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 (drug that causes the body to be insensitive to pain) made from coca plant leaves native to South America. Cocaine can be consumed through snorting, smoking, rubbing your gums, or needle injection. The effects of cocaine occur as a result of the drug blocking the body from absorbing dopamine. Dopamine is the chemical responsible for the ‘reward’ or ‘feel good’ sensation in the brain. Instead, dopamine accumulates and causes a high or euphoric feeling after cocaine usage. While there is potential for cocaine to be used medically as a local anesthetic, recreational use is currently illegal in the United States. Like many drugs, cocaine can have dangerous side effects and can be addictive, especially when consumed often and in combination with other substances. In large amounts, its use can be fatal. 

There are many different effects—both short- and long-term—and risks based on how it is consumed. Some of the reported short-term effects of cocaine usage can include increased confidence and libido, alertness, difficulty sleeping, agitation, and a decreased appetite. When large amounts are consumed, it can increase one’s blood pressure and heart rate, and lead to rapid breathing, tense muscles, and occasionally violent or erratic behavior. Long-term, regular use can often result in cardiovascular or gastrointestinal (GI) issues, as well as cause people to feel paranoid, anxious, and confused. In some cases, people may also begin to experience hallucinations and become depressed. Additionally, there is the risk of addiction—unlike other drugs that may require longer-term habitual use to become addicted, cocaine addiction can begin shortly after a person's first experience using the substance. Eventually, the reward receptors in the brain adapt to the artificially high level of dopamine, which make 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. 

Regarding the question of mixing or combining cocaine with other drugs: yes, it's both possible and been known to happen. Some users will mix drugs in an effort to enhance effects, while others will try mixing drugs that have opposite effects to try counterbalancing the effects of each other. Either way, mixing or combining substances can be risky. For example, mixing alcohol and cocaine creates 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. As your friend mentioned, some people may also mix marijuana or tobacco with cocaine and smoke it. Fentanyl is a synthetic opioid that is often mixed with other drugs, including cocaine. It has become more common in recent years, and a large contributor to overdoses due to its potency (it is 50 times stronger than heroin). Since fentanyl can be fatal even in small doses, you might suggest to your friend that they use fentanyl testing strips for any substances they are considering using as an extra precaution. 

If you or your friend want more information on cocaine, you can check out the page on Cocaine from the National Institute on Drug Abuse. If you feel that your friend’s use is beginning to negatively impact their life or your relationship with them, you might suggest they speak with a health care provider or offer them resources such as: 

It's great that you're trying to learn more about this, especially as you're concerned about your friend. 

Best of luck, 

Last updated Apr 21, 2023
Originally published Oct 27, 1995

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