Cocaine (hydrochloride) is a highly addictive drug which acts as a short lived central nervous system stimulant and local anaesthetic.

It’s extracted from the leaves of coca plants and is generally snorted.

Crack cocaine is the smokeable form of the drug and comes as crystals known as rocks or stones. Crack and cocaine powder can be injected but this is very risky and is associated with many harms.

Mixing can be dangerous

Using alcohol and cocaine together can be dangerous, as they mix together in the body to produce a toxic chemical, called cocaethylene.

This affects the cardiovascular system and increases the risk of overdose.

Using heroin combined with cocaine is especially risky and may trigger an overdose. Each drug puts a lot of pressure on the central nervous system and the heart which can result in respiratory failure.

Dependency and harm

Longer term effects of using cocaine can include:

  • dependency
  • damage to the heart
  • depression
  • anxiety
  • paranoia
  • poor sleeping patterns
  • impotence
  • malnutrition due to suppressed appetite.

Longer term use can make it difficult to manage your mental health and can worsen existing mental health conditions.

If someone is experiencing difficulties with their physical or mental health, it is important they try to reduce or stop use and seek help.

Snorting cocaine can damage the tissues in the nostrils, sometimes causing holes in the septum, the cartilage between your nostrils.  

Smoking cocaine can cause damage to the lips, mouth and lungs.

Injecting cocaine can lead to needle-related injuries, infections and, in extreme cases, amputation of limbs.

Due to the risks of unpleasant and sometimes fatal side effects, you should completely avoid using stimulants like cocaine if you have:

  • high blood pressure
  • heart disease
  • epilepsy
  • depression or anxiety

Try to be safer

Make sure you're in a safe environment, ideally with people you trust, when using cocaine. If you're planning to use cocaine alone, let someone know.

Start low, go slow and begin with a small test dose. Wait at least 1 hour before taking more and avoid mixing with other drugs, including prescribed medications or alcohol.

Drink small sips of non-alcoholic drinks such as water or isotonic drinks, but don’t exceed 1 pint in 1 hour.

Always use new snorting equipment and don’t share any, including straws and keys, with others.

If you’re snorting, grind it down as fine as possible and divide into small lines.

Snorting cocaine is less harmful than smoking and injecting.

Advice for people who smoke or inject cocaine

If smoking cocaine, crush the crack rock into small pieces and smoke using a clean pipe or fresh piece of foil. Remember when smoking, the effects are intense but short-lived.

If injecting cocaine, use less risky areas such as forearms and rotate any injecting sites. Wash hands and injecting site prior to injection, wipe injection area with a swab.

Cocaine hydrochloride (cocaine powder) does not require citric acid or vitamin C as it dissolves in water. Only use citric acid or vitamin C to dissolve crack cocaine.

Use the smallest needle size possible for the area of injection. Always use fresh equipment and filter the solution into the syringe.


If you would like help or support related to drug use please visit support for people affected by drugs.

Further information

For further information on cocaine visit Crew.

Last updated:
20 January 2023