Alice,

My friend recently smoked some pot laced with cocaine. First of all, is this possible? Whatever the case may be, he seems to be infatuated with the idea of trying straight coke. I've heard that trying coke for the first time is quite dangerous, true? Also, what are the effects of the high? And how detrimental is coke in general?

Sincerely, Concerned Friend

Dear Concerned Friend,

Kudos to you for trying to dig up accurate information for your friend. Cocaine (often called coke) is a stimulant and an anesthetic made from coca plant leaves. While it can be used as a local anesthetic and has some medicinal purposes, using it recreationally is currently illegal in the United States. It works by blocking the reuptake of the neurotransmitter dopamine (a chemical responsible for a “reward” sensation in the brain), which leads to dopamine building up in the synapses without being absorbed, which is what creates the feeling of being high. Like many drugs, cocaine can have many serious side effects and be addictive, especially when consumed often, combined with other substances, or taken in large quantities. 

Snorting powder cocaine and smoking crack cocaine are the most common forms of ingestion and the rate at which it takes the effects to kick in vary based on the mode of consumption. When smoked, cocaine takes effect more quickly but the effects last for a shorter amount of time (five to ten minutes), while snorted cocaine takes longer to absorb but lasts for longer (15 to 30 minutes). The reported effects of this drug are increased confidence, alertness, euphoria, increased libido, difficulty sleeping and a decreased appetite. When large amounts are consumed, it raises blood pressure, increases heart rate, causes rapid breathing, tenses muscles, and occasionally leads to violent or erratic behavior. Sometimes coke can result in cardiovascular or gastrointestinal (GI) issues, and in large amounts, its use can be fatal. 

Regarding the question of mixing or combining cocaine with other drugs: yes, it's both possible and known to happen. As your friend mentioned, some people will mix marijuana or tobacco with cocaine and smoke it. Some users will mix drugs in an effort to enhance effects, while others will try mixing drugs that have opposite effects to try balancing the effects of each other. Either way, mixing or combining substances has potential risks. For example, mixing alcohol and cocaine create byproducts that are toxic for the body. When cocaine and heroin are mixed, it may feel to the user as if their effects are offset, which may lead to increased use and potential overdose. 

Along with the short-term risks, cocaine can also lead to problems over time. With regular use, people may feel paranoid, anxious, confused, and sometimes experience hallucinations. Insomnia, agitation, GI problems, and depression can also result from frequent cocaine use. Additionally, there is the potential risk of addiction — and unfortunately addiction can begin shortly after a person's first cocaine experience. Eventually, the reward receptors in the brain adapt to an artificially high level of dopamine, which makes it more difficult to enjoy natural dopamine stimulants such as physical activity or art. This also makes it harder to achieve the high that a person might have experienced early on in their cocaine use and easier to experience the negative effects of the drug.

It's great that you're trying to learn more about this, especially as you're concerned about your friend. If you still have questions, consider checking out the Go Ask Alice! Cocaine, Speed, & Other Stimulants archives. Additionally, if you or your friend want more information on cocaine, you can check out Cocaine from the National Institute on Drug Abuse or speak with a health care provider about any questions or concerns you have. 

Alice!

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