Start Low, Go Slow

For stimulants such as cocaine, moderation and setting limits can be an effective way to reduce the harms associated with its use. It is best to “start low and go slow” – take a small dose and wait a significant amount of time before taking more. 

This is important in order to avoid “over-amping” – the term used to describe what is considered an “overdose” but for stimulants such as cocaine. The effects of this can be physical or psychological, and can include extreme anxiety, paranoia and hallucinations. The effects of over-amping can be reduced by hydrating, eating food, getting sleep, breathing, exercise, walking, taking a warm shower and getting fresh air.

Harm Reduction Methods

The ways in which we can reduce the harms associated with cocaine depend on the route of administration. 

Snorting Cocaine

If the cocaine is being snorted, use a straw instead of a dollar bill. This is one way to reduce the potential for harm. If a straw isn’t available, a post-it can also be used, but whatever is being used should not be shared. You should also make sure that the surface where the cocaine is being cut is clean, as is the card which might be used to cut the cocaine. Flushing your nose with warm water after snorting dissolves any residual powder – making the nasal cavity healthier and ensuring that the drug doesn’t go into the throat.

Smoking Cocaine

If the cocaine is being smoked, as in the case of crack cocaine, make sure the pipe is clean and not too hot. Attention must be paid to the smoking materials being used. For example, the pipe being used shouldn’t get too hot. If the pipe is being shared, use alcohol prep pads to clean the pipe before using to prevent the transmission of bacterial infections. Using a sugar-free chewing gum can help keep saliva production up and prevent tooth decay because a dry mouth may contribute to tooth decay.

Injecting Cocaine

If the cocaine is being injected, use a sterile syringe and use a new one for every shot. In addition, proper injection practices like using a tourniquet – a cord or tight bandage which is used to stop the flow of blood through a vein or artery – and cleaning the body part that is being injected with antiseptic wipes is also important. Access to a safe consumption space, which has sterile syringes and access to medical care, also helps to ensure that the site of injection remains clean and abscess-free. 

Drug Checking 

Drug checking, or the ability to test a drug for adulterants, can also reduce the harms. As fentanyl – a powerful synthetic opioid – is increasingly being found in cocaine samples around the country, fentanyl checking strips should also be used. 

Learn more about fentanyl.

See the fact sheet for more information and sources.