Resource Library

Harm Reduction & Overdose Prevention: Cocaine

Cocaine is a stimulant drug that many of us use to increase our energy and to feel good.

Cocaine can make us feel euphoric, and full of confidence. Powder cocaine is purchased in gram baggies, eight balls (an eighth of an ounce) and other similar quantities, and when purchased on the street is often extremely impure and cut with other substances. Powder cocaine is most often snorted in lines but can also be injected, smoked, or ingested (usually mixed into a drink).

Ways of using (+ harm reduction)

Snorting cocaine: This is the most common way that people use cocaine. The cocaine is inhaled from a flat surface through a straw into the nose. Once inside the nose and sinuses, the drug is absorbed by the blood vessels. People usually feel the effects of cocaine for a fairly short amount of time, usually about 30 minutes.

  • It’s best to use a new, clean straw versus a dollar bill for snorting. If you don’t have a straw, you can use a clean rolled-up piece of paper like a post-it note.
  • Try not to share straws with other people.
  • Rinse your nose out with warm water after snorting to keep the inside of your nose healthy.
  • Snorting can lead to sinus infections, a perforated septum, and frequent and/severe nosebleeds. If you get a nosebleed that won’t stop, or if you believe you have a nasal infection, it’s best to seek medical attention.

If injecting/slamming cocaine:

  • Pick up safer injection equipment from harm reduction centers, including sterile cookers, cottons, tourniquets, alcohol wipes, and more.
  • If possible, wash your hands thoroughly before using and clean the surface you’re using to cook and draw everything up on. Use an alcohol wipe on your skin before injecting.
  • Use a new, sterile syringe for every shot. Use sterile water to dissolve your drugs; if you’re dissolving a rock you can use vitamin C.
  • Avoid touching or licking the needle since bacteria from your saliva could cause an infection.
  • A missed shot (if the needle doesn’t go into the vein or it slips out) when you inject may cause redness or swelling that you may think is an abscess (you may not feel any pain at first because of the numbing effects of the drug). The effects you see from a missed shot may disappear after a day or so.

If you booty bump cocaine: You can dissolve the drug in water and then use a syringe without the needle to “bump” the solution into your butt. Or, you can push some of the drug on your fingertip into your butt. Either way, the drug is absorbed by the blood vessels in the lining of your rectum (butt). It takes about 3-5 minutes to feel the effects. Don’t share booty bumping syringes, which could put you at risk of hepatitis, parasites, or other diseases. If you bottom after booty bumping, have your partner wear a condom since booty bumping can damage the membranes that line your rectum–increasing the risk of giving or getting STIs.

Safer use & overdose prevention

There are some serious things that can happen to your body when using cocaine.

Taking too much can cause seizures, paranoia, heart attacks, and strokes.

If a person has a seizure, help them lie down and put something soft under their head. Turn them to their side, and protect the person’s head and body. Call 911, especially if the person does not regain consciousness, isn’t breathing, or if they have multiple seizures.

Cardiac arrest (heart attack) can also be related to drugs including cocaine and crack. Symptoms can include pressure in the chest, shortness of breath, breaking out in a cold sweat, or discomfort in other areas of the body. Call 911 and explain the person’s symptoms.

Overheating, or “hyperthermia” can be deadly. If you notice someone overheating, get them to slow down and stop agitated movements and try to cool down with ice packs, cool water, and a fan. Make sure they are drinking water or a sports drink with electrolytes so they don’t dehydrate. Place cool, wet cloths on the person’s body.

We also use the term “overamping” to describe what can happen if you take too much. Overamping means a lot of things to a lot of people. Sometimes it is physical, when our bodies don’t feel right. Other times it is psychological, like paranoia, anxiety or psychosis — or a mixture of the two.

Overamping can happen for a lot of different reasons: you’ve been up for too long (sleep deprivation), your body is worn down from not eating or drinking enough water, you’re in a weird or uncomfortable environment, you did “one hit too many,” you mixed some other drugs with your speed that have sent you into a bad place — whatever the reason, it can be dangerous and scary to feel overamped.

Overamping can also feel like: extreme anxiety, panic, paranoia, hallucinations, agitation, aggressiveness, agitation, restlessness, irritability, hypervigilance, suspiciousness.

How to deal with overamping

First, make sure that the problem is not medical in nature (seizure, stroke, heart attack, overheating). If you or a friend is experiencing anxiety or other psychological symptoms of overamping, try some of the following things:

  • Drink water or a sports drink; eat some food
  • Try to sleep
  • Change your environment or the people you’re with
  • Do breathing or meditation exercises: Breath exercises that relieve anxiety & insomnia
  • Create physical contact, like massaging yourself or having someone else do it for you
  • Go walking, walking, walking — walk it off!
  • Take a cool shower or put cooling pads under your armpits or on their neck. Or pour cool water on your face.
  • Get some fresh air

Preventing overamping and other health issues

  • If you’re worried about using too much, break what you have into smaller portions and set some aside. Typically, people who use their cocaine too quickly will tend to go back again and again for more, often on the same night/morning.
  • Try to make sure you know what substance you are using, but also recognize that you may not know exactly what you’re getting.
  • Avoid mixing Viagra with stimulants like cocaine and crack–this can cause very serious heart damage.
  • A small percentage of people who use cocaine may suffer from sudden cardiac arrest. This is a fairly rare event, but anyone with existing heart problems may be at an increased risk. Using with other people who are prepared to respond in case of an emergency is one way to reduce risk.