Research

    • Due to the above two factors, there has been very little research carried out in the UK so far. ​

    • This latest report published last year does address the need for more awareness around Cocaine and alcohol related suicides. 

  • Suicide Prevention Strategies

    • Suicide has been seen as a purely mental health issue and not something that has been caused by a particular toxin.

    • There is no current mention of this issue on National Suicide Prevention Strategies, ie Talk to Me 2 (Wales)


l2r: Nicola Abraham, Nicola Smerdon Maggie Cee, Nadine Taylor & Mandy Naylor (Mar 22)

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