Cocaine and Crack

Consumption and Standard Dose

• Cocaine is a fine, white to off-white powder typically sold as ½ gram, 1 gram, or an “8 Ball” (3.5 grams). It is typically divided into small lines or piles (called bumps) of powder and inhaled through a rolled piece of paper such as a bank note, business card or paper straw
• Crack is a condensed, more potent form of cocaine, and is sold as hard crystals or “rocks.” Crack is typically smoked in a pipe or from tin foil.
• Either drug can be injected or booty bumped into the ass by enema.
  

The Buzz

• Induces feelings of exhilaration, excitement, alertness, hyperactivity and a mild euphoric rush
• Increases confidence and talkativeness
• Decreases hunger and numbs physical pain
• Feel more horny and more confident in propositioning people for sex
• Effects are felt within 1 minute and can last up to 30 minutes when snorted, and less than 30 minutes if smoked
  

Overdose and other negative effects

• 4.8 % of cocaine in Canada has Fentanyl in it, according to recent reports by Canada’s top drug testing labs, due to cross-contamination.
• Minuscule amounts of Fentanyl are fatal.
• Dozing off or feeling sleepy immediately after using cocaine is unusual and could be a sign of fentanyl-contaminated blow
• Never use cocaine alone, always have someone nearby who can respond with Nalxone when using cocaine.
• Cocaine’s effects are short acting. This can lead to using too much and too often.
• Increases body temperature, heart rate and blood pressure
• High doses of cocaine can cause chest pain, breathing difficulties, heart attacks and seizures
• Very high doses (overdoses) can lead to strokes or even death
• Can increase aggressiveness and agitation
• After-effects can include depression, irritability, anxiety and paranoia
• Repeated snorting damages nasal membranes and can deteriorate, and wear down holes in the septum; repeated smoking damages the lungs
• Signs of nasal damage include reoccurring nose bleeds.
• Causes cravings to use more. Tolerance builds up quickly, meaning you need more of the drug to have the same effect. It is easy to become addicted to cocaine.
• Cocaine has impurities mixed in with it, including baking soda, sugar, amphetamines, and toxic substance such as Levamisole (see below).
• Sharing snorting paraphernalia has a risk of transmitting Hepatitis C. Use your own snorting paraphernalia, ideally an unused paper straw.

Dangerous Drug Combinations

• Cocaine and alcohol when taken together combine in the liver to form cocaethylene, which intensifies and prolongs cocaine’s euphoric effects. Cocaethylene increases of the negative effects of both cocaine and alcohol and can increase the risk of a cocaine overdose and liver damage.
• If you are taking HIV meds, you likely need less of both alcohol and cocaine to feel the effects of cocaethylene.
  

Sex on Cocaine

• Increases feelings of personal attractiveness and sexual confidence
• Increases social confidence, decrease social nervousness, and makes you feel more confident in propositioning someone for sex
• Heightens sense of urgency to have sex
• Can decrease sense of importance of safer sex
• Increases stamina and can lead to marathon, rougher sex sessions, which can increase the possibility of transmitting sexually transmitted infections (STIs)
• Heightens intensity of pleasure, and connection during sex
• Can delay climax due to numbing effects and blood pressure changes
• Long-term, heavy use can burn out the brain’s pleasure (dopamine) receptors, making sober sex seem dull and unenjoyable
• Bump Dump: can increase bowel movement urgency and cause diarrhea. Important consideration in preparing for anal sex.
• Coke Dick: temporary impotence is normal with cocaine, as it is with many other party drugs. Try using a cock ring, or be ok with a dick that is not 100% hard during sex on cocaine, rather than adding other drugs into your system, like Erectile Drugs.
  

HIV Medications & Cocaine

• There are no known bad reactions with small-to-moderate use of cocaine and HIV medications
• Higher doses of cocaine increase blood pressure. Take this into consideration if any medication you take affect blood pressure.
• It is easy to forget to take your meds when on cocaine. Make sure you take them, or create a system to remind yourself before you start using
• Make sure you make a plan for eating, for HIV meds that need to be taken with food. Cocaine suppresses appetite and can make it easy to forget to eat.

Contaminants in Cocaine and Crack

• Cocaine can have trace amounts of Fentanyl, Carfentanyl and its analogs.
• Fentanyl is in 4.8 % of cocaine, according to Canada’s national drug labs.
• Minuscule amounts of these substances are fatal. There is no safe way to dose with fentanyl and its analogs.
• Assume there could be fentanyl, or it’s analogs, in cocaine. Get trained in how to administer Naloxone, and get your own Naloxone kit, which you can get at your local pharmacy.
• Always have Naloxone nearby, and people with you at all times when you are using cocaine. Never use alone. Have people nearby who can respond with Naloxone.
• A small number of people have died in Toronto from fentanyl-contaminated cocaine, who had no idea fentanyl could be in their blow.

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• Almost all cocaine and crack contains Levamisole. It’s a toxic substance that’s used for de-worming livestock animals, and it weakens your immune system. This is especially a concern if you are living with HIV or hepatitis C.
• There’s no way of telling by the look or taste of cocaine or crack whether or not it contains Levamisole.
• Seek medical help right away if you experience an onset or increase of the following symptoms after using cocaine:
  • Fever: high, rapid onset, chills
  • Flu-like symptoms: swollen glands, sore throat, shortness of breath, coughs
  • Skin conditions: darkened skin patches and sores that look like dark bruising.
• Tell your healthcare provider that you used cocaine/crack which may have contained levmisole.
• Symptoms caused by levamisole can be misdiagnosed if medical practitioners do not know what they are treating.
• Levamisole poisoning can be treated if your healthcare provider knows what they are targeting.

Help make Toronto safer by reporting bad batches to ReportBadDrugsTO. This helps harm reduction workers across the city know about current bad batches and get the word out to people who use drugs.