photo of white powder

Cocaine is a stimulant which temporarily speeds up the way your mind and body work but the effects are short-lived. Cocaine is more commonly snorted whilst crack cocaine is generally smoked in a pipe.

Crack tends to have a much stronger effect and can be more addictive than snorting cocaine. Cocaine and crack both effect the levels of dopamine in the brain (a natural chemical which is released when we are happy or having a pleasurable experience) which give users a high. However, long term use of these drugs mean that we have less dopamine in our brains leading to low mood and even depression.

The effects of cocaine/crack can include feeling confident, alert and energised, however the come down after using can result in not being able to sleep, feeling agitated and low mood.


Short-term effects

  • Effects of cocaine start quickly but only last for up to 30 minutes
  • You may feel more alert, energetic, exhilarated and confident
  • Your heart and pulse rate speed up suddenly
  • Hyperactivity, dilated pupils, dry mouth, sweating and loss of appetite
  • Higher doses can make you feel very anxious and panicky
  • Increased sex drive

Long-term effects

  • Tightness in chest, insomnia, exhaustion and unable to relax
  • Dry mouth, sweating, mood swings and loss of appetite
  • You may become aggressive or even violent
  • You may feel depressed and run down
  • Damage to nose tissue
  • Digestive disorders, dehydration and anorexia
  • Kidney damage
  • If you use it often you may lose your sex drive
  • Injecting may cause abscesses
  • Smoking may cause breathing problems
  • Anxiety, paranoia and hallucinations, if you use a lotWeight loss


Cocaine and alcohol

When cocaine and alcohol are used together they combine in the body to produce cocaethylene which increases the risk of damaging organs such as the liver and heart.

Cocaethylene is more toxic than cocaine and alcohol alone and produces a greater increase in heart rates and blood pressure.


Cocaine has potential to cause addiction. This is due to the long term changes that repeated use of cocaine can cause to the brain’s reward system. The reward circuit eventually adapts to excess dopamine brought on by the drug. Therefore, people take more frequent doses to achieve the same high but also to prevent the onset of unpleasant withdrawal symptoms such as depression, fatigue, increased appetite and insomnia.

Cocaine Contents

Cocaine is often diluted (‘cut’) with other substances and bulking agents such as lignocaine or levamisole. Cocaine purity in Europe is increasing which can mean increased risks for the person using. Be mindful that you can never be fully sure of the contents, purity or how you will react to a product.


Cocaine is very psychologically addictive so you find it hard to live without it. Your tolerance increases over time so you have to keep taking more to get the same buzz.


You may feel tired, panicky, exhausted and unable to sleep, which can cause you extreme emotional and physical distress. This distress can lead to symptoms such as diarrhoea, vomiting, the shakes, insomnia and sweating. You may have long-term effects such as anorexia and depression. Once you stop using, you will have an intense craving for more.

Other dangers

  • Overdose can cause epileptic fit, stroke, breathing problems and heart attack
  • Damage to veins if you inject
  • Risk of HIV and hepatitis if you share needles
  • When you mix cocaine with alcohol, they combine to produce cocaethylene, which increases the risks of damage to the heart or heart attack
  • Extremely dangerous if you inject it with heroin, known as a ‘speedball’
  • Increased sex drive can lead to unsafe sex, with the risk of unwanted pregnancy, sexually transmitted infections (STIs) or HIV
  • Debt – cocaine is an expensive habit and you may find yourself borrowing money to buy it

12 Tips to Reduce the Harms

The best way to keep yourself safe is to avoid drugs completely. But if you are using cocaine, there are some simple steps you can take to lower the risks.

  • Think about your health: Avoid using if you are feeling low, experience mental health problems, high blood pressure or a heart condition.
  • Think about the contents: There is a risk of substances or adulterants appearing in drugs. Remember, drugs from the same batch can sometimes vary in strength and purity
  • Try not to use drugs alone. It’s best to be with people you trust, who will get help if you need it.
  • Grind cocaine before snorting. This will remove any lumps or crystals. Ensure the powder is as fine as possible before snorting.
  • Try not to mix cocaine and alcohol, or any other drugs. Lots of people don’t use cocaine while sober, but decide to when they are drunk. This can make it more likely to binge and take too much.
  • Drugs and alcohol together can put extra strain on your heart and liver. You might also make poor decisions and take risks you wouldn’t usually take, which could be dangerous.
  • Start with a very small amount and see how you feel. Not all cocaine has the same purity and strength, so it can be hard to judge the dose. Try and stick to small lines to avoid taking too much.
  • Don’t use or share banknotes to snort cocaine. They can be dirty and can spread blood-borne viruses. If you’re using a straw or a tube, don’t share it with other people. Ideally, use a clean surface for cutting up lines.
  • Make sure you drink enough water. Drinking water keeps you hydrated, and makes you less likely to mix cocaine and alcohol.
  • Know the signs of an overdose: your heart going too fast, a very high temperature, feeling sick and vomiting, chest pains, seizures, or panic and anxiety. If you think you or someone else is having an overdose, call 999 straight away. Don’t be afraid to get medical help if you or a friend become unwell or feel suicidal after cocaine use. Be honest with emergency services about what you think was taken.
  • Be aware of your use. Take breaks in between use to give yourself some time to recover. Consider talking to a professional if you are finding it difficult to stop using cocaine.
  • A comedown is a common experience: Talk to a professional about how you are feeling. If you or someone you know is at risk of suicide, you should contact a local doctor, the Accident and Emergency Department of your nearest hospital or call 999

Concerned about your cocaine use?

Cocaine can cause a number of issues for people. Take the DUDIT Online Self-Assessment tool to identify the impact of your use.

Cutting Down or Quitting

If you’re thinking of addressing your cocaine use, don’t be afraid to reach out for help.

There are also some steps you can take yourself to help you cut down or quit:

  • Look out for any ‘triggers’ that make you want to do cocaine. It might be when you drink, or when you’re with certain people, for example.
  • If you can figure out your triggers, you can start to make a plan. You might want to cut some triggers out completely or avoid combinations that give you cravings. Changing your habits or breaking off contact with certain friends can be difficult, but it often helps in the long term.
  • If you usually do cocaine after drinking, you might want to cut down on alcohol as well. Some people don’t use cocaine while they’re sober, but are more likely to take risks while they’re drinking. You can find advice on cutting down your drinking here.
  • Take a limited amount of cash out with you, and leave your bank card at home. This means you’re less likely to spend money on cocaine. Ask your friends to help you stick to your money limit.
  • Work out how much money you spend on cocaine a month. The cost might shock you. Make a list of all the other things you could do with that money.
  • Some people find it useful to make a list of all the reasons they don’t want to take cocaine. ‘I’ll have a better relationship with my friends and family’, for example. Use the list to help you stay focused.

Support & Services

If you are worried about your relationship with cocaine, it is important to reach out. There are a number of non-judgemental friendly services who can help.

The Switchboard Ireland

Outhouse, 105 Capel St, Dublin 1.
The Switchboard Ireland is Ireland’s longest running support service for the LGBT+ community. LGBT+ volunteers are available 7 days a week on phone, email and online chat to offer confidential listening, support and information. Thursdays: Substance Abuse, Chems, Narcotics, Alcohol 6:30pm – 9pm.

Phone: 01 872 1055
Contact: WhatsApp @089 26 74 777
Email: for support & signpost by email for other questions

The MPOWER team of peer sexual health outreach workers offer information, support and resources relating to HIV, STIs and other sexual health & wellbeing needs. The team is available to speak to you by phone, email, WhatsApp, and Zoom.

Phone: 01-8733799 and ask for the MPOWER Team (Mon-Fri 10am – 5pm)

Whatsapp: 086 065 7212 (Davy), 0866002996 (Mark), 0892291869 (Diego)

Sexual Health Centre Cork
Sexual Health Centre Cork offer the services of a dedicated Sexual Health Advisor to members of LGBTQIA+ community. Konrad Im provides sexual health advice and support in an understanding and warm environment, on a wide range of matters such as healthy relationships, sexuality, sexual dysfunction, gender and sexual identity.

You can make an appointment by sending an email to, calling the Sexual Health Centre on 021 427 5837 or contacting Konrad directly at

Visit the National Directory of Drugs and Alcohol Services and find a local service to help you.

Drugs helpline: Freefone 1800 459 459

Further information & services at

or from the drugs helpline: Freefone 1800 459 459