Cocaine

coke, bags, blow, charlie, C, candy, dust, flake, nose candy, snow, white, white lady, crack, rock or freebase

What is cocaine?

Cocaine is derived from the coca plant. It is a stimulant drug, which means that it speeds up messages travelling between the brain and the rest of the body.

Cocaine comes in the following forms:

Cocaine hydrochloride is a powder and the most common form of the drug – it is usually sniffed through the nose but may be injected
If the hydrochloride is removed through a chemical process the drug is converted to ‘free base’ cocaine – ‘free base’ is predominantly smoked or injected
‘Crack’ is another form of free base cocaine that comes as small rocks or crystals – it is usually smoked or injected

In Australia, cocaine is most commonly in powder form (usually a white or off-white colour) and is normally sold in ‘points’ (0.1g) or grams.

What are the effects?

The effects of cocaine are almost immediate and last between 30 minutes and four hours, which can lead to a pattern of binge use characterised by frequent, repeated use (Darke, Lappin & Farrell, 2019).

The effects of cocaine depend on the quantity consumed, a person’s height and weight, general health, mood and past experience with cocaine, whether cocaine is used on its own or with other drugs, and the composition of the drug. Acute effects can include:

Increased energy, talkativeness and confidence
A feeling of euphoria (‘high’) and alertness
Reduced appetite
Dry mouth
Enlarged (dilated) pupils
Higher blood pressure and faster heartbeat and breathing (after initial slowing)
Higher body temperature
Increased sex drive
Irritability, agitation or aggressive behaviour (ADF, 2019)

The ‘rush’ from cocaine doesn’t last very long — usually between 30 to 45 minutes, if snorted. People may experience a ‘comedown’ or a ‘crash’ the next day when the drug starts to wear off. This can last a few days and symptoms may include:

Feeling uncomfortable
Lethargy (having little energy or motivation)
Irritability
Paranoia

What are the risks?

Cocaine use can come with a range of harms if taken in high doses and on a regular basis, or by people with pre-existing problems or susceptibilities (e.g. heart conditions that people may or may not be aware of).

Regular use of cocaine may eventually cause:

Insomnia and exhaustion
Depression
Anxiety, paranoia and psychosis
Sexual dysfunction
Hypertension and irregular heartbeat
Heart disease and death (ADF, 2019)
Stroke
Liver, kidney and lung problems
Cognitive impairments like loss in attention, memory, and impulsivity control (Darke, Lappin, & Farrell, 2019).

Snorting cocaine regularly can also cause:

Runny nose and nose bleeds
Nose infection
A hole in the tissue separating the nostrils
Long term damage to the nasal cavity and sinuses (ADF, 2019)

Mixing cocaine with other drugs

Mixing cocaine with other drugs, including over the counter or prescription medication, or alcohol can be dangerous and fatal. Polydrug use increases the risk of drug toxicity, which can lead to unpredictable adverse effects, severe negative health and mental health outcomes, and even death.

Toxicity and overdose

Consuming a large amount or strong batch of cocaine could cause overdose. Symptoms include:

Nausea and vomiting
Extreme anxiety
Chest pain
Panic
Extreme agitation and paranoia
Hallucinations
Tremors
Breathing irregularities
Kidney failure
Seizures
Stroke
Heart problems (ADF, 2019)

Dependence and withdrawal

There is a recognised psychostimulant withdrawal syndrome. The prominent symptoms include:

Dysphoria
Agitation
Anxiety
Fatigue and depression
Insomnia
This is followed by prolonged periods of sleep, with a craving for psychostimulants

The acute phase of withdrawal peaks within the first 24 hours after taking the drug but with heavier use and severe dependency, these symptoms intensify and may last longer.

Mental health

Repeated use of cocaine can be associated with mental health problems, including:

Depression
Anxiety, paranoia and panic attacks
Cocaine psychosis, with symptoms such as delusions, hallucinations, and aggressive behaviour (Headspace, 2020)

How many people use cocaine?

According to the Australian Institute of Health and Welfare, in 2019, 4.2 percent of Australians had used cocaine in the previous 12 months. This is the highest proportion seen since 2001 and has risen from 2.5 percent in 2016. Increases were seen across all age groups (except 14 to 19 year olds), but the overall rise was mainly driven by men (AIHW, 2020).

Treatment

Treatment for dependence differs depending on a number of factors like the individual’s age, comorbidity of other mental and physical conditions, and level of dependence. Treatments could include 12-step programs, inpatient rehabilitation programs, outpatient therapy, support groups or cognitive behaviour therapy (CBT).

Emergency info

If you, or someone around you, is experiencing undesired or distressing psychological or physical symptoms from the intake of alcohol or other drugs please seek immediate medical attention.

If you need urgent help from ambulance services call Triple Zero (000). If a person has been mixing drugs with alcohol or other drugs, tell the paramedic exactly what has been taken.

Services

For free and confidential advice about alcohol and other drugs, call the National Alcohol and Other Drug hotline on 1800 250 015.

The hotline will automatically direct you to the Alcohol and Drug Information Service in your state or territory.

More resources

The Illicit Drug Reporting System is an Australian monitoring system that identifies emerging trends of local and national interest in illicit drug markets.

The Ecstasy and Related Drugs Reporting System is an Australian monitoring system for ecstasy and related drugs that identifies emerging trends of local and national interest.

The Clinician’s Guide to Illicit Drugs and Health examines the health effects of each of the major illicit drugs.

The Australian Institute of Health and Welfare collects information on alcohol and tobacco consumption, and illicit drug use among the general population in Australia.

The Australian Bureau of Statistics is Australia’s national statistical agency, providing official statistics on a range of economic, social, population and environmental matters of importance to Australia.

Sources

Alcohol and Drug Foundation (2019). Cocaine. Retrieved from https://adf.org.au/drug-facts/cocaine/

Australian Institute of Health and Welfare (2020). National Drug Strategy Household Survey 2019. Retrieved from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/contents/table-of-contents

Darke, S., Lappin, J., & Farrell, M. (2019). The Clinician’s Guide to Illicit Drugs and Health, Great Britain: Silverback Publishing.

Headspace (2020). What is Cocaine and the effects on mental health. Retrieved from: https://headspace.org.au/young-people/understanding-cocaine-for-young-people/