Cocaine

What is cocaine?

Cocaine is a white crystalline powder that acts as a stimulant. The active substance of cocaine is cocaine hydrochloride (cocaine HCl). It is obtained from leaves from the coca plant. Other names for cocaine include coke, charlie, blow, snow, nose candy, flake and white.

Cocaine hydrochloride can be made into freebase cocaine when, for example, sodium bicarbonate or ammonia are added. This substance becomes cooked coke (freebase), crack, rock, pure coke or simply white.


Effects

Cocaine is a stimulating substance.

The effect of a drug is determined by properties of the drug itself, but also by the set and setting of the user. Here we describe the effects that cocaine generally has.

When using cocaine, users generally feel more energetic, more confident and ‘on top of the world’. You can talk more easily and connect with others more quickly. Cocaine increases alertness, mood and it causes a pleasant euphoria. At low doses it can be erotically stimulating. In women and small people, the effects and side effects may be stronger.

The effects of crack/basecoke are similar to those of coke but a lot more intense, intense and shorter. When it wears off, the craving for the next dose is very strong. This makes the risk of loss of control and addiction very high.

Positive effects (negative) Side effects

Easier talking and social contact

Inhibitions that you might normally experience in social contact may be less present. For example, while drinking alcohol at a party, it may be easier to approach someone or connect with other people.

Paranoia and delusions

Anxiety, paranoia and delusions (e.g. the idea that people are talking about you).

Cheerful, happy, euphoric feelings

You feel energetic and comfortable in your own skin. This is often accompanied by cheerfulness and happiness.

Increase in blood pressure and heart rate

Due to increased cardiac stimulation, heart rate and blood pressure rise.

Increase in concentration

Your attention span may be longer or better than normal. Where you might normally be easily distracted, you can now keep your concentration for a long time on, for example, your hobby, conversations or other chores.

Dilated pupils

Due to an increased noradrenaline level in the body after taking certain drugs, the pupils become larger. The pupil size is influenced by many different processes. Increase in noradrenaline plays a role in some of those processes.

Increase in self-confidence

You feel more confident. It may be easier to ignore the opinions of others, and you will feel less self-conscious about yourself and your own actions.

Muscle cramps and muscle pain

Muscle cramps and muscle pain

Alertness

This drug can make you more active than usual. You are feeling sharp, awkae and it is easy to focus your attention on the things that are happening around you.

Increased sweating

In response to the increased stimulation and changes in body temperature, the skin will start to secrete sweat to cool the body temperature back to normal levels.

Sexually stimulating

Certain drugs can cause you to experience an enhanced sexual arousal. You feel more attracted to your partner or to others. For example, kissing can be extra pleasant and this experience can feel more intense than usual.

Dizziness

Dizziness

Energetic feeling

You have feelings of being energized. Sitting still is sometimes more difficult and this energetic feeling is often expressed through the urge to dance or move.

Nausea/vomiting

An uneasy and tense feeling in the abdomen, which may cause discomfort. Nausea often precedes vomiting.

Teeth grinding

Grinding your teeth

Head ache

Head ache

Aggressive

Some drugs can make you more aggressive.

Check out this short animation from the BBC documentary ‘How Drugs Work’ (in English) about the effects of cocaine in your brain.


Dosage and method of use

Coke is almost always snorted. However, it can also be injected.

Cocaine is also sometimes smoked in a cigarette. This is called a “plofje’’ in Dutch. This is not effective however. Because cocaine does not heat well, only a small portion of the coke is absorbed into the body. Base coke or crack can be smoked however. This is usually done with a base pipe.

Cocaine is also absorbed into the body when chewing coca leaves. This is hardly ever done in the Netherlands.

There is no safe dose, but you can limit the risks by not using too much and not too often. From 1 gram of cocaine 10 to 20 lines are usually made. Many users find that a quarter of a gram is enough for one evening.

Oral dose
Low 25 – 75 mg
Medium 75 – 150 mg
High 150+ mg

Cocaine is often cut with other substances. It is possible that these are harmful substances. You can have your cocaine tested. The staff at the testing service can tell you more about the various adulterants and the associated risks.


Duration

The duration of action of cocaine depends on how you use it:

  • Snorting: up to about 30 minutes;
  • Injecting: a few minutes;
  • Smoking (crack): a few minutes

Risks

You can go beyond your own limits under the influence of cocaine because it lowers the need for sleep and how tired you feel. You then tap into your reserves and can be overtired and depressed for days after using. The longer you have used, the longer these feelings can last.

Cocaine speeds up the heart rate and increases blood pressure. People with high blood pressure and/or heart problems are discouraged to experiment with stimulants.

Users indicate that using cocaine can lead to cravings (a strong desire to take more). This is even more the case when injecting or smoking cocaine or base coke.

Caution! Cocaine is often adulterated. The coke may be adulterated with substances that carry additional risks. The adulterant levamisole is used in veterinary medicine as an anthelmintic (deworming drug). Regular snorting of coke adulterated with levamisole can lead to a (dangerous) deficiency of white blood cells, reducing resistance to disease. In 2021, one-third of cocaine samples submitted to the testing service contained levamisole. The adulterant phenacetin is a painkiller which no longer is being prescribed. This drug can cause kidney damage. Coke is also regularly adulterated with caffeine. Make sure your cocaine is tested

Short term risks

Overdose

You can overdose on a drug. This can make you nauseous and vomit, develop a very high fever and become overheated. You can also develop liver disorders, your kidneys can no longer work properly, you can have an epileptic seizure. An overdose can lead to a comatose state and possibly even death.

Triggering a drug-induced psychosis

Frequent and high-dosage ketamine use can increase susceptibility to developing psychosis. During a psychosis, you may suffer from delusions, hallucinations, losing your grip on reality, and you could become very anxious. It becomes difficult to differentiate between reality and your thoughts. Your behaviour and thought patterns are often erratic and chaotic.

It is still unclear whether this can only be triggered in people who are already predisposed to psychosis, or whether regular drug use and an unhealthy lifestyle (e.g. little sleep) by itself can induce psychosis.

Using ketamine consecutively for days without sleeping, resting and eating exhausts your body, and therefore increases the risks of psychosis. Does someone in your environment react erratic and anxious? You can help that person by removing distractions (music, TV off for a while) and finding another environment where that person can get some rest. Speak calmly, be understanding and, if necessary, go outside together. Do not deny or confirm any delusions and if it does not get better, call a general practice centre. Medical staff are there to help you and can, if necessary, arrange a consult, write a prescription or provide care in another way.

Read more about psychosis in this article.

Vasoconstriction (blood vessel contraction)

Stimulation of the sympathetic (fight-or-flight response) nervous system causes blood vessels supplying some organs to constrict, in order to increase relative blood flow to the muscles.

Overheating

Overheating (hyperthermia) can occur when your body temperature rises too high. Using drugs in a hot, humid, crowded environment (such as a club or indoor party, or in the sun at an outdoor festival) will raise your body temperature even further. Combined with intense, long, uninterrupted dancing, overheating can occur.

Early symptoms of overheating;

  • Headache
  • Confusion
  • Stiff muscles
  • Dizziness

These are all symptoms that can also fall under the “normal” side effects of a drug. If the body temperature does not drop, the following symptoms may also occur:

  • Shivering
  • Elevated heart rate
  • Pale appearance
  • Impaired consciousness
  • Nausea
  • Vomiting

If the body temperature rises to 40-41 degrees Celsius, the situation is life-threatening:

  • Breakdown of muscle tissue
  • Blood clotting throughout the body
  • Impaired functioning of kidneys and liver
  • Epileptic seizure

 

Depending on circumstances, overheating may also occur with “normal” doses of a drug.

Overheating is very dangerous and difficult to treat. Attempting to cool down, resting, and drinking enough water (no more than one glass per hour) is necessary to prevent overheating. Sweating is also an important way to cool down: by evaporating the sweat on your skin, it cools down slightly. But if the ambient humidity is very high (when condensate drops fall from the ceiling), sweat can’t evaporate well enough and therefore your body can’t cool down properly.

Epileptic seizure

Taking this drug increases the risk of having an epileptic seizure if you are prone to it.

Acute confusion / excited delerium syndrome

An acute arousal state is also called an excited delerium syndrome. It is a state of being that is usually caused by excessive drinking or drug use. Often stimulants are involved, like cocaine. The excited delerium syndrome is a life-threatening situation that requires immediate intervention by professional care providers. You can recognize it by very restless and aggressive motorically behaviour. The victim flails around and is unable to calm down. The aggression is not directed, but at random. You can’t make contact with the victim. The victim keeps fighting even when he/she is overpowered by police or security.

Because someone behaves like this, it is easy to imagine that security or police want to overpower someone by pressing him or her down or holding him/her (fixation). However, this is dangerous and can lead to death. The moment you stop someone with excited delirium syndrome, the person will only resist harder, causing the heart rate/blood pressure to continue to rise dangerously.

Long term risks

Psychological dependency

When someone has a psychological dependency, they are convinced that they cannot function without using the substance.

However, there is no physical change in body chemistry that would produce bodily side effects from quitting the substance.

Mental problems

Mental complaints can arise or already existing psychological complaints can worsen. Feeling gloomy or anxious, not feeling well and poor concentration.

Increased chance of heart arrhythmias, heart attack and stroke

Increased chance of heart arrhythmias, heart attack and stroke.

Exhaustion and trouble sleeping

Exhaustion and trouble sleeping

Weight loss

When using stimulants, you usually don’t eat very well (or at all), and you are often moving around a lot on the dancefloor. Combined with higher energy requirements from your body during stimulant use, this causes you to use more energy than you take in, which leads to weight loss.

Damage to nasal mucosa

Snorting drugs can damage the nasal mucosa. This can manifest itself in a reduced sense of smell and taste. It can also lead to chronic colds and nosebleeds.

Brain damage

Brain damage

HIV and hepatitis infection (only with injecting)

When injecting drugs you run an increased risk of HIV, hepatitis and other blood-borne infections. Injecting is strongly discouraged for this reason. If you do decide to inject, make sure you don’t share equipment such as needles with others and that you use a clean needle every time.

Changes in personality

Chronic use of this drug may cause permanent changes in personality or the development of new personality traits. Think of distrust, aggression, paranoia, or arrogance.

Impaired fertility and harm to unborn child

Impaired fertility and harm to unborn child


Interactions

Combining different types of drugs can be risky and unpredictable. When you combine drugs you can have a higher risk of health problems. In the following paragraphs you can read about the effects and the risks of a number of combinations that occur frequently and also a about few that are extra hazardous. Also check our theme combining drugs.

Alcohol and cocaine

You feel the effects of alcohol less after using cocaine. That is why you can continue to drink more and longer. On the other hand, the alcohol can help to soften the effects of the cocaine. You are more relaxed and less tense. This interaction is often experienced as pleasant. But keep in mind that if you drink (and snort) faster and more, the hangover is also considerably bigger. Consider whether the combination actually gives you the effects that you want.

You can associate alcohol with coke use after a while. When you drink alcohol you feel the urge to snort more quickly and when you are snorting you want to continue drinking. When both substances are in your body, the substance cocaethylene is also produced. This is an extra burden and is harmful to your heart and blood vessels. In addition, cocaine also gives you the feeling that you are not or less drunk than you really are. This can be very dangerous, for example in traffic. Therefore, think carefully in advance how much you want to use, so the risks are limited.

Cocaine and cannabis

Sometimes people consider smoking weed after or while using cocaine to calm down or fall asleep more easily. Cannabis can soften the intoxication, especially towards the end. However, this is not recommended for everyone, some people may feel anxious or restless. If you suffer from insomnia after using cocaine, it is advisable to time your use better.

Ecstasy/MDMA and other stimulants like speed and cocaine

Combining MDMA with uppers mainly ensures that you notice less of the MDMA. The desired effects, such as euphoria, are smoothed out. So you feel less of the MDMA. There is a chance that you will then take more MDMA to get a bit more effect. The uppers also remove the vagueness of the MDMA. You feel a little brighter.
The more MDMA you take and if you combine it with other uppers, the bigger the hangover. You feel empty and exhausted.
The combination also causes more brain damage. And a greater load on the heart and blood vessels.


Unity tips

There is no such thing as a truly safe use of cocaine. However, the risks can be mitigated, so read the Unity tips:

  • Have your cocaine tested! Look for addresses of the testing service at Drugs and testing.
  • Only use when you feel physically and psychologically well.
  • People with a weak heart, weak arteries, high blood pressure, diabetes or epilepsy have extra health risks and are advised not to use cocaine.
  • Do not use to fight fatigue or depression or to eliminate the unpleasant effects of the last use.
  • Prevent infectious diseases. Use your own snorting tube and do not share it with others.
  • Rinse your nose well with luke warm salt water afterwards, for example by using a nasal spray or nasal douche.
  • Use in moderation. Keep track of how much you use.
  • Make an agreement with yourself on the maximum amount you want to use in one evening.
  • Driving is dangerous under the influence of cocaine.
  • Take into account that cocaine is bad for the heart and blood vessels.
  • Make sure your body recovers by eating and resting properly
  • Do not use if you are on medication or suffer from depression, anxiety or psychosis.
  • Do not use when pregnant. Cocaine is harmful to the unborn child.

Unity tips for using stimulants

  • Do not combine high stimulant doses with other stimulants
  • Do not use stimulants if you suffer from diabetes, cardiovascular disease, epilepsy or psychological afflictions. Also, do not use stimulants if you are pregnant, or in combination with medications (especially MAO inhibitors and asthma medication).
  • Make sure you don’t get too warm while using stimulants: rest every now and then, don’t wear (too) warm clothes or headgear and drink water/soft drinks occasionally.
  • Get enough rest before using stimulants. If you are very tired or suffer from insomnia, do not use stimulants!
  • Moderate use is key. Keep track of how much you take.
  • Drink enough to keep yourself hydrated, but no more than 2 glasses of water per hour. Exceeding this increases the risk of water intoxication.
  • Stimulants can give you a dry mouth, which, combined with teeth grinding, increases the risk of damage to your teeth. It is important to stimulate your saliva production. You can do this by chewing sugar-free gum. Saliva substitutes or artificial saliva (such as Saliva Orthana, Xialine and Oral Balance) can also be used and can be purchased without a prescription.

Unity tips for using drugs

  • When using a drug for the first time, take only a small dose to see how your body reacts to the substance
  • Only use drugs when you are feeling well
  • Use drugs recreationally, not to combat psychological issues like fatigue
  • Avoid using drugs if you have (had) psychological afflictions or if you have a family history of psychological diseases (such as depression) in your family
  • Test your drugs before use at a drugs-testing service
  • Make sure to prepare a good set and setting for drug use
  • Only use drugs sparingly. Keep track of your use over time.
  • Decide in advance how much you are planning to use over the evening, and stick to that. 
  • Do not combine drugs with other substances or medicines
  • Do not participate in traffic after drug use
  • Prevent infectious diseases; Use your own snorter/sniffer and do not share paraphernalia with others
  • After insufflating, rinse your nose well with lukewarm saline water (for example, by using a nasal spray or nasal douche)
  • Are you, or one of your friends not feeling well? Keep an eye out for one another, take care of each other and visit the first aid (if one is available)
  • Call 112 in a life-threatening situation
  • Eat healthy before and after drug use. In particular, foods with lots of antioxidants and vitamins (blueberries, raspberries, blackberries, grapes, raisins, oranges, kiwi, broccoli). This is perhaps the most important tip! It can be difficult to eat during and after drug use, but make sure to try to eat something anyway. Eating well is a great way to reduce the hangover! If you can’t hold in solid foods, try juices, breakfast drinks, and smoothies.

FAQ

Can your character change from often using cocaine?

Cocaine use can change your character. Cocaine users can develop a number of negative traits during the period of heavy use. You often see that people become self-centered, cold and arrogant. Fortunately, these character traits can disappear after stopping use.

If you suspect that someone is using cocaine for a long time and you observe this change in character traits, it may be advisable to have an open conversation about this and possibly seek appropriate help (together).

What to do if someone has a bad trip?

Always make sure that you are and remain safe yourself. If you are in danger, you cannot help the person in need.
Find a quiet place with the one who is having a hard time. Don’t try to deny that he/she is having a bad trip. Try to reassure him/her: he/she has taken drugs and the effects and thus the bad trip always wear off. Ask the person about what they are experiencing and try to talk the trip on a positive side without downplaying it. For example, by giving a positive meaning to the things he/she sees. Try to do things that make him/her feel comfortable, such as moving or singing. See if it makes sense to talk about pleasant things. Distraction can also help, for example by drawing. Let your voice sound calm and reassuring.
Make sure that the user does not end up in dangerous situations such as traffic. Call emergency services if it becomes unsafe for the user or his environment or if the bad trip is too intense to solve it yourself.

What if I have medical complaints after the use of partydrugs?

Some complaints after using drugs can last longer, A medical explanation or even treatment may then be necessary. The Brijder has set up a national consultancy for party drugs related medical complaints. If you have medical complaints after the use of party drugs, you can call the consultancy: 088 – 358 29 40. This service is only available in the Netherlands.

 

I am planning to use cocaine with another drug. What can the consequences be?

Combining different drugs can be extra risky and unpredictable. If you combine, you are more likely to have problems with your health. Here we describe the effects and risks of a number of combinations that are common or that are very risky. For more information, check the theme of combination use.

Cocaine and XTC

This combination increases the risk of overheating. It can lead to changes in your brain that affect memory, concentration and mood. It’s a heavier load on your heart. There is an increased risk of physical exhaustion. Your hangover may be more severe, you may feel drained and drained. Cocaine can also flatten the ecstasy intoxication. You then feel less euphoric and happy.

Cocaine and cannabis

This combination increases the risk of psychological complaints such as anxiety and restlessness.

How does cocaine work in the brain?

Cocaine inhibits the reuptake of dopamine, norepinephrine and serotonin. This animation from the BBC documentary How drugs work explains how cocaine works in the brain.

What is cocaine regularly cut with?

Cocaine is regularly adulterated. The cocaine may have been cut with substances that have additional risks. Read more about adulterations.

Get your cocaine tested!

How long is cocaine detectable in your body?

How long a drug is detectable in your blood or urine depends on a number of factors. How often and how much you use and your personal metabolism (the speed at which substances are broken down by your liver in particular) are important. Drugs are longer detectable in your urine than in your blood.

Cocaine is detectable for three to a maximum of seven days. It is detectable in the blood and urine. The more and longer it has been used, the longer it can remain detectable.

How about the law and cocaine?

Cocaine is on list I of the Opium Act and is considered a hard drug. Possession, production and trade are therefore punishable by law.

Check the theme The law for more info.

How did the use of cocaine start?

Cocaine has a long history. The use of coca leaves has been around for at least five thousand years in the Andes region. It was and still is used as a remedy for altitude sickness, to reduce fatigue, to fight hunger and as an anesthetic during surgery. The coca plant was sacred to the Incas and its leaves are still chewed by South Americans.

In the early 1500s, Europeans first came into contact with coca. Chewing coca did not become popular in Europe because the leaves lost their effect during transport across the ocean. By 1850, coca extract was being used in throat surgery.

In 1900, the Dutch Cocaine Factory (NCF) was founded. This made the Netherlands the market leader in cocaine production. In 1928 the Opium Act was passed in the Netherlands. This law prohibited the non-medical use of cocaine. As a result, sales of the NCF declined sharply. It is true; the very first bottles of Coca-Cola also contain cocaine, which has since been replaced by caffeine.

In the late 1970s and early 1980s, cocaine became popular again in the Netherlands.

Also check out this video from  ATTN  about the history of cocaine and base coke (crack) in the US.

What is crack and how did it get it’s name?

Crack, or base coke, is a processed form of cocaine, also known as snuff cocaine. The processing is necessary to make the cocaine smokeable and to maintain its effectiveness. The ‘cracking’ sound that is released when using it, is the reason it is called crack. Once absorbed into the body, the distinction between crack/base coke and (sniff) cocaine is lost. The effects of crack/base coke are also comparable to those of (sniff) cocaine, but a lot more intense and shorter. When it has worn off, the craving for the next dose is high. This makes the risk of loss of control and addiction very high. Therefore, agree well with yourself or others how much you will use in order not to exceed your limits.

Someone close to me uses this substance almost every weekend. Should I worry?

When someone close to you uses a substance often it is normal to worry. There are risks: to physical health; that he/she will gradually use more and more and become dependent. When only using it on weekends, there is the possibility that he/she is able anymore to go out without using. It can then be useful to have a conversation with each other in an open, non-judgmental way. Mention the impact the use has on you as a person, for example that you are worried. If you would like tips or advice for this, please contact the addiction care institution in your region.

What is meant with Colombian cold?

Cocaine use can inflame your nasal mucosa and cause the nasal mucosa to produce extra mucus. Users then get a strong runny nose. This is also known as the ‘Colombian cold’. Inflamed mucosa can be very painful and annoying and there is also a risk of permanent damage. When you start snorting cocaine, it is therefore important that you clean your nose well regularly to ensure that you do not get this form of cold and that your use is as safe as possible.

I snorted cocaine last month. Can I be a blood donor?

No this is not allowed. If you have used cocaine, you are not allowed to donate blood for 4 months. This has to do with the risks associated with snorting/injecting drugs. As a result, you may have contracted infectious diseases that have not yet manifested itself. If you donate blood within 4 months of use, there is a chance that this infectious disease is present in your blood and is transferred to the receiver of your blood. These are often people with fragile health, so this can be dangerous. To exclude that you have not contracted an infectious disease through use, you will have to wait at least 4 months. So realize that if you want to donate blood, the use of cocaine may be a limitation and you may have to cancel or reschedule the appointment at the blood bank.

What is the excited delirium syndrome and what does it have to do with cocaine?

The excited delirium syndrome is characterized by extremely aggressive behavior due to the use of stimulants. Often this will be cocaine. As a result, a person feels extremely strong, does not experience fatigue despite the excessive effort and is insensitive to pain. The person is very aggressive without being directed at anything or anyone. You can’t make contact. So you can’t calm someone down by talking to him/her. The person cannot restrain himself and can literally fight himself to death because the heart and lungs cannot handle the effort. This is not only very dangerous for the person himself (due to major health risks), but also for his/her environment due to damage to people or property.

By consciously dealing with your use, the risk of an excited delirium syndrome can be effectively limited. Decide before you start using how much cocaine you want to use and doing so responsibly can help.


Read more

Check out ATTN‘s video on the real history of cocaine in the US:

Here’s a short animated video that shows how the risks of cocaine do not only relate to the risks to your own health: