What is it?
Cocaine is a stimulant derived from the coca plant, usually sold as a white powder. Purity and adulterants vary and are usually unknown to the person using it.
Common forms
- Powder
- Paste
- Products of unknown purity sold as cocaine
How it affects the body
Cocaine increases dopamine and noradrenaline signalling, raising heart rate, blood pressure and body temperature while producing short-lived stimulation.
Short-term effects
- Increased energy, confidence and alertness
- Reduced appetite
- Raised heart rate and blood pressure
- Anxiety, agitation or paranoia
- A pronounced 'comedown' afterwards
Long-term effects
- Cardiovascular problems, including heart attack and stroke risk
- Damage to the nasal passages when snorted
- Anxiety, low mood and sleep problems
- Dependence and financial or relationship harm
Dependence and addiction
Dependence can develop when the body and brain adapt to regular use. It is not a moral failing or a lack of willpower. Signs people describe include needing more to get the same effect, difficulty cutting down, spending more time thinking about use, and continuing despite harm. Support is available at any stage — you do not need to have reached a crisis point.
Withdrawal
Stopping or reducing after regular use can cause withdrawal. Withdrawal varies between people and depends on how much and how long someone has used, their physical health and other substances involved. Some withdrawal can be medically serious, so it is safer to plan a reduction with a clinician or a drug and alcohol service rather than stopping abruptly alone. People often describe fatigue, low mood, disturbed sleep and strong cravings.
Overdose risks
Signs of a stimulant emergency include chest pain, severe headache, very high temperature, seizures, confusion, or collapse. Call 999 immediately — these can be signs of a cardiac or neurological emergency.
Mixing substances
Combining cocaine with alcohol produces cocaethylene in the body, which places extra strain on the heart. Combining stimulants with opioids masks sedation and increases overdose risk.
Harm-reduction information
- Avoid using alone
- Do not share snorting or injecting equipment — blood-borne virus risk
- Take breaks, keep hydrated and avoid overheating
- Be cautious if you have heart problems or take medicines affecting the heart
- Seek urgent help for chest pain — do not wait
When to seek urgent medical help
Call 999 if someone is unconscious or cannot be woken, is having difficulty breathing, has a seizure, has chest pain, becomes very confused or agitated, or you are worried they may have overdosed. For urgent advice that is not life-threatening, call NHS 111. You will not get someone into trouble by calling for medical help.
Treatment and recovery options
- Talking therapies and structured psychosocial support
- Community drug and alcohol services, including self-referral where available
- Medication-assisted treatment where clinically appropriate
- Medically supported withdrawal, arranged and monitored by clinicians
- Peer support and recovery communities
- Residential rehabilitation for some people, usually via assessment
- Support for related needs — mental health, housing, family and welfare
UK support resources
- NHS — health information and service finders (nhs.uk)
- Talk to FRANK — UK drug information service (talktofrank.com)
- Your local community drug and alcohol service — many accept self-referrals
- Local pharmacy teams, who can offer advice and signposting
Sources / references
This page is a plain-language summary written for education. For clinical or legal detail, use authoritative UK sources: NHS (nhs.uk), Talk to FRANK (talktofrank.com), NICE (nice.org.uk), UK Government and devolved government publications, and guidance from UK professional bodies. Each page on this site carries a review date, and we welcome corrections.