What Are Cocaine and Crack?

What Is Cocaine?

Cocaine is a powerful stimulant extracted from coca plant leaves. It comes from the Erythroxylon coca plant, native to the Andean highlands in South America. Chemically, cocaine is a local anaesthetic and vasoconstrictor – properties that made it medically useful in the 19th and early 20th centuries.

The name “cocaine” derives from the coca plant itself. Interestingly, Coca-Cola originally contained nine milligrams of cocaine per glass until 1903, when it was removed due to growing awareness of the drug’s addictive potential. The drink still uses coca flavouring today.

Historical use: In 1884, an American surgeon named William S. Halstead injected cocaine into nerve trunks and demonstrated its numbing effect. Cocaine quickly became the gold standard for surgical anaesthesia. By 1898, German surgeon August Bier used cocaine as a spinal anaesthetic – a groundbreaking development. However, as medical professionals became aware of its addictive nature, safer alternatives were developed. Cocaine gradually fell out of clinical use for pain relief.

Today, cocaine is primarily used as a recreational drug and illegal stimulant. It produces intense but short-lived euphoria, making it highly addictive. Street names include coke, Charlie, draw, flake and snow.

Global context: Britain ranks among the world’s biggest users of cocaine and crack. According to the United Nations Office on Drugs and Crime (UNODC), other countries with high cocaine use include the USA, Spain, Australia, the Netherlands, Chile and Uruguay.

What Is Crack Cocaine?

Crack cocaine is a form of cocaine that has been chemically treated to make it smokeable. The name comes from the crackling sound it makes when heated. Crack is more potent and faster-acting than powder cocaine, making it significantly more addictive. Street names include pebbles, rock, stone and wash.

What Do Cocaine and Crack Look Like?

Powder cocaine: Appears as a white powder. Because cocaine is expensive, dealers often mix it with other white powdery substances to increase volume and profit. This means street cocaine varies significantly in purity and may contain dangerous adulterants.

Crack cocaine: Comes in the form of small white crystals or rocks, typically about the size of raisins. The crystals are denser and more condensed than powder cocaine.

How Are Cocaine and Crack Taken?

Cocaine can be consumed in three main ways:

Crack is nearly always smoked. Users often improvise pipes from soft drink cans or aluminium foil. Smoking cocaine—whether powder or crack—produces the fastest onset of effects and the highest addiction potential.

Societal impact: The cocaine trade drives organised crime, corruption and violence across the globe. From South American coca farms to UK street corners, the industry leaves a trail of devastation. Cocaine use strains healthcare systems and emergency services—paramedics regularly respond to overdoses, whilst accident and emergency departments treat cocaine-related heart problems and mental health crises. The ripple effects touch families too, with relationships strained and children neglected due to addiction.

Short-Term and Long-Term Effects

How Cocaine Affects the Brain

Cocaine is a strong stimulant that interferes with how the brain processes neurotransmitters—chemical messengers that regulate mood, motivation and reward. Specifically, cocaine prevents the reabsorption of dopamine, a neurotransmitter linked to pleasure and reward. This causes dopamine to build up in the brain, producing intense euphoria.

Cocaine typically produces a high lasting 15–30 minutes. When effects wear off, dopamine levels drop sharply below normal, leading to a crash—feelings of depression, anxiety and emptiness. This crash drives users to take the drug repeatedly to maintain the high, establishing a powerful cycle of craving and use.

Immediate Short-Term Effects

Even low, “recreational” doses carry serious cardiovascular risks. Cocaine causes blood vessels to constrict and increases heart rate and blood pressure simultaneously—a dangerous combination that can trigger heart attacks, strokes or seizures without warning.

Long-Term Effects of Cocaine Use

Regular cocaine use causes progressive physical and psychological damage:

• Nasal damage: Prolonged snorting causes ulceration and perforation of the nasal septum, leading to chronic nosebleeds, loss of sense of smell and difficulty swallowing.
• Injection risks: Injecting cocaine with unsterile equipment transmits HIV, hepatitis C and other blood-borne infections.
• Neurological damage: Long-term use causes memory loss, movement disorders (including Parkinson’s-like symptoms) and cognitive decline.
• Weight loss: Cocaine suppresses appetite, leading to severe malnutrition and weight loss.
• Mental health: Chronic use causes depression, anxiety, paranoia and psychotic symptoms that can persist for months after stopping.
• Cardiac damage: Regular use increases risk of hypertension, arrhythmias and premature heart disease.

Much of this damage is permanent. Even after stopping cocaine use, users may experience lasting cognitive and physical impairment.

Is Cocaine Addictive?

Yes. Cocaine is highly addictive. Users develop tolerance quickly, requiring larger doses to achieve the same high. Research shows that:

• Prolonged cocaine snorting leads to addiction in approximately 17% of users
• Smoking crack cocaine is far more addictive—nearly 50% of users become addicted
• Addiction can develop rapidly, sometimes within weeks of first use

Those who become addicted compulsively seek the drug, often bingeing for days until resources are depleted. Financial difficulties, depression, sleep problems and social isolation commonly follow. Even after stopping use, users experience withdrawal symptoms including fatigue, insomnia, depression and intense cravings. These symptoms can persist for weeks or months.

The psychological component of cocaine addiction is particularly powerful. Users develop strong cravings triggered by environmental cues (places, people, times of day), making relapse common even after treatment. The risk of relapse remains high for months or years after stopping.

Legal Status in the UK

Under the Misuse of Drugs Act 1971, cocaine and crack are classified as Class A drugs—the most serious category. Penalties are severe:

The UK Cocaine Crisis

Despite strict penalties, cocaine remains widely available across the UK. Recent trends are concerning:

• Purity levels have doubled since the 1990s, averaging around 60% per gram (compared to 30% in the 1990s)
• Street prices have fallen dramatically—from £74 per gram in 1990 to approximately £40 in 2020
• In 2020/21, over 4% of adults aged 16–59 reported using cocaine in the past year—more than double the 2011/12 level
• Hospital admissions with cocaine-related mental health issues have risen 76% over the last decade
• Cocaine was mentioned on death certificates of over 700 people in 2020—the highest number since records began in 1993
• Cocaine-related crime is rising sharply. Around half of those starting treatment for crack addiction report committing crime to fund their habit

These trends reflect both increased availability and the changing demographics of cocaine use—it’s no longer confined to wealthy urban areas but is now prevalent across all socioeconomic groups and age ranges.

Cocaine Testing in the Workplace

Many UK employers implement drug testing policies to maintain workplace safety and comply with health and safety regulations. Cocaine testing is particularly common in safety-sensitive roles such as transport, construction, healthcare and security.

Employer Rights and Regulations

Under UK employment law, employers can conduct drug testing if it’s part of a clear workplace policy and employees have consented. ACAS (the Advisory, Conciliation and Arbitration Service) provides guidance on drug and alcohol testing in the workplace. Key principles include:

• Testing must be justified (e.g., safety-sensitive role, reasonable suspicion)
• Employees must be informed of the testing policy in advance
• Tests should be conducted fairly and consistently
• Results must be kept confidential
• Employees have the right to appeal or request a retest

If testing for cocaine in the workplace, employers typically use urine drug tests, as these are cost-effective and can detect cocaine use from the past 2–4 days. Some employers also use saliva tests or hair tests for longer detection windows.

How to Test for Cocaine Use

Cocaine can be detected by several drug testing methods. The detection window depends on the type of test and the route of use:

The most commonly used test is the urine drug test, which looks for benzoylecgonine—the primary metabolite of cocaine. When cocaine is ingested, the body breaks it down into benzoylecgonine, which is then excreted in urine. How long cocaine stays in your system depends on factors such as frequency of use, body weight, metabolism and kidney function.

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Originally published: 2018 | Last updated: November 14, 2025
Photo by Zoom Testing

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