Overview

Cocaine is a powerful stimulant. It is also called coke, snow, C, flake, or blow. It may be mixed (cut) with other substances, such as cornstarch, talcum powder, or sugar. It may also contain other drugs, such as fentanyl, procaine, or amphetamine.

Two forms of cocaine are:

• The white powder form. It can be sniffed through the nose (snorted) or dissolved in water and injected in a vein (intravenous, or I.V.). It can also be taken by mouth or rubbed onto the gums.
• The rock crystal, or freebase, form. It can be smoked. Freebase cocaine is called crack, chips, chunks, or rocks.

Small amounts of cocaine make a person feel euphoric, energetic, talkative, and mentally alert. It also decreases appetite and the need for sleep. Some people use cocaine and alcohol together, which can cause stronger, longer-lasting effects. When large amounts of cocaine are taken, the high is more intense. But large doses can cause strange or violent behavior. For example, the person may have tremors or muscle twitches or become paranoid.

After using cocaine, the person feels irritable, tired, and depressed. This is called a coke crash. If a person takes the drug at higher and higher doses (a binge), they can get more and more irritable, restless, and paranoid. This can cause a person to hear or see things that aren't there (hallucinations).

Use of cocaine can lead to serious health problems. They include:

• Changes in heart rhythm and heart attack.
• Headache, seizure, and stroke.
• Loss of smell, persistent runny nose, nosebleeds, hoarseness, and destruction of the nasal separation (nasal septum) when the drug is snorted.
• Bowel tissue death.
• Damage to the kidneys.
• Serious infections, HIV, hepatitis, or allergic reactions when injected into a vein.
• Weight loss and poor nutrition from loss of appetite.
• Developing a stimulant use disorder.

Sometimes sudden death can occur, even with the first use of cocaine. Sudden death from cocaine use may occur because of a heart attack or seizure in which breathing stops. Sudden death is more likely to occur when cocaine is used along with alcohol.

The effects of cocaine last about 1 to 2 hours. Cocaine can be detected in a urine drug screen up to 6 days after it has been taken.

Signs of use

Signs that a person may be using cocaine include:

• Having supplies for injecting cocaine. These are called an outfit or rig. It may include syringes, spoons with smoke stains, small pieces of glass, and razor blades.
• Persistent runny nose and nosebleeds, which may be a sign of snorting cocaine.
• "Track marks" where it has been injected into veins.
• Going long periods of time without sleeping or eating.
• Personality changes.