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Harm Reduction Tips for Cocaine Users

Follow These Tips to Lower the Risks

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Updated October 10, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Taking cocaine is always risky and unpredictable.  Knowing what is in cocaine will help you understand why one dose can vary so much from another, but even the purest cocaine carries the risk of overdose, triggering mental illness, dangerous cardiac and neurological consequences, and unpleasant cocaine withdrawal symptoms.  The best advice for cocaine users is to quit, using treatment services if you need help.  But as many people do use cocaine regardless, following these tips will help reduce the risk of harm occurring as a result.  Harm reduction will only better your chances of coming through cocaine use unscathed, it will not make it safe.

1. Avoid Bingeing

Cocaine users can find themselves taking the drug multiple times in one session -- this is known as a cocaine binge. The half-life of cocaine is two to four hours, so the greatest danger of overdose comes from topping up your dose during this time period.  You can reduce the severity of the crash you will get afterwards by not repeatedly dosing in the same session.  For the best chance at a painless recovery, and to reduce the risk of cocaine addiction, let the drug wear off, get some rest and don't use again the next day.

2. Don't Use Cocaine to Avoid Withdrawal

Cocaine is well known for the "crash" that happens after coming down from the cocaine high.  This unpleasant state is marked by physical and mental exhaustion, and often, a low mood.  The crash is part of the drug's rebound effect. Using more cocaine to avoid withdrawal will simply increase the intensity of the withdrawal symptoms when they catch up with you, as well as increase feelings of dependence on the drug.

3. Take Care of Your Nose

Snorting cocaine repeatedly can cause damage to the delicate nasal tissue.  Harm reduction literature recommends diluting cocaine with water before snorting, to reduce the damage to the nose.  Take a break from cocaine if you develop tissue damage in your nose and give your body a chance to recover. 

4. Get Appropriate Help for Mental Health Problems

Using cocaine to deal with such emotional problems as depression and social anxiety tends to worsen these problems over time, although cocaine might seem to help when you are high. Using cocaine to cope emotionally is a form of self medication; instead, talk to your doctor about medications and other treatments that may help with these emotional conditions.  Unlike cocaine, they are legally available on prescription and improve, rather than worsen, day-to-day functioning.

Cocaine can induce or trigger psychosis -- problems with perceiving things realistically -- which is treatable.  See a doctor right away if you think you might be seeing or hearing things that are not there or think people are having bad intentions towards you.

5. Take Care of Yourself Physically

The stimulant effects of cocaine can interfere with your sleep patterns, and you can find your appetite disappears when you are high.  Eating regular meals and a healthy diet, getting enough sleep and good hygiene are all important aspects of staying healthy when you use cocaine.  While it is possible to stay healthy when using cocaine on an occasional basis, your physical health can easily slip if you use cocaine frequently, particularly if you are using every day.   

Letting your physical health slip can lead to more serious problems, affecting work and relationships.   It's worth getting clean, even if just to get healthy again.  Talk to your doctor if you need help with physical health issues or a referral for  treatment services.

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Sources:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition (Text Revision). American Psychiatric Association, 2000.

Denning, P., Little, J., and Glickman, A. Over the Influence New York: Guilford. 2004.

Hser, Y., Evans, E., Huang, D., Brecht, M. and Li, L. "Comparing the dynamic course of heroin, cocaine, and methamphetamine use over 10 years." Addict Behav 33:1581-1598. 2008.

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