Addiction Drug Use Cocaine Harm Reduction Strategies When Using Cocaine By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial process Updated on February 19, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print The best cocaine tip is to cut it out 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. If you are having trouble quitting, be sure to contact a healthcare professional or call the SAMHSA hotline at 1-800-662-4357. Verywell / Cindy Chung 1 Avoid Bingeing 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. 2 Plan Ahead 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. 3 Take Care of Your Nose 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. 4 Be Smart About Supplies Sharing anything that you use cocaine with can lead to infection. Snorting straws can pick up small particles that may carry infectious diseases. Likewise, a pipe with a broken piece may cut users unexpectedly and sharing a pipe puts you at risk for oral 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 cocaine is not well absorbed this way, so it's really not worth it. It's also never wise to inject any drug with needles that you are not 100% 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. 5 Know the Overdose Signs An overdose of cocaine can lead to heart attack or stroke. 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 may respond unpredictably 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 faceDifficulty breathingVomitingFoaming at the mouthSeizureChest painUnconsciousness 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. 6 Get Help for Mental Health Issues 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. 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. 7 Take Care of Yourself 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 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. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Scheidweiler KB, Spargo EA, Kelly TL, Cone EJ, Barnes AJ, Huestis MA. Pharmacokinetics of cocaine and metabolites in human oral fluid and correlation with plasma concentrations after controlled administration. Ther Drug Monit. 2010;32(5):628-37. doi:10.1097/FTD.0b013e3181f2b729 Ciccarone D. Stimulant abuse: pharmacology, cocaine, methamphetamine, treatment, attempts at pharmacotherapy. Prim Care. 2011;38(1):41-58. doi:10.1016/j.pop.2010.11.004 Pekala KR, Clavenna MJ, Shockley R, Weiss VL, Turner JH. Chronic invasive fungal sinusitis associated with intranasal drug use. Laryngoscope. 2015;125(12):2656-9. doi:10.1002/lary.25429 Pichini S, Solimini R, Berretta P, Pacifici R, Busardò FP. Acute Intoxications and Fatalities From Illicit Fentanyl and Analogues: An Update. Ther Drug Monit. 2018;40(1):38-51. doi:10.1097/FTD.0000000000000465 Heard K, Palmer R, Zahniser NR. Mechanisms of acute cocaine toxicity. Open Pharmacol J. 2008;2(9):70-78. doi:10.2174/1874143600802010070 Morton WA. Cocaine and Psychiatric Symptoms. Prim Care Companion J Clin Psychiatry. 1999;1(4):109-113. Roncero C, Palma-Álvarez RF, Ros-cucurull E, et al. Cocaine-induced Psychosis and Brain-derived Neurothrophic Factor in Patients with Cocaine Dependence: Report of Two Cases. Clin Psychopharmacol Neurosci. 2016;14(1):109-13. doi:10.9758/cpn.2016.14.1.109 Mahoney JJ, De la garza R, Jackson BJ, et al. The relationship between sleep and drug use characteristics in participants with cocaine or methamphetamine use disorders. Psychiatry Res. 2014;219(2):367-71. doi:10.1016/j.psychres.2014.05.026 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. By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.