Cocaine

Due to the aesthetic properties of cocaine, and the usual stimulant effects of heightened arousal and increased feelings of energy and stamina, sex sessions can go for longer than they might otherwise and the risk of breaking the skin or anal lining along with bleeding are increased and less likely to be noticed. This can increase the risk of transmitting HIV and hepatitis C, and other STIs.   If you are choosing to use using condoms, you should check the condom regularly, continuously add lube and change it every half an hour or with every new partner.

Condoms and lube may come off or get forgotten altogether. For HIV-negative guys using cocaine to enhance sex – PrEP can be a great way to protect against HIV infection. If you’re HIV negative, and your HIV prevention (condoms or PrEP) fall by the wayside, you can access PEP within 72 hours to prevent HIV.

It’s also worth considering other STIs and BBVs, such as syphilis, gonorrhea and hepatitis.  If you aren’t using condoms then regular sexual health check-ups are a good idea.

The purity and strength of cocaine will vary from dose to dose. It’s always wise to have less than you think you need at first, just in case what you buy this time is stronger than you’re used to.

Extended cocaine binges can cause a range of health problems, including damage to the inside of the nose from snorting. You might not notice this at the time due to the pain killing properties of the drug. Some people mix their cocaine powder with water and snort it that way to try to dilute it. Another strategy is to insert the straw a bit deeper into the nose, past the nasal hairs, when snorting.

If you are going to use cocaine, there are a few ways to keep your play safer.

Set limits, and stick to them. Decide how much you want to sue beforehand and how much you’ve got to spend.

Under pressure? Don’t let others put pressure on you to do more, or push your limits.

Eat it! Cocaine decreases your appetite. Before you play have some food, and keep hydrated.

Manage aftercare. Having an extended play session? Make sure the fridge is stocked, and you have time off afterward to rest properly before you get back into the swing of things.

Plan your come down Do you get severe anxiety/depression or thoughts of suicide when coming down? Put together a plan on how to manage it before you play.

Let ‘em know. Tell mates where you’ll be, and what time you plan to be home.

Stay protected: Wherever you’re playing and for however long, keep enough of your HIV meds or PrEP with you, and set some phone reminders.

Read the signs: In some people, using cocaine and going for extended periods without sleep can trigger the onset or the recurrence of mental illness, including depression, anxiety and/or psychosis. If you are living with a mental illness, it’s a good idea to learn your relapse early warning signs (getting irritable, seeing shadows, hearing whispers, experiencing feelings of paranoia, etc.). If you start to get symptoms, you should stop using and try to get some sleep. If things don’t improve, of course you should see a health professional.

Blood borne viruses such as Hepatitis B, C and HIV can be transmitted through sharing drug using equipment. That’s not just needles and syringes, but other equipment you’re using too like tourniquets, swabs, spoons, surfaces, and snorting implements like straws or rolled up bills.

Injecting is not usually the preferred method of administration for cocaine. Cocaine is quite short acting and while injecting can produce a bigger high, it wears off more quickly – sometimes within just a few minutes.  For this reason, most cocaine users snort, drink, or rub the powder into their gums. People who do choose to inject often end up doing so much more frequently over a shorter period. This combined with the local anaesthetic properties of cocaine means that you can end up doing more damage to your veins and be at much greater risk of overdosing.

1. Get the best equipment:

The most important thing is always using a new needle-syringe. A map of where you get free unused needle-syringes in Victoria can be located here

Aside from needle-syringes, make sure you’ve got a good tourniquet, cup/spoon, and heaps of swabs/Band-Aid’s. Keep your equipment stocked up to make sure that you never have to share.

Remember – ‘a new fit for every hit’ (and never sharing equipment) means that you significantly reduce your risk of catching a blood borne virus.

2. Learn about vein care: Do your own research or speak to a professional; this might include a good GP or a worker in a needle syringe program.

Some basics include:Rotating your veins so you give injecting sites time to heal.

Drinking water (before injecting) to make veins easier to find

Keeping your hands, equipment and injecting site clean to make sure you don’t get an infection. This includes putting a band-aid on your injecting site to keep bacteria out.

3. Take it slow and develop a good technique check out out safer injecting video.

If you would like more support, there are heaps of non-judgmental services that can help you to improve your injecting style. You can contact ‘Harm Reduction Victoria’ for safe injecting workshops, or head down to the Medically Supervised Injecting Room (MSIR) who have some great equipment and technology that can really help you inject as safely as possible.

Different batches will have different levels of potency and will affect people differently depending on how the drug is taken, body size, general physical and mental health, and other individual factors.

The desirable short term effects of cocaine use include feelings of euphoria, increased alertness, energy, self-confidence and sociability. Less desirable effects can include insomnia, hyperactivity, irritability, restlessness and feelings of anxiety or depression, particularly as the drug wears off. Other possible effects are increases in body temperature (after an initial drop), spikes in blood pressure and heart rate, irregular heartbeat or palpitations, and nausea.

Higher doses or extended periods of use may cause people to experience shortness of breath, vomiting, chest pain, feelings of panic, depression, paranoia, hallucinations, tremors, seizures, heart attack, kidney failure or stroke.

Using cocaine and alcohol together can increase health risks. When these two substances combine, they create a more powerful substance that stays around for much longer in the body called  cocaethylene. It can stay around for a much longer time in the body than either alcohol or cocaine on their own and cause increased damage to major organs, particularly the heart and liver and much greater risk of having a heart attack or stroke.

If you or any of your friends are using cocaine and start to experience chest pains, tremors or heart palpitations, or anyone collapses, passes out or has a seizure, it’s important that you seek medical attention immediately.

The body builds up a tolerance to cocaine when used frequently. Feeling like you need more to get high each time you play is a sign that you may be developing a tolerance and it might be time to take a break for a while. Increasing your use or dosage can increase your risk of overdosing, put a much higher economic burden on you, and increase your dependency upon cocaine to function socially.

Long term, regular use can result in a range of negative physical and psychological impacts, including dependence on cocaine to feel and function ‘normally’ and a decreased ability or desire to have sex without the drug. Regular use can also have a cumulative effect on the heart and blood pressure lead to an ongoing higher risk of heart attack or stroke.

If you feel like you are prioritising cocaine use over other activities, needing more of the drug to get the same effects, always using more than you initially intended to or no longer feeling in control of your use, it may be worth talking to someone about it.

Cocaine + prescription anti-depressants can cause serotonin syndrome, which requires immediate attention. Symptoms include insomnia, agitation, irregular or increased heart beat and muscle spasms.

Cocaine + Psychedelics and other stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences.

Cocaine + Ketamine– No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

Cocaine + MDMA– Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

Cocaine + GHB– Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the G may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind.

Cocaine  +  Alcohol –Taking cocaine and alcohol together creates a more powerful substance that stays around for much longer in the body called cocaethylene. It can increase the risk of heart attack and stroke, and cause damage to a number of internal organs.

Cocaine  +  Decongestants can increase strain on the heart.

It is not recommended to use cocaine if you suffer (or have suffered) from:

• Heart conditions
• Hypertension
• Thyroid problems
• Pre-existing mental health issues
• Cocaine + PrEP work just fine together with no known interactions. If you’re using cocaine and you’re HIV-negative then PrEP is a great way to protect yourself from HIV.

 What if shit goes wrong?

• Stay away from crowds.
• Avoid loud noises.
• Reassure yourself or the person affected that what you are experiencing is because of the cocaine.
• If it gets out of control dial 000 and remember paramedics are not obliged to involve the police.

 Things not feeling great?

If you’re experiencing negative side effects from your cocaine use you can access Thorne Harbour Health’s counselling services

For LGBTI drug information check out Touchbase or Harm Reduction Victoria’s drug resources

If you need help on dealing with drug and alcohol addiction, please contact DrugInfo at 1300 85 85 84

If you’re in crisis contact Switchboard  or Lifeline

Ask us anything! Got more questions about booze? Ask our specialists and we’ll get back to you with some help or answers.