AKA: coke, Charlie, C, snow, blow, a toot, Bolivian/Peruvian/Colombian marching powder

Coke is a powerful stimulant made from the leaves of the South American coca shrub. It makes the brain release its natural ‘feel good’ chemical dopamine.

Coke usually comes as a powder. It’s often cut with impurities such as baking soda, sugar, amphetamines or painkillers.

Freebase and crack, also known as rocks or stones, are types of cocaine which have been treated to make them smokeable. Crack cocaine is a less pure version of freebase cocaine and comes as small, dirty white/light brown rock-like pieces. Crack has a more powerful high than cocaine and is even more addictive.

How it’s used

Coke is normally divided into lines on a smooth surface, then snorted through a straw or rolled up banknote (which is not recommended at all). Other ways of taking it are smoking it or rubbing it into the gums or arsehole.

Crack is smoked in a pipe, glass tube, plastic bottle, or from foil.

Highs and lows of cocaine

A hit with either coke or crack comes on fast, usually within a minute, making the user feel exhilarated, alert, full of energy, confident, sociable, talkative and physically strong. It stops people feeling hungry or tired and kills pain.

Effects last for up to approximately half an hour if it’s snorted and less if its smoked or injected.

The drug pushes up body temperature, blood pressure and heart rate and can cause chest pain and an irregular heartbeat even in healthy people. People who use coke or crack are much more likely to have a heart attack than people who don’t use them.

Cocaine and crack use is also linked to strokes and seizures.

Comedown symptoms include:

  • feeling down, rough and tired
  • agitatation
  • craving for more of the drug.
  • Sudden death is more likely with large doses but smaller doses can kill, especially if someone has sensitivity to the drug. 

Sex on coke (and crack)

Both drugs can make users feel physically strong, horny, more sexually aggressive or confident and with more stamina for longer sessions. Peoples sense of touch can be heightened, and they might get longer, stronger orgasms.

As inhibitions are lowered, it might be more likely that users will have unsafe sex.

Cocaine’s painkilling effects can lead to rougher sex, making the cock and arse sore or bleed. This damage might not be noticed but it makes it easier for HIV, hepatitis C and other infections to be passed on.

Problems getting a hard-on, difficulty cumming and a lower sex drive can be other side effects, especially if the dose is big or it is taken for a long time.

A long term relationship?

When someone takes a lot of cocaine or crack, they build up tolerance and they’re likely to start taking higher doses to achieve the same high. Coke has a reputation for being more addictive than most chems and crack is even more addictive.

The drugs can cause lasting damage to how the brain works and, given the drug’s price, becoming addicted can ruin users financially.

Using cocaine or crack for a long time, or taking large doses, can cause panic attacks, hallucinations, depression, paranoia and psychosis.

Snorting coke can, over time, destroy the lining of the nose and the septum (the wall between the nostrils made from thin cartilage).

Coke/crack with other drugs


Using booze together with coke or crack makes the bad effects of both worse and can give people the illusion of being sober when they’re drunk. These drugs mix together in the body with alcohol to make cocaethylene, a toxin that damages the brain, liver and heart. This is the reason for the bigger risk of sudden death in people using alcohol and coke or crack together.

Speed, crystal meth, mephedrone, ecstasy, or Viagra

Mixing these drugs with coke or crack means even more pressure on the heart and circulatory system, with a bigger risk of stroke and heart attack.


Taking cocaine or crack when on some antidepressants can cause ‘serotonin syndrome’. This could be dangerous and causes symptoms such as a fast heart beat, sweating, muscle spasms and not being able to sleep. Users need to seek urgent medical help if this happens to them. If someone is on antidepressants the advice is to check with a doctor before using these drugs.

HIV drugs

As the body uses different pathways to processes these two drugs, there are no known dangerous interactions. However, regular use of cocaine has been linked to poor adherence to HIV treatment.

Useful to know and share

  • If users share straws or banknotes to snort coke, tiny amounts of blood could go from the lining of one person’s nose to another’s. This might spread blood-borne viruses such as hepatitis C. The same could happen if crack pipes are passed from a mouth with ulcers or burns to another person’s mouth.
  • Rubbing coke into the arsehole will make it numb and irritate the skin. This makes it more likely someone will pick up or pass on infections, including HIV.
  • Rougher, longer sex sessions mean there is more risk of condoms breaking, so putting a fresh one on after fucking for about 30 minutes is recommended.
  • These drugs make the heart beat harder and push up the blood pressure so should be avoided if the user has high blood pressure or a heart condition. They should be avoided by people with a history of mental health problems too.

Next module: MDMA (Ecstasy)

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