Cocaine is considered the ‘champagne’ of stimulants – it can take you to the ultimate high – but only for a short time. This makes it the kind of drug you might want to use again and again, putting pressure on your wallet, your heart and other organs, your mental well-being and damaging your septum (the bit separating your nostrils) – not a good look.

Cocaine is a stimulant similar to speed, with a more intense but short-lived buzz. It has the potential to be very addictive and is very expensive. It’s also likely to be cut (mixed) with impurities. The most common form is a white powder, which is snorted or injected.

The Coke Hit (immediate effects):

• Depends on the individual’s size, mood, health, etc., their experience with cocaine or similar drugs, the amount taken and how it is used.
• Intravenous (IV) use is more harmful than other methods of use because some impurities can get into the body. Also you need to blast more often because its high effects are short-lived.
• A coke hit comes on fast, with an euphoric buzz that makes users feel totally on to it. However, it usually lasts only about 20 to 30 minutes before the comedown. Coke acts on brain chemicals (dopamine and other neurotransmitters) in a similar way to speed. It also temporarily increases adrenaline levels.

This results in:

• Widened pupils.
• Dry mouth.
• Increased heart rate and body temperature.
• Euphoria with increased energy and confidence. These feelings can become more unpredictable after a few hours of use and some users can become chaotic.
• For males, possible temporary impotency.

Crack is a more potent form of cocaine that is sold as small crystals or rocks. It is usually heated and the vapour inhaled. Crack produces a more intense but shorter-lasting buzz, with a harder crash than snorting cocaine. Crack is very addictive and is more likely to create psychotic reactions. Side effects from smoking include black phlegm, chest pains and lung damage.

The Crash (coming down):

It’s common to feel tired, irritable, depressed, anxious, and sometimes a bit paranoid. You may experience headaches and have a sore nose. The usual trap is to continue using to avoid the comedown. This makes the final crash longer and more intense, and can create $ problems.

A Coke overdose:

• Fits, heatstroke, lung failure, heart attack or burst blood vessels in the brain (stroke), and death.
• Dizziness, short blackouts, increased temperature without sweating, fast and irregular heartbeats, muscle cramps and stiffness in arms and legs.

If symptoms occur seek medical advice quickly. Towels soaked with ice and water can help reduce temperature. Drink water, but sip rather than gulp. (See heatstroke.)

Long-term effects:

Using coke can lead to general ill-health, mental or emotional disturbances and, occasionally, death. Injection of cocaine leads to greater health risks including the spread of HIV and hepatitis if needles (and other equipment) are shared. Other circulation or organ damage results from the substances mixed with cocaine.

When snorted, coke is rapidly absorbed into the bloodstream via the mucous membrane in your nose. Sometimes the membrane can become inflamed and irritated, resulting in a runny nose, blood in your snot (mucus), nasal congestion and nosebleeds. Long-term use can cause sores in your nose and holes/perforations in the septum (the bit separating your nostrils); not only does this look really ugly, but it might need surgery to fix.

Regular use of coke over a long period can lead to:

• Apathy, low mood, insomnia, increased irritability, poor concentration and aggression. These are usually caused by changes in brain chemistry (e.g. depletion of dopamine levels). Symptoms can improve with a period of abstinence.
• Heart pain (angina) or other heart problems.
• Insomnia.
• Weight loss.

Harm Reduction:

• No use is the safest choice.
• Using a water nasal spray or sniffing up water immediately after snorting dissolves the residual coke and will significantly reduce the potential damage to your nose.
• IV coke numbs the injection site, so any damage done there is not felt immediately. Avoid using the same injection site when having several blasts in the same night, to reduce vein damage. Getting advice and filters (to remove impurities) from your local needle exchange is also advisable.
• The combined effects of coke with other drugs become more unpredictable and will often increase health risks. Speedballs (IV coke and opiates) can increase the chance of an OD. If you use other stimulants then reduce your usual dose of each substance by at least half.
• Avoid drinking alcohol when using coke as they combine in the body to form cocaethylene which is more dangerous than coke or booze.
• Although tempting, avoid continual using to prevent the crash as it makes the eventual comedown worse.
• Heavy use increases the chances of psychotic episodes.
• Use lube during sex. Coke can cause shrinkage guys and makes it harder to cum. Also, putting coke on genitals is not good for anyone’s bits!
• If you have mental health, respiratory or heart problems or sensitivity to other stimulants avoid using coke at all.

Long-term use can also result in cocaine psychosis (similar to schizophrenia) where the user will hear voices, have delusions, be suspicious and have a fear of persecution. This can be permanent, but usually improves or goes away if coke use is avoided.

IF YOU ARE CONCERNED about your own or someone else’s cocaine use, contact CADS on (09) 845-1818 or www.cads.org.nz