Cocaine support · Scotland · RCA Trust
Where are you coming from?
This site has different things for different people. Tell us who you are and we'll take you straight to what matters.
Is something happening right now? They've collapsed, they're fitting, or you can't wake them — start here.I'm worried about someone.
Something feels off — their behaviour, mood, money, or routine. We'll help you read the signs, plan the conversation, and figure out what to do next. You don't need to be certain to call us.
Young PeopleI want the facts. No lecture.
Using, thinking about it, or worried about a mate? Here's what cocaine actually does, what's in it, and how to stay safer if you're going to use. Straight. No judgment.
People Who UseI use cocaine. I want to stay safer.
You decide what changes — if anything. We give you what you need to make safer choices and to spot a pattern forming. Support is there on your terms, when you're ready.
Why this matters
The conversation Scotland has been avoiding.
Cocaine is no longer a fringe drug. It's in living rooms, group chats, and Friday nights across every postcode in Scotland. The signs are missed. The risk is misunderstood. And by the time families act, patterns are usually established.
Drug deaths in Scotland in 2024 involved cocaine — the highest number ever recorded.
National Records of Scotland, 2025
Of all Scottish drug deaths in 2024 involved cocaine — up from 35% in 2022 and 41% in 2023. Every other major drug is falling. Cocaine is the only one still going up.
National Records of Scotland, 2025
Of everyone starting drug treatment in Scotland is there for powder cocaine — more than heroin (22%). Cocaine is now the main reason people come through the door. The latest figures say the same.
Public Health Scotland, RADAR, April 2026 · position unchanged in July 2026 report
Almost half of Scottish samples sent for testing didn't contain only what the person thought they'd bought. You cannot tell by looking.
Public Health Scotland, RADAR quarterly report, July 2026 (WEDINOS testing, March–May 2026)
Cocaine's share of Scottish drug deaths
Every other major drug is falling. Cocaine is the only one still climbing.
Annual figures come from National Records of Scotland, whose most recent release (September 2025) covers 2024. The 2025 figures are due around September 2026. We'll update this chart when they land.
| Year | Share of drug deaths |
|---|---|
| 2022 | 35% |
| 2023 | 41% |
| 2024 | 47% |
| 2025 | Not yet published — expected September 2026 |
Drug deaths overall fell 13% in Scotland in 2024. Suspected deaths dipped another 4% in the three months to May 2026. That's welcome. But hospital visits went up over the same period. And cocaine was still the drug found most often in three places at once: in treatment assessments, in post-mortem testing, and in hospital emergency testing. The overall numbers are easing. Cocaine's share of them is not.
Figures current as at 3 August 2026. Annual death figures come from National Records of Scotland (2024 data, published September 2025). Quarterly figures come from Public Health Scotland's RADAR report (July 2026, covering March–May 2026). We update this page when new figures are published.
Early signs
One sign means nothing. Patterns matter.
Cocaine use rarely starts with a crash. It starts with subtle shifts — energy, confidence, secrecy, sleep. Behavioural signs almost always come before physical ones. Knowing what to watch for buys you time.
01 — Behavioural
How they're acting
- Sudden bursts of energy or confidence
- Talking faster, more, or staying up late
- Increased secrecy — phone, plans, friends
- New social circle, especially late-night
- Irritability or low mood when "coming down"
02 — Physical
What you might see
- Dilated pupils, restlessness, fidgeting
- Reduced appetite, skipping meals
- Frequent nose rubbing, sniffing, runny nose
- Weight loss without another clear reason
- Disrupted sleep patterns
03 — Financial
Money & lifestyle
- Asking for money more often
- Cash going missing or unaccounted for
- Unexplained spending or "lost" money
- Sudden cash with no clear source
- Hobbies or routines dropping away
04 — Emotional
Mood & mind
- Mood swings bigger than usual
- Anxiety, paranoia, feeling on edge
- Short temper, anger surfacing quickly
- Crashing — flat, low, unmotivated
- Pulling away from family or supports
You don't need to be certain. You don't need to confront. You just need to make sure they know you've noticed, and that the door is open.
The risk most people don't know about
Cocaine + alcohol creates a third drug.
It's called cocaethylene — and it's more dangerous than either substance on its own.
Use cocaine and alcohol together and your liver makes a new compound. It's called cocaethylene. Your body doesn't just flush it out. It becomes a drug in its own right. It hits harder and does more damage than the cocaine or the drink on their own.
- It stays in the body longer than cocaine alone — sometimes for days.
- It puts far more strain on the heart and blood vessels.
- It increases the risk of irregular heartbeat, stroke, and sudden cardiac events.
- It builds up with repeated use — even at "social" levels.
- Most people using cocaine and alcohol together have never heard of it.
If you remember one thing from this site: the night you mix cocaine and alcohol is not the same as the night you have one or the other.
Effects on the body
What cocaine actually does — system by system.
Cocaine is a powerful stimulant. It hits fast and clears fast. The damage it leaves is often invisible, until it isn't. Some effects are immediate. Some accumulate quietly over months. And before any of it begins, there's usually something else in the powder you didn't sign up for.
Before you read on
You're almost never just taking cocaine.
Around 80% of cocaine seized in the UK has levamisole in it. It's a worming treatment for animals. It was taken off the market for humans because of what it does to your immune system. Most people who use cocaine have never heard of it.
It stops your body fighting infection.
Levamisole stops your bone marrow making the white cells that fight infection. Doctors call it agranulocytosis. A cut. A chest infection. An abscess in a tooth. Things that would normally be nothing can put you in hospital, because your body can't fight back.
It causes skin to die.
You get dark purple patches, usually on the ears, cheeks and nose. The skin under them can die. Some people need surgery. Doctors call it levamisole-induced vasculitis. It can show up weeks or months into using.
It builds up.
The damage adds up every time you use. Someone fine for months can end up in A&E with an immune system that's packed in. There's no warning sign, and no test most people would think to ask for.
It's a global problem.
Levamisole is in 60–90% of cocaine across the UK, US, Spain, Holland, and Switzerland. In February 2026 Europe's medicines regulator moved to pull it from human medicine. And not for the immune damage above. For a separate risk: leukoencephalopathy. That's damage to the brain's white matter. It causes confusion, weakness and slurred speech, sometimes after one dose. It's still in most street cocaine.
Levamisole is the one we know most about. It's far from the only thing in there. Some of the others can kill you on one line, not over months. See what's actually in it →
What the cocaine itself does
Click any system below to explore what's happening, when it shows up, and what's reversible. Use the arrow keys to move between systems.
Heart & circulation
Cocaine constricts blood vessels and forces the heart to work harder while starving it of oxygen. Heart rate and blood pressure spike within minutes. It can happen the first time, to someone perfectly healthy. The heart goes out of rhythm. Chest pain. In rare cases the heart stops. Long-term use thickens heart muscle and damages the arteries that supply it — silently, until it isn't.
Brain & reward system
Cocaine blocks the brain's ability to recycle dopamine, flooding the reward circuits with several times the normal level. The result is intense euphoria, focus, and confidence — followed by a steep crash as dopamine collapses below baseline. With repeated use, the brain dampens its own dopamine response. Everyday pleasures stop registering. The drug becomes the only thing that feels like anything at all.
Stroke & brain injury
The same narrowing of blood vessels that strains your heart can burst them in your brain. Cocaine causes both kinds of stroke: the bleeding kind and the blocked kind. It does it to people in their 20s and 30s with nothing else wrong with them. The danger is highest while you're using and in the hours right after. Using again and again also damages the tiny blood vessels in the brain. Over time that hits your memory, your focus and your judgement.
Nose, sinuses & throat
Snorting cuts off the blood supply to the inside of your nose. The tissue dies. Heavy users get blocked up constantly, pick up infection after infection, and lose their sense of smell. Over time the wall between your nostrils collapses — doctors call it a perforated septum. Once it's gone, it's gone. The damage can spread back into the roof of your mouth. Surgery can sometimes rebuild it. It doesn't always work.
Lungs (smoked / crack)
Smoking cocaine inflames your lungs, gives you a cough and leaves you short of breath. It also causes “crack lung”. Fever, chest pain, wheezing and bleeding inside the lungs. It can look like pneumonia. Smoking it long term shrinks how much air your lungs hold, for good. You pick up chest infections more easily too.
Gut & bowel
Less talked about, but real. Cocaine squeezes the blood vessels feeding your gut, and the bowel tissue can start dying from lack of blood — doctors call it ischaemic colitis. It shows up as severe stomach pain and bloody diarrhoea, and sometimes needs emergency surgery. It happens to young, healthy people. Long-term use also messes up your appetite and digestion.
Kidneys & liver
Cocaine puts strain on the kidneys directly and through dehydration, muscle breakdown (rhabdomyolysis), and high blood pressure. The liver bears the metabolic load — and with cocaethylene (cocaine + alcohol) it's working much harder. Some adulterants, particularly phenacetin, are independently associated with chronic kidney damage.
Mental health
Anxiety, paranoia, panic and a short fuse are common both while you're on it and coming down. Keep using and you can end up hallucinating, or feeling insects crawling under your skin — doctors call that formication. If you already live with depression, anxiety, ADHD or trauma, cocaine usually makes it worse. Suicidal thoughts on a comedown are common and they need taking seriously.
Sleep, appetite & teeth
Cocaine kills your appetite and wrecks your sleep. You eat badly and you sleep less. That makes the next comedown worse, and the anxiety and paranoia sharper. Clenching your jaw and grinding your teeth is common. Doctors call it bruxism. It cracks teeth, makes your jaw ache, and wears your teeth down fast. Most people don't realise how obvious it looks to everyone else.
Pregnancy & fertility
Using cocaine while pregnant raises the risk of miscarriage, the placenta tearing away from the womb, the baby coming early or being underweight. It can also affect how the baby develops. It passes straight through to the baby. If you're pregnant and using, you need specialist help fast. You also need it without judgement. Judgement is the main reason people say nothing. In men, using long term is linked to a lower sperm count and trouble getting an erection.
Tolerance & dependence
You need more and more to get the same high. Your heart never builds up any tolerance at all. So every time you chase that first feeling, you risk more with your heart. Nothing warns you. The mental hold usually takes grip long before anyone notices the physical side. It's the most common reason people come looking for help.
The good news
Stop, or cut right down, and most of the damage heals a long way back. That covers the heart, the brain, mood, sleep and skin. Not all of it, and not always fully. Septum perforations don't heal. Some cardiac scarring is permanent. But for the majority of users in the majority of systems, the body recovers more than people fear. That's a message worth leading with.
The basics
What is cocaine?
A powerful stimulant derived from the South American coca plant. Class A in the UK — up to 7 years for possession, life for supply. Street names include charlie, coke, gear, powder, grams, white. Dealers commonly use tops for cocaine and bottoms for heroin. This list isn't complete, and it changes from area to area. If you've never seen it and wouldn't know what to look for, start here.
Powder cocaine
cocaine hydrochlorideAppearance
White or off-white powder, sometimes yellowish or pinkish depending on what it's cut with. Fine and dusty (heavily cut) to slightly shiny and clumpy (higher purity). Sold in small snap-seal bags, cling film wraps, or folded lottery tickets.
How it's taken
Snorted — most common. Lines racked up on a flat surface using a card, inhaled through a rolled note or straw. Gummed — rubbed on gums for slower effect. Injected — rising in Scotland (60% of injectors). Bombed — wrapped in paper and swallowed.
Duration
High lasts roughly 15–30 minutes. This short duration is why users redose repeatedly throughout a session.
Crack cocaine
freebase, rocks, washAppearance
Small, hard, irregularly shaped lumps — off-white, cream, or yellowish. Waxy, crystalline, or chalky. Pea to thumbnail sized. Sold in small bags, foil, or cling film.
How it's made
Powder cocaine cooked with bicarbonate of soda and water. Some users make it at home ("washing up"). Signs: bicarb in unusual places, burnt spoons, small glass vials with oily residue.
Why it's different
Reaches the brain in 8–10 seconds. Lasts only 5–10 minutes. The rapid high-crash cycle makes it one of the most compulsive drugs known. Dependence develops extremely quickly.
Freebase
ammonia-processed, less commonWhat it is
Cocaine processed using ammonia rather than bicarbonate of soda. Purer than crack but the process is more dangerous (highly flammable solvents). Smoked the same way as crack. Less commonly encountered in Scotland.
Low purity — "council" / "bash"
~10–30% cocaine
Heavily cut with bulking agents (creatine, glucose, boric acid, caffeine, paracetamol). Fine, dusty, doesn't clump. Most common at street level. Users need more to feel the effect, increasing exposure to harmful cutting agents.
Medium purity — "gucci"
~30–60% cocaine
Still cut, but noticeably stronger. More likely to clump with a slightly shiny appearance. Pronounced gum numbing. Most recreational users in Scotland sit in this range. Still contains cutting agents.
High purity — "flake" / "fishscale"
~60–85% cocaine
Flaky, slightly oily or pearlescent. Clumps easily, dissolves quickly. Higher purity = higher cardiovascular risk per dose.
Important: the "fishscale" shine isn't proof of purity. Levamisole — found in ~80% of UK cocaine — has a natural fishscale-like shimmer. Dealers add it to fake the look of premium product. Boric acid is also used. You cannot tell purity by appearance.
Very high / uncut — "prop"
85%+ cocaine
Rare at street level. Often arrives as a hard-pressed block or brick. Extremely dangerous at standard doses. Any user moving from lower-grade to uncut cocaine is at serious risk — especially alone.
Any single item has an innocent explanation. Several together — particularly alongside behavioural changes — tells a clearer story. Click each item to learn more.
If you find something
Don't panic. Don't confront. Don't throw it away. Photograph it. Then read our conversation guide before you say anything. The first conversation sets the tone for everything after it.
Not sure what you've found? Call us on 0141 887 0880. You don't need to give your name.
What's actually in it
Sometimes the real danger isn't the cocaine. It's what's hidden in it.
Most of what cocaine is cut with does its damage slowly. A few things don't. The contaminants below can kill on a first line. They're invisible — no taste, no smell. You can't tell by looking and you can't tell by tasting. That's not a reason to panic, but it is a reason to know what's out there. Tap a contaminant to see what it does.
Find out what's actually in it.
WEDINOS (Welsh Emerging Drugs and Identification of Novel Substances) is a free, confidential drug-checking service. You post a small sample. No name, no personal details. They test it and publish what they find. It's based in Wales but accepts samples from anywhere in the UK, including Scotland.
Want to know what you're actually taking? Right now this is the most practical way to find out. Visit WEDINOS →
WEDINOS puts the results online, with no name attached. They won't contact you. Note your reference number and look it up on their website.
Free, and you can carry it.
Naloxone reverses an opioid overdose for a while. So if there's fentanyl or another opioid in the cocaine, it buys time for an ambulance. It's free to anyone over 16 in Renfrewshire. You get short training on how to spot an overdose and how to use it.
In Renfrewshire, HaRRT hands out naloxone and shows you how to use it. HaRRT is Change Grow Live's Harm Reduction Response Team. No appointment, no questions. You don't need to be in treatment or trying to stop. Renfrewshire ADP also runs free naloxone and overdose-awareness sessions.
Anywhere else in Scotland, Scottish Families Affected by Alcohol & Drugs (SFAD) will post a kit to your door. It comes in plain packaging. Age 16+, or 14+ for the nasal spray.
One thing to know: naloxone only works on opioids. It won't reverse cocaine itself, or sedatives like xylazine and medetomidine. Give it anyway. There are usually opioids in the mix too. And always call 999.
The supply is volatile and changes by area and over time. Slow or stopped breathing. Blue lips. No response. If that's you or someone near you, treat it as an emergency. Here's exactly what to do.
If something goes wrong
What to do in a cocaine emergency.
3am. A party. A bathroom. Your own house. If something goes wrong, this page tells you what to do in the next 60 seconds. Read it now. Screenshot it. You won't have time to search later.
Call 999 immediately if:
- They've collapsed or are unconscious
- They're having a seizure or fitting
- Chest pain that won't go away
- Difficulty breathing or blue-ish lips
- They're extremely confused, aggressive or paranoid and can't be calmed
- They've stopped responding to you
Tell the paramedics what they've taken. Be honest. You will not be arrested for calling an ambulance. The paramedics need to know — it changes how they treat.
While you wait for the ambulance
- If they're conscious: keep them calm, sitting upright. Loosen tight clothing. Reassure them. Don't let them take more.
- If they're unconscious but breathing: put them in the recovery position (on their side, head tilted back, top knee forward). Stay with them. Monitor their breathing.
- If they're not breathing: start CPR. 30 chest compressions, 2 rescue breaths. Repeat until the ambulance arrives.
- If they're having a seizure: move anything hard or sharp away from them. Do not put anything in their mouth. Do not hold them down. Time the seizure. Call 999 if it lasts more than 5 minutes or if they don't regain consciousness.
- If you have naloxone, use it. Cocaine is often cut with fentanyl or other opioids without anyone knowing. If their breathing is slow or they've stopped breathing, give naloxone even if you're sure it was only cocaine. It cannot harm them if there are no opioids in their system, and it can save their life if there are. Keep going with CPR either way, and still call 999.
Naloxone kits are free. In Renfrewshire, HaRRT and Renfrewshire ADP both supply them. Anywhere in Scotland, Scottish Families Affected by Alcohol & Drugs will post one to your door in plain packaging.
Signs of a cocaine-related heart event
- Crushing or tight pain in the chest, arm, jaw, or neck
- Heart racing irregularly (not just fast — uneven)
- Sudden dizziness or feeling faint
- Nausea, cold sweat, sudden exhaustion
- Feeling of dread — "something is very wrong"
This can happen to young, fit, first-time users. Chest pain is the single most common reason cocaine users end up in A&E. It's a known cause of heart attacks in people under 40 with nothing else wrong with them. Do not wait to see if it passes.
Signs of cocaine-induced psychosis
- Extreme paranoia — believing people are watching, following, or trying to harm them
- Hallucinations — seeing or hearing things that aren't there
- Feeling like insects are crawling under the skin — doctors call it formication
- Severe agitation, aggression, or terror
Do not argue with what they're experiencing. Stay calm. Reduce stimulation (lights, noise, people). Call 999 if they're a danger to themselves or others. Otherwise, call NHS 24 on 111.
Do not
After the crisis
When the immediate danger has passed, that's when the conversation matters most. Not in the ambulance. Not in A&E. In the days after — when the shock has settled and the door is still open. Read our conversation guide, or call us on 0141 887 0880. We've helped families through this before.
Harm reduction
If you're going to use, use safer.
Not using is the safest option. We won't pretend otherwise. But people use anyway, and pretending they don't has never reduced harm. So here's the practical reality — clearly, without lecture, and based on what frontline workers actually see.
Don't use alone
If something goes wrong — heart, breathing, mental state — you need someone who'll call 999 without hesitating.
Don't mix with alcohol
Cocaethylene is real and it's dangerous. If you're drinking, don't use. If you're using, don't drink.
Smaller. Slower. Spaced.
Smaller test amounts. Slower between lines. Wait longer than feels necessary. Repeated use in short windows is where most harm happens.
Watch your tolerance
Needing more to feel the same is the signal — not just that tolerance is rising, but that use is shifting. Notice it.
Look after the basics
Hydrate with water (not alcohol). Eat before and after. Sleep matters more than you think. The crash is bigger when the body's already running empty.
Know when to stop the night
If your heart's racing, your chest feels tight, you're paranoid, or your body's not right — that's the night ending. Tell someone. If symptoms persist, call 111 or 999.
Don't use in unfamiliar places
You should know who's around, where the exits are, and how to get home. Risk multiplies when the environment is unknown.
Mental health matters
Cocaine and existing anxiety, depression, or trauma is a hard mix. If you're already struggling, use will usually make it worse — not better.
The rest depends on how you use. Open only what applies to you.
Crack carries different risks from powder. It comes on faster. The high is shorter. The pull to re-dose is stronger. And the pipe and the heat bring their own damage. These aren't warnings to stop you. They're the things that matter if you're using.
Use your own pipe
Sharing pipes shares blood — cracked lips, mouth sores, and cold sores are common in people who smoke crack. Hepatitis C transmits this way. Your own pipe, every time.
Protect your lips and fingers
Hot pipes cause burns to lips and fingers that get infected. Pipe mouthpiece covers (available from needle exchanges) significantly reduce this. Burn wounds on the hands or mouth are a sign. Worth mentioning to HaRRT or a GP. You don't have to explain why.
Know what crack lung looks like
Fever, chest pain, struggling to breathe, and coughing up blood after smoking — that's crack lung, which is bleeding inside the lungs. It can look like pneumonia. It needs emergency treatment. Call 999. Be straight about what was smoked — it changes how they treat it.
The re-dose pull is physiological
The high from crack lasts 5–10 minutes. The compulsion to redose immediately after isn't weakness — it's the drug. Knowing this doesn't stop it, but it helps to name it. Longer gaps between hits reduce total exposure and the speed of dependence development.
Slow down, don't stop, on a new batch
Purity varies sharply between batches. The same weight of crack from a different source can be significantly stronger. Start smaller than you think you need to on anything new.
Ventilate
Smoking in a closed space with no airflow concentrates crack vapour and carbon monoxide. Open a window. The lung damage compounds fast in enclosed environments.
Injecting is the riskiest way to take cocaine. An overdose hits almost instantly, the pull to go again is intense, and the damage to your body stacks up fast. This is practical information, not a lecture. If you inject, you need it.
Never share any equipment
Not just the needle. The spoon, the water, the filter, the tourniquet — all of it. Hepatitis C, HIV, and other blood-borne viruses transmit on everything that touches blood. One shared filter is enough.
Use sterile water only
Tap water carries bacteria that cause abscesses and sepsis when injected. Use sterile water for injection (available free from needle exchanges) or water that has been boiled and cooled. Never use fizzy drinks or flavoured liquids.
Go smaller on a new batch
Cocaine purity varies significantly between batches. Injecting a dose that felt normal from the last batch can cause an overdose from a stronger one. Always test a smaller amount first when the source or appearance has changed.
Rotate your sites
Using the same vein repeatedly causes collapse, scarring, and chronic damage. Rotate injection sites systematically. Avoid the groin and neck — both carry serious risks of life-threatening bleeding or infection that is very hard to treat.
Cocaine overdose is different from heroin
Injecting cocaine can tip someone into overdose within seconds — heart going out of rhythm, fitting, blacking out. Naloxone won't reverse a cocaine overdose the way it does an opioid one. Give it anyway. There are often opioids in the supply. Call 999 straight away. Put them in the recovery position if they're out cold. Start CPR if they stop breathing. If you inject, carry naloxone — HaRRT will give you a kit and show you how to use it, no questions asked.
Never inject alone
This matters more for cocaine than almost any other drug. The window between injection and overdose can be under 60 seconds. If no one is with you, no one can call 999. Have someone present, or at minimum tell someone where you are before you use.
Know the signs of an abscess or infection
Redness, heat, swelling, or pus around an injection site means infection. Left untreated it becomes an abscess; left longer it becomes sepsis. HaRRT offers wound care with no questions asked. A GP can treat an abscess without involving police. Don't wait until it's serious.
Get free kit in Renfrewshire
The needle exchange in Paisley gives out free sterile needles, syringes, citric acid, sterile water, filters and sharps bins. No charge. No referral needed. HaRRT can also provide equipment and BBV (blood-borne virus) testing. Contact details below.
Let's start with the bit nobody puts in a leaflet: cocaine makes a lot of people extremely horny. Not a side effect — for plenty of folk it's one of the main reasons they use. That's not shameful and it's not unusual. But it drives everything else on this page. So it's worth knowing what it does to your judgement, to your body, and to what you end up agreeing to. Using cocaine during sex — what people often call chemsex — changes what your body does and what your judgement does, at the same time.
Wanting it more, thinking about it less
That combination is what does the damage. Wanting goes up, judgement goes down, at the same time. So it's harder to know what you want. Harder to read whether they're up for it. Harder to say no to something you'd normally knock back. It works both ways — you can end up doing things you wouldn't, and so can they. If you're not sure they're into it, they're not into it. Leave it.
You probably won't finish, and that causes its own problems
Sex on coke goes on longer because climaxing is harder. Sounds like a selling point. In practice that means more friction, more tearing, and small splits you might not notice. Torn skin is an open door for HIV and hepatitis. Anything rougher than usual, including anal, makes that more likely. Use lube, more than you think you need, and use condoms.
Trouble getting hard? That's the coke, not you
Cocaine narrows your blood vessels, including the ones you need for an erection. Plenty of men can't get hard on it. They feel humiliated, so they take more to shake the mood off. That makes it worse. If it happens every time you use, that's the coke, not you. It settles when use does. And taking Viagra to force it is a genuinely dangerous mix for your heart.
Alone, wired, and three hours into porn
You want sex badly. You can't finish. You're wide awake anyway. That's how a lot of people end up spending half the night on porn. It's one of the most common things men tell us about and one of the least talked about. A lot of people end up watching things they wouldn't normally go near. That's the drug pushing for more, the same way it does with everything else. Then the shame lands with the comedown, and shame is what sends people back for another line. If it's bothering you, it's worth saying out loud to somebody. It's far more ordinary than you think.
Locked in for the weekend
Most cocaine and sex doesn't happen at a party. It happens behind a locked door with the curtains shut.
Couples do it. A Friday that becomes Monday. Enough gear in that nobody has to leave. People on their own do it too. A hotel room. Porn running for hours. Escorts at 4am. Money going out that isn't there.
Nobody talks about it because of how it feels on the Tuesday. That silence is what keeps it going.
- Three days, no sleep, no food. Your heart works flat out the whole time.
- Paranoia lands about day two. Arguments then aren't really arguments.
- Consent gets muddy even between people who love each other. Going along with it at 4am on day three isn't the same as wanting it.
- The money. Hundreds gone. The damage lands later.
- If other people were involved, get tested. Free postal kits.
- The crash is brutal — and the shame is worse than the comedown. That's what sends people back.
Recognise your own weekend in that? It's far more common than you think. Nobody here is going to be shocked.
Get tested. It's easier than you think
Sexual health clinics don't ask what you were on, don't judge, and don't tell anyone. You can order free home testing kits online in Scotland and post them back — nobody has to see you walk in. If you inject or share pipes, ask about hepatitis C too. It's curable now.
Periods, fertility and pregnancy
Long-term use can stop your periods, so "I can't be pregnant, my periods stopped" isn't safe to rely on. Cocaine in pregnancy raises the risk of miscarriage, the placenta tearing away, and the baby coming early. If you're pregnant and using, talk to somebody — asking for help is not what puts your baby at risk.
If something happened that you didn't agree to
Being on cocaine does not make it your fault, and it does not make it less serious. It changes nothing about what you're entitled to.
You can get a forensic medical examination without going to the police. It's called self-referral, it's free, and the service is SARCS on 0800 148 88 88, open 24 hours. They'll store the evidence so you can decide about reporting later, or never. Being on drugs at the time doesn't stop you using it.
To talk to somebody first, Rape Crisis Scotland is free on 08088 01 03 02, every day 5pm to midnight, for anyone 13 or over, any gender. Calls don't show on your phone bill. You can also text 07537 410 027.
This sounds like the boring bit. It's one of the few things fully in your control. And it makes a real difference to how rough the next three days are. Cocaine kills your appetite, keeps you awake and burns through you — so the tank is empty before you notice.
Eat before, because you won't during
If you know a session's coming, get a proper meal in you beforehand. Once you've started you won't feel like eating, and by then it's too late. Something with protein and slow carbs in it — a proper dinner, not a bag of crisps.
Water, and something with salts in it
Coke pushes your temperature and heart rate up, and drink dehydrates you on top. You lose fluid and you lose the salts your heart and muscles run on. Keep water beside you and take sips even when you don't want it. A bottle of isotonic sports drink does more than water on its own, because it puts the salts back too.
The comedown is when it counts
Not eating and not drinking makes the low mood, the anxiety and the shakes worse. And a worse comedown is what sends people back for more. Getting food and fluid in you is doing something about the comedown, even when it feels like it isn't.
Losing weight isn't the drug working
Cocaine killing your appetite isn't a bonus, it's the start of your body running short. Missing vitamins and minerals makes anxiety worse and sleep worse. It slows down how you heal. And it leaves you picking up every infection going. If you're dropping weight without meaning to, that's worth mentioning to a GP.
HaRRT — Harm Reduction Response Team
Change Grow Live's Harm Reduction Response Team (HaRRT) operates across Renfrewshire — offering practical, non-judgemental support for people who are currently using. That means safer use information, naloxone supply, wound care, and a way in to further support when you're ready. No waiting list pressure. No requirement to be in recovery.
Find out how to reach HaRRT →Street intelligence
What's emerging on the supply.
The drug supply doesn't stay still. New drugs appear. Old ones get cut differently. The risk changes, sometimes fast. This section tracks what's turning up on the street and in drug-checking services. So you know what you're dealing with.
Check back here regularly. We update this section as new information comes in. It comes from drug-checking services, frontline workers, and public health teams across Scotland and the UK.
If you're seeing something new on the street in Renfrewshire that isn't covered here, contact us on 0141 887 0880. Frontline intelligence from people with lived experience is how we stay ahead.
Pink Cocaine
Being seen across Scotland. Usually contains no cocaine at all — most batches are ketamine, MDMA and whatever else was to hand.
Full alert Active alertMedetomidine
An animal sedative now in the Scottish supply. Naloxone does not reverse it. PHS flagged it in July 2026.
Full alertUnderstanding the pattern
Addiction is a schema.
You can outstructure it.
A schema is a learned pattern — a loop of triggers, thoughts, and behaviours that runs on autopilot. Cocaine addiction isn't a character flaw. It's not a lack of willpower. It's a deeply grooved pattern the brain has learned to run without asking permission. But patterns can be replaced — if the replacement is stronger than the loop.
There's no methadone for cocaine.
If someone's dependent on heroin, there's a medicine that holds them steady while they sort the rest out. Methadone, or buprenorphine. For alcohol there are tablets that help too. For cocaine there is nothing. No substitute prescription, no patch, no pill. That's not us being gloomy. It's where the science sits right now. And it's the thing people are most let down to hear.
Here's the part that matters, though. No medication is not the same as no treatment. It means the treatment isn't a chemical. What works for cocaine is changing the shape of your week. The money. The people. The places. The hours you spend on your own. That's slower than a prescription and it asks more of you, but it's the thing with the evidence behind it.
So people ask us what the substitute for cocaine is. There is one. It's a life. It just takes longer to get hold of than a prescription — and that's what the rest of this section is about.
The addiction loop — the pattern that keeps running. Click The Structure to see what replaces each stage.
Trigger
Stress, a Friday night text, boredom, emotional pain, being around people who use. The environment sends a signal the brain already knows.
Awareness
Name the trigger when it arrives: "This is the moment. I know this pattern." Awareness doesn't stop the trigger — but it stops autopilot.
Belief
"I deserve this. Just this once. I can handle it. It's not that bad." The schema provides its own permission. It's convincing because it's practiced.
Challenge
"Is this true — or is this the schema talking?" Separating yourself from the thought is the single most powerful skill in recovery. The belief isn't yours. It belongs to the pattern.
Craving
The body remembers the reward before the mind catches up. Heart rate shifts. Restlessness rises. The pull is physical before it's psychological.
Delay
Cravings peak and pass — usually within 15–20 minutes. Delay. Move. Change the room. Call someone. The craving will feel permanent. It isn't.
Use
Relief. Euphoria. Escape. The schema delivers exactly what it promised — in the short term. The brain files this as solution.
Alternative reward
Exercise, connection, purpose, creative work, helping someone else. The alternative has to be pre-committed — decided before the trigger, not during it. Have it ready.
Crash
Guilt. Shame. Anxiety. Physical comedown. The gap between who you want to be and what just happened. This is the most dangerous stage — because shame is what feeds the next loop.
Self-compassion
Shame fuels the schema. Kindness breaks it. "I slipped. That doesn't make me the slip." Recovery isn't a streak. It's a direction.
Vulnerability
Depleted, ashamed, isolated. Exactly the state that makes the next trigger hit harder. The loop closes. The schema reloads.
Structure
Build it before you need it. Routines. Sleep. Food. Connection. Purpose. Environment. The goal isn't to never feel triggered. The goal is to have a structure in place that's stronger than the schema.
The key insight
You don't beat a schema with willpower. You outstructure it — by building alternative patterns that compete with the loop at every stage. You don't remove the old pattern. You build a new one on top of it, and you run it until it becomes the default.
The schema isn't smarter than you. It's just more practiced. Structure closes the gap.
Stage 03, in practice
Cravings: what actually works for cocaine.
Cocaine cravings don't behave like drink or heroin cravings, so most of the standard advice misses. Four things that do work:
- 01 Money is the biggest trigger nobody names. Decide what happens to it before it lands.
- 02 Drink is how most relapses start. Decide before you go out, not at the bar.
- 03 It passes in about twenty minutes. Set a timer. Decide at the end, not now.
- 04 Map your cues, then move them. Write the list down. Change what you can.
How to speak about cocaine
The conversation matters more than the script.
Most families wait too long because they don't know how to start. This guide walks you through it — step by step. Click each stage.
Before you say anything
Timing, mindset, and what to have ready.
Set yourself up
- Pick a quiet, private moment — neither of you rushed or tired
- Know what you've noticed. Write it down if it helps
- Decide on one small thing you want to come out of it — not a solution, just a next step
- Tell one trusted person what you're about to do
Don't
- Go in drunk, exhausted, or mid-argument
- Do it in front of others
- Search their things first — trust collapses fast
How to open
Three ready-made opening lines you can use tonight.
“I've noticed a few changes lately and I don't want to make assumptions, but I am a bit worried. Can we talk?”
“I'm not asking you to tell me everything. I just want you to know I've noticed, I'm not angry, and I'm here when you want to talk.”
“I don't know exactly what's going on for you, but I love you and I'd rather we figure this out together than me find out the hard way.”
Lead with what you've noticed — not what you've decided. Use "I" statements: "I've been worried" not "You've been..."
During the conversation
Listen more than you speak. Here's how.
What works
- Listen more than you speak — pauses are not your enemy
- Separate the behaviour from the person: cocaine isn't who they are
- Make clear the door stays open, whatever they say today
- Aim for connection, not confession
What shuts it down
- Catastrophising — "you're throwing your life away"
- Moralising — they've heard it, it hasn't worked
- Ultimatums you can't or won't enforce
- Expecting them to admit everything on day one
If they shut down
It doesn't mean it failed. Here's what to do.
Denial, anger, or silence doesn't mean the conversation failed — it means they heard you. The first conversation plants the seed. The second one matters more.
Then leave it. Don't push. Don't follow up the same day. Come back to it in a few days — calmly, briefly, with the same warmth. Consistency is what builds trust.
After the conversation
The next 48 hours matter. Here's the play.
If it went well
- Follow through on whatever you agreed — even if it was small
- Don't over-talk it. Let the conversation breathe
- If they agreed to get help, offer to make the call together
- Call us: 0141 887 0880
If it didn't
- You still did the right thing. The door is now open
- Keep noticing. Keep being present. Don't withdraw
- Consider calling us yourself — you don't need their permission
- Read our Schema section to understand the pattern
Check in
Not sure where you stand? Start here.
These quick, anonymous check-ins won't diagnose anything — but they'll help you figure out whether it's worth talking to someone. Nothing is stored, nothing is sent, and no one will see your answers. How they're scored.
Should I be worried?
You've noticed changes. You're not sure if it's cocaine, stress, or something else. This 8-question check-in will help you decide whether to act now, watch and wait, or have the conversation.
Takes 2 minutes · Completely anonymousIs my use becoming a problem?
You might think it's under control. Maybe it is. This 8-question check-in looks at frequency, tolerance, impact, and pattern — the things that shift before you notice them.
Takes 2 minutes · Completely anonymousPeople ask how these work, so here it is. There's a longer version for workers and funders on the about page.
The maths
Eight questions. Each one gives you four answers. They score 0, 1, 2 or 3, lowest first. Add them up and you get a number between 0 and 24. We cut that at 6, 12 and 18. That gives four bands.
| Score | Band | What it means |
|---|---|---|
| 0 – 6 | Band 1 | Not much here points one way. Worth knowing the signs. |
| 7 – 12 | Band 2 | A pattern, not a one-off. Worth paying attention to. |
| 13 – 18 | Band 3 | A lot of it points the same way. Talk to someone. |
| 19 – 24 | Band 4 | Near the top of nearly every question. Don't wait. |
We show you the band, not the number. Eight questions can't be as exact as “19 out of 24” makes them look. A number like that reads like a verdict. It isn't one.
Two answers that count on their own
Every question counts the same. That keeps it simple. But two of them are about dying this weekend, not about how set the pattern is. So they show up on their own, even if your total lands in the lowest band:
- Using alone. There are opioids in the cocaine supply now. You can't see them or taste them. Alone means nobody to call 999.
- Mixing with alcohol. The two together make cocaethylene. It's harder on the heart than either one, and it builds up.
What this isn't
It isn't a diagnosis. It isn't a clinical test. Nobody has checked it against one. It can't tell a family it's cocaine — eight questions about secrecy, sleep and money can't tell cocaine from depression, another drug, or a bad six months.
What it does do is give you a clear look at what you've already noticed. And it gives you a push towards a conversation.
We wrote the questions here, from frontline work. They cover the ground clinical tools cover: how often, tolerance, planning your week round it, what it costs you, how hard stopping is. A worker will use a proper assessment. This is the thing that gets people as far as phoning one.
What it gets wrong
- There's no “I don't know” option. Not knowing scores nought, and that drags your total down. If you weren't sure on a few, treat your band as the lowest you could be, not the answer.
- In the family check-in, how long you've worried counts the same as everything else. So a long stretch of worrying about nothing pushes the total up.
- Every question counts the same. Eight mild answers and four bad ones can land in the same band. The band is a nudge, not a measurement.
What happens to your answers
Nothing. There's no account, no cookie and nothing tracking you. Your answers sit in your browser tab and go the second you close it. We never see them. Nobody else does either. Nothing is sent anywhere, so there's nothing anyone can ask us for.
Real stories
You're not the first person to feel this way.
These are anonymised accounts from real people across Scotland. Some are parents. Some are partners. Some are people who used. All of them started exactly where you might be right now.
“I'd noticed changes in my son for a while — couldn't put my finger on what. Then I found a wee bag in his jacket pocket when I was hanging it up. I didn't know what it was. My sister was the one who told me. I felt sick. I didn't sleep for two nights. I kept thinking — where did I go wrong? And I realised I knew nothing about it. Not what cocaine actually was, not the signs, not how to even start a conversation. I went to the RCA Trust as an affected other — to get the picture before I sat down with my son. They walked me through it all: the signs, the tells, the complications, what addiction actually looks like up close. When I finally talked to him, I came at it informed instead of scared. He's been clean 14 months now. But I had to walk into a building to find this out. Something like this site should be available to every parent in the country — and who knows how many of us are out there right now with no idea where to turn.”
“I collapsed in a mate's bathroom on a Saturday night. Heart was going that fast I thought it was going to come out my chest. I couldn't breathe. Couldn't speak. My mate thought I was just whitey-ing but something was different. He called 999. The paramedics said if he'd waited another twenty minutes it could've been a different outcome. I was 26. Fit. Played five-a-sides twice a week. I didn't think it could happen to me. Nobody does — and I never saw how fast it had all spiralled. If the check-in tools on this site had been around when I was at the height of it, I'm sure I'd have done things differently. A year on, I haven't touched it since.”
“In HR you spot patterns that don't always have an obvious explanation — absences, performance shifts, conflicts that feel out of character. Managers come to us worried about someone and we haven't had a single trusted place to send them, or for staff to read for themselves. This site fills that gap. It's honest, practical, and doesn't moralise — which is what makes it usable. I'll be referencing it for our managers and signposting staff who get in touch. Honestly, I wish something like this had been around years ago.”
“I was selling, using, and tangled up in things a lot bigger than me. The whole way down, the services I came across told me different things — wrong advice, wrong assumptions, or just no answer when I needed one. By the time I overdosed and woke up in hospital, I'd convinced myself there was genuinely no way out. The RCA Trust were the first people who didn't moralise. They just dealt with what was in front of me. Three years on I'm clean — daughter, full-time job, none of it was on the cards. If this site had existed back then — one place with the right information, that every service trusts — I'm sure I wouldn't have gone that far.”
If you're struggling with thoughts of suicide or self-harm: you don't have to face it alone. Call Samaritans on 116 123 — free, 24/7, confidential — or text SHOUT to 85258.
If you'd like to share your experience anonymously to help others, contact us at info@rcatrust.org.uk with the subject line "My Story."
For professionals
Frontline workers: what you need to know about cocaine.
Housing support. Nursing. Ambulance. Social work. Justice. Education. Primary care. You all meet cocaine use, and most of you were never trained on it. Open whichever applies to you. And if the person in front of you would be better served somewhere else, send them there. Nobody here is counting referrals. The only thing that matters is that they land somewhere.
You are often the only person crossing the doorstep, which means you see things nobody else does. Rent arrears appearing suddenly in a tenancy that was stable. Visitors at odd hours. A flat that's cold because the money went elsewhere. Someone who's been fine for months and is now avoiding you.
Cocaine costs money. That often shows up in a tenancy before it shows up anywhere else. Sudden arrears are often the first thing you see. Payday is the riskiest point in the month, so arrears and use tend to run on the same cycle.
Our paraphernalia guide covers what to look for and what it means. It includes the things that are easy to miss. If you find something you don't recognise, you don't need to identify it before raising a concern.
Ask about cocaine separately from other drugs. Many people don't count it as "drug use" at all: "How often do you use cocaine, including socially?" works better than "Do you take drugs?"
Two things worth carrying: know where naloxone comes from (HaRRT, Renfrewshire ADP, or SFAD by post) — cocaine is increasingly contaminated with opioids. And if you're worried about someone's use rather than certain about it, that's enough to call us on 0141 887 0880.
You'll know the clinical picture better than this site can tell you. This section is about the handover. The bit after the emergency, when someone is stable and about to leave.
The discharge moment is the opening. Someone just in with a cocaine-related problem will hear you now. Next week they won't. Our emergency page is written to be screenshotted. The harm reduction and cutting agents sections are written for someone who isn't planning to stop.
Worth knowing when you hand over: cocaine is increasingly cut with nitazenes and other synthetic opioids. Also with sedatives — xylazine and medetomidine — that naloxone won't reverse. Give naloxone regardless. Opioids are usually in the mix too.
Anyone can refer to RCA Trust, including the person themselves, and no formal referral letter is needed. If you'd rather just hand over a card or a link, that works too.
Refer to our paraphernalia guide for visual identification. In assessments, ask about cocaine on its own. Plenty of people don't count it as “drug use”. Use this question: "How often do you use cocaine, including socially?" — not "Do you use drugs?"
Lead with curiosity, not authority. "I've noticed a few things — I'm not judging, I just want to check in." Young people respond to honesty about risk (the cocaethylene section and cutting agents section work well as conversation starters) and shut down to moralising.
Nose problems, chest pain with no clear cause, anxiety, broken sleep, weight loss. With any of those, cocaine belongs on your differential. Ask it like it's routine, because it is: "Some of my patients in similar situations have told me they've been using cocaine — is that something that applies to you?"
Refer to RCA Trust for specialist assessment. No formal referral letter needed — a phone call or email is sufficient.
Follow your school's child protection policy. Document behavioural changes (attendance, concentration, mood, peer group shifts). You don't need to confirm cocaine use before raising a concern with your named person or pastoral lead. We're working towards a PSE-aligned schools pack for S3–S6. Get in touch if your school would like to help build it.
Referral pathway
Behavioural signs, paraphernalia, disclosure, or clinical presentation
Use our conversation scripts. Don't diagnose or confront — notice and open the door
Phone: 0141 887 0880 · Email: info@rcatrust.org.uk · No formal letter needed
Assessment within 5 working days. Person-centred. Confidential. We'll update you with consent.
Get support
Talk to us. Confidential, free, and anyone can get in touch.
Worried about yourself, or about someone else? Your first step doesn't have to be a big one. Pick the channel that feels easiest right now.
Where you live decides who you see — not whether you get help.
Everything on this site is for anyone in Scotland. Appointments with RCA Trust are for people living in Renfrewshire — Paisley, Renfrew, Johnstone, Linwood, Erskine, Bishopton, Bridge of Weir, Kilbarchan, Lochwinnoch, Houston, Elderslie and the villages around them. Anywhere else, everything below still applies. Phone us and we'll help you work out who to contact.
What "confidential" means here. What you tell us stays with us. We won't tell your family, your work or the police that you've been in touch. There are two exceptions. If we think you or someone else is at serious risk of harm. Or if the law makes us. We'd talk to you first. How we handle what you tell us →
- RCA Trust0141 887 0880Mon–Fri 9am–5pm. Renfrewshire appointments; phone advice for anyone. You don't have to give your real name.
- Cocaine Anonymous Scotland0141 959 63638am–11pm, seven days. Answered by people who've been through it themselves — not a call centre.
- Know the Score0800 587 5879Free and confidential, open until 9pm.
- Scottish Families08080 10 10 11If it's someone else's use you're worried about. Mon–Fri 9am–11pm.
- Renfrewshire ADRS0300 300 1199Option 2. The NHS and social work recovery team — assessment, treatment, detox and medication where it's needed. Open access, and they take self-referrals. Email addictions.sw@renfrewshire.gov.uk
- RCA Trust — that's us0141 887 0880Counselling and structured support. Anyone can refer, including you. Waiting list may apply.
- Your own GPFind a GP ↗Two reasons. They can refer you on. And cocaine strains the heart, so chest pain, a racing heart or being out of breath is worth getting checked. You will not be judged and it won't be shared with your employer.
- Cocaine Anonymous meetingscascotland.org.uk ↗Free, no referral, turn up and listen. Meetings across the west including Greenock. You don't need to speak and you don't need to have stopped.
- CIRCLE Recovery Hub0300 300 119981 Glasgow Road, Paisley. A recovery hub run with people who've been through it. Drop-in café, one-to-one support and weekly groups. Around 250 people use it at any one time.
- We Are With Youwearewithyou.org.uk ↗Including the Renfrewshire Community Links Programme. Self-referral welcome.
- HaRRT0141 314 4364Change Grow Live's Harm Reduction Response Team — nurses and outreach workers who work out of a van and come to you, around Renfrewshire. Naloxone, clean equipment, wound care, blood testing. No appointment, no questions, and you don't need to be in treatment or trying to stop. Ring for where the van will be. Mon–Fri 9am–5pm, Sat 10am–2pm, or email Renfrewshire.Info@cgl.org.uk.
- SFAD — naloxone by postsfad.org.uk ↗Free kit posted anywhere in Scotland in plain packaging. Age 16+, or 14+ for the nasal spray.
- ALISSaliss.org ↗Type in a postcode. Funded by the Scottish Government. It covers peer groups, money advice and housing as well as drug services. It has its own quick exit button.
- NHS informnhsinform.scot ↗The statutory drug and alcohol service for every part of Scotland.
In an emergency, none of this applies — call 999. And if you're struggling with thoughts of suicide, Samaritans on 116 123 is free, 24 hours, any day.
1 working day
UK-wide
What happens when you contact us
- We answer. Same person, same conversation — no scripted call centre.
- You tell us only what you want to. No interrogation.
- We agree the next step together. That might be one call, a one-off appointment, or ongoing support.
- You decide if and when to come back. The door stays open either way.
About
Built in-house. By a charity that's been doing this work for 49 years.
Let's Talk About Charlie is a service of RCA Trust in Paisley. We've supported people with alcohol, drug and gambling addiction since 1977. Anyone can refer — including you.
How we built this — sources, reading age and accessibility → For professionals, funders and anyone checking our figures.
49
years delivering frontline addictions support
3
addictions covered — alcohol, drugs, gambling
Open
referral — anyone can refer themselves or someone else. Waiting list may apply.
PA1 1HP
8 Incle Street, Paisley — phone & in-person support