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.


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


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.


The feeling that someone is spinning, or that the world is spinning around someone. This impairs balance.

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.


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


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.


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


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


You can take an overdose of a drug. This can make you feel nauseous and vomit, get very high fever, and overheat. You can also develop liver disorders, your kidneys may stop functioning properly, and you may have an epileptic seizure.

An overdose can lead to a coma and possibly even death.

(Nederlands) Triggeren (drugs-) psychose

Sorry, this entry is only available in Dutch.

Vasoconstriction (blood vessels narrowing)

Stimulation of the sympathetic (fight-or-flight response) nerve pathways causes the blood vessels around some organs to contract and narrow, redirecting the relative blood flow to the muscles to increase.



Stimulants increase your body temperature. Additionally, more physical activity also raises your body temperature. If this happens in an environment that is already warm, where you cannot dissipate heat effectively, it can become dangerous.

Because your body loses heat through sweating, this risk mainly occurs in warm and humid environments. If the air is very humid (muggy or clammy), the cooling effect of sweat is reduced. This can cause your body to overheat. Additionally, you lose a lot of body heat through your head. Avoid wearing a hat or cap when it’s warm so that heat can escape.

Some drugs, especially those that cause a significant release of serotonin, can lead to mild overheating with “normal” use.

Symptoms of mild overheating (hyperthermia):

  • Headache
  • Confusion
  • Stiff muscles
  • Dizziness

In this case, seek a cool place and consider wetting your head, neck, and face with water. If you then blow air over these well-vascularized areas of your body with a fan (or ask a friend to do so), you can quickly cool down to a more comfortable temperature.

Symptoms of more severe overheating (hyperthermia):

  • Shivering Rapid heartbeat
  • Pale appearance
  • Reduced consciousness
  • Nausea Vomiting

When experiencing these symptoms, it’s time to seek help from a first aid post or other healthcare provider. If the body temperature rises to 40-41 degrees Celsius, the situation is life-threatening. It’s important to quickly move to a cooler place.

Very severe symptoms:

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

Call 112 immediately if you notice or experience these symptoms.

Epileptic seizure

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

(Excitement) delirium

This is a state of being that is usually caused by excessive alcohol or drug use. Often, it involves stimulants such as cocaine. The acute state of excitement is a life-threatening situation that requires prompt intervention by professional caregivers. You can recognize it because someone behaves very agitated and aggressive motorically. The victim lashes out and cannot be calmed down. The aggression is not directed, but rather random. It is impossible to make contact with the victim. The victim continues to fight, even when subdued by police and security.

Because someone behaves this way, it is understandable that security or caregivers may want to subdue them by pushing them down or restraining them (fixation). However, this is dangerous and can lead to death. When you try to stop someone with an excitement delirium, the person will only resist harder, causing their heart rate/blood pressure to dangerously increase.

Long term risks

Psychological addiction

Psychological addiction means that you feel like you can’t live without a substance.

You can however stop taking this drug, without your body experiencing any issues.

Psychological issues

Psychological issues can arise, or pre-existing psychological problems can worsen. Feeling down or anxious, feeling out of sorts, and experiencing poor concentration.

Increased risk of arrhythmia, heart attack, and stroke

Stimulants increase your bodily functions.

Among other things, your heart rate increases and your blood pressure rises.

People with high blood pressure and/or heart problems are advised against experimenting with stimulants.

Cocaine has more negative effects on the heart than other stimulants.

Decreased resistance

Your resistance might decrease. That means you’ll get sick faster and more often. Your fitness can also decline. For example, you might feel tired more quickly or exercising may not feel as good as it did before using this drug.

Over-fatigue and insomnia

Under the influence of (stimulating) substances, you can exceed your own limits and boundaries, because it suppresses your fatigue and sleep. You then tap into your reserves and can be over-fatigued and downcast days after use. The longer and more you have used, the longer these feelings can persist.


Weight decrease

When you use uppers, you usually eat poorly (or not at all), and often you’re also moving a lot on the dance floor. This, together with the higher energy demands of your body during upper use, means that you use more energy than you take in and therefore lose weight.

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

This drug can give you 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


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.


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: