What it does

Cocaine is a short-acting stimulant that floods the brain with dopamine. Effects last 20–90 minutes depending on route. It raises heart rate, blood pressure, and body temperature, and can trigger heart attack or stroke even in healthy young people at any dose.

Safer-use principles

• —The illicit supply is now frequently contaminated with fentanyl. Test with fentanyl strips before use.
• —Never use alone. Overdose can happen suddenly and without warning.
• —Space out doses. Repeated re-dosing to chase the peak is the highest-risk pattern.
• —Never share straws, pipes, or needles — HIV and hepatitis C spread this way.

Dangerous combinations

Cocaine + alcohol forms cocaethylene in the liver, which is more toxic than either alone and strongly linked to sudden cardiac death. Cocaine + opioids ('speedball') is one of the most lethal combinations in overdose statistics — the stimulant masks the opioid, then wears off first.

If something goes wrong

Chest pain, severe headache, seizures, extreme agitation, or loss of consciousness — call 911. If opioids may be involved, give naloxone; it won't hurt if they aren't.