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What is it?

Cocaine is a stimulant drug extracted from the leaves of the South American coca bush. It speeds up the messages between the brain and the body – basically, it gets us to stepping. In Australia, cocaine comes in the form of white powder that has a bitter, numbing taste. It is usually mixed or ‘cut’ with unsafe products to pad out its quantity for profits (basically when the gear is all baking powder and no coke – you know what I’m talking about).

There are two other forms of cocaine, both of which remove a specific chemical (hydrochloride) and creates a purer solution. One is called crack cocaine (named after the crackling sound it makes as it crystallises) and the other is called freebase which is a much more volatile version of the drug. Cocaine is also sometimes called snow, blow, nose candy, white lady, Charlie, white dust or stardust.

Cocaine is usually snorted in its powder form but it can be rubbed into the gums for a similar effect. It can also be injected and the other two versions of cocaine (crack and freebase) are typically smoked. With injecting, there is a risk of contracting blood-borne viruses, such as hepatitis B & C and HIV if needles are shared and the risk of infection at the injecting site.

What are the effects?

The effects are usually felt soon after taking it and last for around 30 minutes.

  • Greater happiness and confidence
  • Becoming more talkative
  • Greater energy and alertness
  • Anxiety and paranoia
  • Irritability and agitation
  • Headaches and dizziness
  • Boost in physical strength and mental aptitude
  • Reduced appetite
  • Dry mouth
  • Dilated pupils
  • Higher blood pressure, faster heartbeat and breathing
  • Higher body temperature
  • An increased sex drive
  • Insomnia
  • Unpredictable, violent or aggressive behaviour
  • Indifference to pain
  • Lung conditions such as bronchitis
  • Anxiety, paranoia and psychosis
  • Sexual dysfunction
  • Kidney failure
  • Stroke
  • Seizures
  • Hypertension and irregular heartbeat
  • Damage to the tissue separating the nostrils if you are snorting

Extended and heavy consumption of cocaine can induce psychosis which leads sufferers to experience paranoia, hallucinations, unusual thoughts and strange behaviour. These symptoms usually disappear a few days or weeks after the person stops using cocaine.


If we take a large amount or have a strong batch of cocaine, then it’s possible to overdose. Knowing the signs of overdose helps keeps us and others safe, and when we might need to call an ambulance. Watch out for these symptoms and call 000 in an emergency:


Nausea and vomiting


Chest pain




Extreme agitation and paranoia






Breathing irregularities


Kidney failure






Heart problems

Mixing with other drugs

The effects of mixing cocaine with other drugs – including over the counter or prescribed medications can be unpredictable and dangerous. Do not mix cocaine with the following medications because it may increase the risk of overdose, and even death:

  • Opioids
  • Anti-depressant medications (specifically MAOIs)

There are a range of unsafe interactions to be cautious of when mixing cocaine and other drugs, and they can be found at TripSit.

HIV Medications

The interactions between cocaine and antiretroviral medications are not well known. But we did find that the use of cocaine may impact the efficacy of antiretroviral medications.

In combination with HIV medications, cocaine may:

  • Aggravate HIV-associated neurocognitive disorders;
  • Impact inflammatory and oxidative systems; and
  • Impact coronary health.

We also found that protease inhibitors can increase concentrations of cocaine in the body, which amplifies its effects, both positive and negative, so best to be aware of cocaine toxicity.

Additionally, some studies have highlighted the interactions between significant stenosis and the use of particular HIV medications, including Lamivudine, Stavudine and Zidovudine. Furthermore, research has also identified issues for long-term cocaine users and kidney functioning for patients taking Efavirenz, Etravirine, Nevirapine, and Rilpivirine.

Anyone using cocaine should chat with an HIV specialist about their medication regimens and what the possible interactions are.

The interactions between cocaine and PrEP and PEP are not well known. There’s currently no evidence to suggest that cocaine use directly interacts with these medications or reduces their efficacy. We’ll keep looking and update you if any new research comes to light.

To learn about the interactions between specific HIV medications and cocaine head to Liverpool HIV Drug Interactions Checker.


There’s currently no evidence to suggest that cocaine use directly reduces the efficacy of HRT. We’ll keep looking and update this information if something new comes to light.

Feminising hormones and anti-androgens can alter the experience of stimulants generally, including cocaine. It can result in experiencing amplified effects including excess sweating, rapid heart rate and dehydration, and this is more likely with low testosterone levels.

Fluctuations in Oestrogen and Progesterone can change how we respond to stimulants (although studies have been just with cisgender women), and it can affect our state of mind when taking cocaine.

Oestradiol can contribute to deep vein thrombosis, and cocaine use has been shown to increase thrombic risk, so best to chat with a healthcare professional to help manage and mitigate the risk.

Progesterone can cause us to feel tired, drowsy or sleepy a couple of hours after taking it, so it can help to schedule when to take it and when to take cocaine.

Testosterone can increase irritability, and restlessness and impact our emotions, so we may find changes in our response when taking cocaine, such as increased sweating and heart rate, and our experiences of irritability and mood swings.

Both Testosterone and Cocaine use can contribute to a condition known as polycythaemia (a high concentration of red blood cells). This may feel like fatigue, weakness, dizziness, or shortness of breath. Chat with your doctor to keep an eye out during any blood tests.

For more information about cocaine head to the Australian Drug Foundation or TripSit.

The information given on this page is not medical advice and should not be relied upon in that way.