Harm Reduction Strategies When Using Cocaine

The best cocaine tip is to cut out the white stuff completely. After all, even the purest cocaine carries the risk of overdose, triggering mental illness, dangerous cardiac and neurological consequences, and unpleasant cocaine withdrawal symptoms.

Regardless, if you do choose to use cocaine, a few harm reduction strategies will help reduce your risks. Keep in mind, however, that harm reduction will only better your chances of coming through cocaine use unscathed, it will not make it safe to keep using.


Avoid Binging

Close-up of a drug user using drugs, Maine, USA.
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Cocaine users can find themselves taking the drug multiple times in one session. This is known as a cocaine binge. The half-life of cocaine is two to four hours, which is pretty short for a stimulant. The greatest danger of overdose comes from topping off your dose during this time period. 

You can reduce the severity of the crash you will get afterward by not repeatedly dosing in the same session. For the best chance at a painless recovery, and to reduce the risk of addiction, let the drug wear off, get some rest, and don't use again the next day.


Don't Use Cocaine to Avoid Withdrawal

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Cocaine is well known for the "crash" that happens after coming down from the cocaine high. This unpleasant state is marked by physical and mental exhaustion, and often, a low mood.

The crash is part of the drug's rebound effect and the worst part of it only lasts for 45 minutes to an hour. Using more cocaine, alcohol, or other drugs to avoid withdrawal will simply increase the intensity of the symptoms when they catch up with you.

A better approach is to get some sleep or planning a day of rest ahead of time if you know you're likely to binge. Also, be sure to drink plenty of water or juice and eat some food, even if you don't feel like it. Your body needs nutrients to recover and small things will help significantly.


Take Care of Your Nose

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Repeatedly snorting cocaine can cause damage to the delicate nasal tissue inside your nose. It can even eat a hole in your septum after awhile.

Some people recommend diluting cocaine with water before snorting to reduce the damage to your nose. You can also insert the straw deeper into your nasal passage so the cocaine doesn't get stuck in the nose hairs. Alternating nostrils and ensuring the cocaine is chopped into a fine powder will also help.

Take a break from cocaine if you develop tissue damage in your nose. It will give your body a chance to recover. 


Be Smart About Straws, Needles, and Pipes

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Sharing anything that you use cocaine with can lead to infection. Snorting straws can pick up small particles that may carry infectious diseases like HIV or hepatitis C. Likewise, a pipe with a broken piece may cut users unexpectedly and sharing a pipe puts you at risk for herpes and other diseases. 

If you smoke cocaine, be cautious about burning yourself. Avoid using makeshift pipes or foil from bottles, cans, or other sources as you may be inhaling harmful chemicals. These can damage your lungs even more than the cocaine.

If you have never injected cocaine, it's best not to start. The risks of abscesses from using the same injection site and missing a vein are too great. You'll also want to avoid skin popping because the body's tissue doesn't absorb cocaine well, so it's really not worth it.

It is never wise to inject any drug with needles that you are not 100 percent certain are sterile or that have been used by someone else. Know where your local needle exchange program or safe injection facility is and take advantage of the resources they offer.


Know the Overdose Signs

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An overdose of cocaine can lead to heart attack or stroke because your heart will begin to beat too fast. It may be due to a bad batch of cocaine or from a combination of drugs.

Cocaine can be cut with all sorts of harmful additives, including poisons and other stimulants. It's best to start slow anytime you buy a new supply to test out its effects.

Speedballing—using an opiate and cocaine at the same time—can lead to an overdose as well. Your body doesn't know how to react to both a stimulant and a sedative simultaneously. It's best to avoid it, as well as using cocaine with alcohol or any other drugs.

Overdose Signs

  • Blue or extremely pale face
  • Difficulty breathing
  • Vomiting
  • Foaming at the mouth
  • Seizure
  • Chest pain
  • Unconsciousness

Signs of a cocaine overdose include the user's face turning blue or extremely pale. You may find it hard to breathe or go limp, even find that it's impossible to talk. Vomiting, foaming at the mouth, seizure, chest pain, or unconsciousness are also signs that you need to call for emergency help immediately.


Get Appropriate Help for Mental Health Problems

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Using cocaine to deal with such emotional problems as depression and social anxiety tends to worsen these problems over time. This is true even though cocaine might seem to help when you are high. The relief is only temporary and whatever problems you are experiencing will still be there when you come down.

Using cocaine to cope emotionally is a form of self-medication. Instead, talk to your doctor about medications and other treatments that may help with these conditions. Unlike cocaine, they are legally available on prescription and can improve, rather than worsen, day-to-day functioning.

Cocaine can induce or trigger psychosis—problems with perceiving things realistically—and this is treatable.

See a doctor right away if you think you might be seeing or hearing things that are not there, or think people are having bad intentions toward you.


Take Care of Yourself Physically

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The stimulant effects of cocaine can interfere with your sleep patterns, and you may find that your appetite disappears when you're high. Eating regular, healthy meals, getting enough sleep, and using good hygiene habits are all important aspects of staying healthy when you use cocaine.

It is possible to stay healthy when using cocaine on an occasional basis. However, your physical health can easily slip if you use it frequently, particularly if you are using every day. Letting your physical health slip can lead to more serious problems that can affect your work and relationships. 

A Word From Verywell

Consider that the health risks associated with cocaine use are often not worth the high the drug offers. It's worth getting clean, even if it's just to get healthy again. Talk to your doctor if you need help with physical health issues or a referral for treatment services.

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Additional Reading

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-5. 2013.
  • Harm Reduction Coalition. C Is for Cocaine. 1998. http://harmreduction.org/wp-content/uploads/2012/01/CisforCocaine.pdf
  • Marlatt GA, Larmer ME, Witkiewitz K. Harm Reduction: Pragmatic Strategies for Managing High-Risk Behaviors. 2nd ed. New York, NY: Guilford Press; 2011.