Cocaine

Cocaine is a powerful stimulant drug that speeds up the brain and body. It is illegal and carries significant risks to both physical and mental health, even with occasional use.

Cocaine is commonly used in social settings, nights out or to boost confidence and energy, but the effects are short-lived and often followed by a difficult comedown.

Street names you might hear

Across the UK and North West, cocaine is often known as:

  • Coke

  • Charlie

  • White

  • Snow

  • Gear

  • Blow

Crack cocaine may be referred to as:

  • Crack

  • Rocks

  • Stones

What does cocaine look like?

There are three main forms of cocaine:

Powder cocaine (coke)
A fine white powder.

Crack cocaine
Small off-white or yellowish rocks or lumps.

Freebase
A crystallised powder that is usually smoked.

The strength and purity of cocaine can vary widely, increasing the risk of harm.

What does it smell or taste like?

Cocaine powder has a bitter, chemical taste and smell.
Crack cocaine can smell like burnt plastic or rubber when smoked.

How do people use cocaine?

People use cocaine in different ways, all of which carry risks.

Snorting powder
Most people snort cocaine through the nose. This can damage the lining of the nose and, over time, destroy the cartilage between the nostrils.

Smoking crack or freebase
Crack or freebase is smoked using pipes, foil or improvised devices. This leads to a very fast and intense effect but increases the risk of dependence and harm.

Injecting
Powder cocaine or crack can be prepared for injection. This is extremely dangerous and greatly increases the risk of overdose, infections and vein damage.

How cocaine can make you feel

Cocaine affects people differently, but common effects include:

  • Feeling confident or energetic

  • Excitement or euphoria

  • Feeling alert and wide awake

  • Reduced appetite

It can also cause:

  • Anxiety or panic

  • Paranoia

  • Nausea or stomach problems

  • Increased heart rate and body temperature

  • Overconfidence, leading to risky decisions

Some people feel “on top of the world” while using cocaine, but this can quickly turn into agitation or distress.

How cocaine can affect behaviour

Cocaine often makes people:

  • Very talkative or restless

  • Edgy or agitated

  • Overconfident or impulsive

It can also increase sex drive, although higher doses or frequent use can reduce sexual performance and desire.

How long the effects last

The effects of cocaine are short-lived.

  • When snorted, effects usually begin within 5 to 30 minutes

  • When smoked as crack, effects are almost immediate

The main high typically lasts:

  • 20 to 30 minutes for powder cocaine

  • Around 10 minutes for crack, with a very intense but brief peak

Afterwards, people may feel low, anxious or paranoid for several days.

Cocaine can usually be detected in urine for up to 3 days after use.

Physical health risks

Cocaine places significant strain on the body, particularly the heart.

Risks include:

  • Heart attack or stroke, even in young and otherwise healthy people

  • Fits or seizures

  • High blood pressure

  • Chest pain and breathing problems

Snorting cocaine can:

  • Damage the inside of the nose

  • Destroy the cartilage between the nostrils over time

Smoking crack regularly can lead to long-term breathing problems.

Using cocaine during pregnancy increases the risk of miscarriage, premature birth and harm to the baby.

Risks from injecting and mixing drugs

Injecting cocaine increases the risk of:

  • Overdose

  • Vein damage, ulcers and gangrene

  • Blood-borne viruses such as HIV and hepatitis B or C

Mixing cocaine with heroin is known as “speedballing” and can be fatal.

White heroin can also be mistaken for cocaine. People have been hospitalised and have died after accidentally snorting heroin.

Mental health risks

Regular cocaine use can lead to:

  • Anxiety and paranoia

  • Low mood or depression

  • Feeling run-down or exhausted

  • Worsening of existing mental health conditions

Cocaine can also trigger past mental health difficulties or make them return.

What cocaine is often mixed with

Cocaine is commonly cut with other substances to increase profit.

This can include:

  • Sugars and starches

  • Benzocaine, a local anaesthetic that causes numbness but not a high

Because cocaine is often mixed with other substances, it is difficult to know how strong it is.

Mixing cocaine with alcohol and other drugs

Mixing drugs always increases risk.

Mixing cocaine and alcohol is particularly dangerous. Together they form a toxic chemical called cocaethylene, which:

  • Stays in the body longer

  • Increases strain on the heart and liver

  • Raises the risk of sudden death

Dependence and addiction

Cocaine is highly addictive.

Regular use changes how the brain releases dopamine, making people want to use more. Some people continue using to avoid the comedown rather than to feel good, which can lead to bingeing and dependence.

Staying safer

If someone is using cocaine, harm reduction steps include:

  • Avoid mixing with alcohol or other drugs

  • Take breaks between uses

  • Avoid injecting

  • Switch nostrils if snorting and care for the nose

  • Avoid using alone

If someone experiences chest pain, severe anxiety, overheating, collapse or fits, call 999. Seeking medical help will not get you into trouble.

Support from Wirral Ways

Wirral Ways offers free, confidential support for people affected by cocaine or crack use, as well as support for families and carers.

We can help with:

  • One-to-one support

  • Support to reduce or stop using

  • Harm reduction advice

  • Mental and physical health support

  • Support with housing, finances and wider wellbeing

Support is shaped around your goals and what matters to you.

Worried about someone else?

If you are concerned about a friend, partner or family member, you can contact us for advice and support. You do not need to manage this alone.

Get support

You can contact Wirral Ways to access support:

  • Self-refer online

  • Speak to a member of our team

  • Visit one of our services

Support is available, and help is there when you’re ready.

Last Updated on 4 February 2026