Cocaine is a powerful central stimulant that is produced from coca leaves and is also known as Charlie, Kola, Coke, Powder, White, or Snow. Emojis such as the snowflake ❄️ are often used to represent cocaine.

⬆️ Cocaine is an “upper” that provides rapid and intense euphoric effects.

🔴 Cocaine triggers a strong craving for more and has a high potential for psychological addiction.

Cocaine and crack are both popular in recreational drug use and are quite well-known. Usually, cocaine and crack are not included in “chemsex drugs,” but they are often used in a sexual context to increase energy, endurance, and enhance sexual experiences. It is common to use cocaine in combination with other substances.

Cocaine is typically a fine, white crystalline powder. The powder can be mixed with other substances, which can slightly alter its appearance.

Crack is a freebase form of cocaine made by processing cocaine powder with sodium bicarbonate (baking soda) and water, resulting in a solid, crystalline form that looks like white or yellowish lumps or small rocks that can be smoked.

Cocaine is most commonly snorted, providing a gradual onset of effects. Cocaine is rarely injected, as injection provides a quicker and more intense effect.

Crack is smoked, resulting in an almost immediate and intense high.

The effects of cocaine are felt within minutes (faster when smoking crack) and provide an intense feeling of euphoria, increased energy, and mental clarity. The effects last about 30 minutes to 1.5 hours. Common experiences include:

• Restlessness, a strong desire to move, talkativeness, and increased self-confidence.
• Significantly reduced inhibitions and fears, and decreased pain perception, which can lead to greater risk-taking.
• Increased sexual arousal.
• Decreased appetite or thirst.

Cocaine can also cause the following side effects:

• Increased heart rate, blood pressure, and body temperature.
• Feelings of nervousness, anxiety, restlessness.
• Memory problems and disorientation.
• Aggression

Coming down from cocaine can be unpleasant, with feelings of mental and physical exhaustion, low mood, and depression being common. Because cocaine triggers a strong craving for more, it can be difficult to stop once you start coming down.

In chemsex, cocaine is used to prolong sex sessions, increase endurance, and enhance sexual pleasure. Cocaine can also help users let go of sexual inhibitions, leading to risk-taking (e.g., not using condoms or exceeding one’s comfort zone). A reduced pain threshold can lead to physical injuries and overexertion.

Cocaine is often used together with other substances like GHB/GBL, ketamine, or methamphetamine to modulate and enhance the effects.

Safer Sex with Cocaine

• If using a condom during sex, change it after 30 minutes to prevent tears and breakage
• Ensure you have what you need, such as condoms, lube, gloves, and cleaning supplies for dildos and plugs
• Always talk to your partner(s) about consent, preferences and boundaries

Cocaine and common chemsex-drugs

Combining GHB/GBL and cocaine should be avoided as the effect of G can be suppressed when used simultaneously. The risk of overdose increases because the effects are not felt, leading to taking too much or too quickly.

The risk of overstimulation is high when using cocaine and other strong stimulants like methamphetamine and mephedrone together.

• The combination can lead to extremely high blood pressure and heart rate, increasing the risk of heart attack, stroke, and other cardiovascular problems.
• Concurrent use can cause anxiety, paranoia, and hallucinations.

With more regular use, the risk of long-term health problems increases. Withdrawal symptoms can include exhaustion, severe mood swings, difficulty concentrating, delusions, or depression.

Long-term use of cocaine can also lead to a weakened immune system, irritation or inflammation of the nasal mucosa (from snorting), and impact on the heart, liver, and kidneys.

It is difficult to know how much cocaine can cause an overdose. An overdose can be very harmful and, in some cases, life-threatening. Signs of overdose include:

• Chest pain
• Rapid or irregular heartbeat
• Seizures
• High body temperature
• Nausea and vomiting
• Severe anxiety or panic attacks, including paranoia and hallucinations
• Violent behavior
• Unconsciousness

If an overdose is suspected, it is important to:

• Seek emergency care: Call for an ambulance (112 in Sweden, which also works in all EU countries).
• Monitor breathing: Ensure the person is breathing and keep their airways clear.
• Keep the person calm: Try to ensure that the person does not harm themselves or others during hallucinations or confusion.
• Provide accurate information: Try to obtain information about what and how much the person has taken, so you can give the correct details to medical personnel. This is important to ensure the person receives appropriate treatment.

⚠️ Cocaine has a high addiction risk due to its strong euphoric and short-term effects. Regular use can quickly lead to both physical and psychological dependence. Users develop tolerance, meaning they need larger doses to achieve the same effect.

Addiction can lead to serious health problems, including cardiovascular diseases, mental disorders, and social consequences.

Cocaine can affect HIV treatment, weakening the immune system, altering the drug’s effect, and increasing the risk of side effects. Long-term cocaine use can lead to forgetting to take medication, reducing the effectiveness of HIV treatment.

🕐 Always have your HIV medications with you. If you often forget to take your medication, set an alarm or reminder on your phone. Take substances and HIV medications at different times to reduce the risk of side effects. Always take low doses of substances when taking medications simultaneously.

🗣️ Talk to your doctor or an expert about interactions between HIV medication and cocaine.