Cocaine: Harm Minimisation Strategies

General Safety Tips for Cocaine Use

Understand Your Substance:

• Test Your Cocaine: Always test a new batch for purity and potency. Cocaine can often be cut with other substances, which can significantly alter its effects and increase health risks.
• Know Your Dose: Start with a small amount to assess how it affects you, especially if it's from a new source or batch. Use a milligram scale to measure precise doses.

Set and Setting:

• Know Your Body & Mind (Set): Be aware of your mental and physical state before using. Using cocaine when anxious, stressed, or fatigued can heighten negative effects.
• Know Your Environment (Setting): Use in a familiar, safe setting and ideally with friends you trust. This can provide safety and support if you have an adverse reaction.

Mixing and Masking Effects:

• Avoid Mixing with Other Drugs: Using cocaine with other substances can lead to unpredictable and often more severe effects. Understanding these interactions is key to reducing your risk.

Measure Your Doses Accurately:

• Precision Is Key: Use precise tools like milligram scales to measure your doses accurately. Cocaine's effects can be intense, and overdose is a real risk with high doses or potent batches.

Hydrate and Nourish:

• Stay Hydrated: Cocaine can cause dehydration, especially during extended use sessions. Drink plenty of water to keep hydrated.
• Eat Healthily: Cocaine can suppress appetite, but maintaining good nutrition helps support your body’s health.

Care for Your Nose:

• Nasal Care: If snorting, alternate nostrils and use saline sprays to moisturize and protect nasal passages. Avoid using shared snorting tools to reduce the risk of infection.

Avoid Synthetic Forms:

• Stick to Known Substances: Synthetic or unknown blends can have unpredictable and harmful effects. Stick with known and tested products to minimize risks.

Routes of Administration: From Safer to Riskier

Intranasal (Snorting)

• Common but Risky: Damages nasal tissues and can lead to long-term issues like loss of smell and frequent nosebleeds.
• Safer Use Tips: Finely grind the cocaine to reduce harm. Use your own snorting device, like a straw or rolled paper, and clean your nostrils with saline before and after.

Oral Ingestion (Gumming)

• Less Common: Rubbing cocaine on the gums. Slower absorption, avoids nasal damage.
• Risks: Can lead to gum disease and tooth decay.

Injection (IV Use)

• High Risk: Rapid and intense effects but comes with risks of vein damage, infection, and overdose.
• Safer Practices: Use sterile needles, never share injecting equipment, and be aware of dosage.

Smoking (Freebase, Crack Cocaine)

• Very Risky: Leads to rapid dependency due to intense and immediate effects.
• Lung Health: Smoking can damage the lungs; use vaporization if possible to reduce harm.

High-Risk Drug Combinations

Cocaine and Alcohol

• Risks: Increases the liver’s production of cocaethylene, which can be more toxic and put additional strain on the heart.
• Symptoms: Greater impairment of motor skills, decision-making, and significantly increased risk of sudden death.

Cocaine with Other Stimulants (MDMA, Meth, Speed)

• Risks: Mixing stimulants can overburden the heart and lead to psychosis. Cocaine can also block the effects of other dopamine releasers, diminishing their effects but increasing strain on the heart.
• Symptoms: Extreme agitation, hallucinations, and chest pain.

Cocaine and GHB

• Risks: Stimulants increase respiration, allowing a higher dose of GHB. If the stimulant wears off first, the GHB can overwhelm the user and cause respiratory arrest.
• Symptoms: Similar to opioid mixing, with added risks of severe confusion and unconsciousness.

Cocaine and Benzodiazepines

• Risks: Benzodiazepines can mask the stimulant effects of cocaine, leading users to consume more cocaine than they can safely handle, increasing the risk of overdose.
• Symptoms: Drowsiness, confusion, respiratory depression, and difficulty waking up.

Cocaine and MDMA (Ecstasy)

• Risks: Both are stimulants, and their combination can lead to significant strain on the cardiovascular system and potential neurotoxic effects.
• Symptoms: Extreme agitation, high body temperature, hallucinations, and potential for severe dehydration and heart issues.

Cocaine and Opioids (Speedballing)

• Risks: Combining the stimulant effects of cocaine with the depressant effects of opioids can confuse the body’s ability to properly gauge its limits, increasing the risk of respiratory failure.
• Symptoms: Unpredictable heart rate, breathing rate, and high risk of fatal overdose.

Cocaine and Cannabis

• Risks: Cannabis can mask some of the stimulant effects of cocaine, potentially leading users to consume more cocaine to achieve the desired effects.
• Symptoms: Increased heart rate, paranoia, and impaired judgment.

Recognising and Responding to Overuse or Overdose

Recognising Overuse or Overdose

• Extreme restlessness or agitation.
• Elevated heart rate and blood pressure.
• High body temperature and excessive sweating.
• Hallucinations or psychosis from sleep deprivation.
• Chest pain or difficulty breathing.

Responding to Overuse or Overdose

• Call Emergency Services (000): Be clear about what was taken and the symptoms being exhibited.
• Stay Calm and Reassure the Person: Move them to a quiet, cool area to help them relax. Visit a doctor immediately for any severe reactions or persistent symptoms.
• Cool Down: If overheating, apply cool cloths to the skin and provide water if they're conscious and able to drink.
• Seek Immediate Medical Attention: Especially if symptoms like chest pain, severe agitation, or difficulty breathing are present.

Safe Management of Withdrawal

Cocaine withdrawal can be challenging and involves both physical and emotional components, including:

• Physical Symptoms: Fatigue, increased appetite, disturbed sleep patterns.
• Emotional Symptoms: Depression, irritability, anxiety, cravings.

Managing Withdrawal Safely

• Medical Supervision: Consult with a healthcare provider if experiencing severe withdrawal symptoms.
• Supportive Care:Maintain good hydration and a healthy diet to help the body recover, and seek support from friends, family, or professional services.
• Rest: Ensure adequate sleep and rest to support recovery.
• Counselling and Support Groups: Engage with support groups or counseling to manage the emotional aspects of withdrawal.