Cocaine enters the bloodstream via the nasal mucous membranes, by inhalation when smoking crack or free base, or by injection. Cocaine is fat-soluble and can therefore cross the blood-brain barrier to develop its effect in the brain.

Cocaine prevents the reuptake of the neurotransmitter dopamine into the nerve cell. This leads to an accumulation of neurotransmitters in the synaptic cleft. This allows dopamine and noradrenaline to constantly stimulate the downstream nerve cells, which is experienced psychologically as a feeling of elation and strength. After the high, the brain needs a few days to rebuild the neurotransmitters: depressive moods, tiredness and apathy can be the result.

Cocaine has a high psychological dependency potential. The temptation to use cocaine again quickly in order to feel the state of strength and euphoria again and thus also to resolve the state of emptiness, which is difficult to bear, leads to psychological dependence in some people. Addiction to cocaine is not usually characterised by continuous consumption of the substance, but by the so-called "binge" pattern: a few days of intensive consumption of large quantities are followed by a phase of exhausted abstinence in which those affected believe they have their consumption under control and can stop at any time. The abstinent days are again followed by cocaine "binging" (intensive use). After a short time, this pattern of use can lead to exhaustion of the body, flu-like aches and pains, weight loss and chronic colds.

Psychologically, intensive cocaine use can lead to anxiety disorders, personality changes, depression and so-called cocaine psychosis. In cocaine psychosis, those affected suffer from paranoid delusions, visual, acoustic or tactile hallucinations (e.g. severe stinging under the skin).

Although cocaine is considered a sex drug, chronic cocaine use significantly reduces the desire for sex. In psychology, this is referred to as a decrease in libido. Men addicted to cocaine often suffer from impotence. In women, there are disruptions to the menstrual cycle or the absence of menstruation.

On a physical level, frequent cocaine use can lead to chronic inflammation of the nasal mucosa, which is difficult to heal. In extreme cases, this can also lead to perforations or holes in the nasal septum. In the long term, chronic cocaine use can also lead to spasmodic constriction of the heart vessels in young people and thus to damage to healthy heart tissue. Heart defects and heart attacks can be the direct consequences of these physical changes.

• Pre-existing conditions of the cardiovascular system, asthma, liver disease and hyperthyroidism. The contraction of the coronary arteries can lead to reduced blood flow, particularly in people with pre-existing cardiovascular conditions. This results in a reduction in oxygen, which in extreme cases can lead to a heart attack.
• Cocaine increases the risk of seizures and therefore poses an increased risk for epileptics.
• Cocaine can exacerbate or trigger psychological problems or illnesses.
• Cocaine use during pregnancy increases the risk of premature birth, malformations and sudden infant death syndrome. The vasoconstrictive effect of cocaine leads to poorer blood circulation in the uterus and thus to an undersupply of oxygen to the unborn child. Damage to all organs and tissue can occur as a result of cocaine consumption, particularly in the first trimester of pregnancy. It often leads to malformations of the urogenital tract, i.e. the urinary and reproductive organs, and to neuronal damage (pathological changes and developmental disorders of the nervous system).

• Cocaine & Alcohol
  The combination of cocaine and alcohol leads to an underestimation of the effects of alcohol. You feel sober and don't realise the effects of the alcohol, even though you are drunk. Overconfidence and loss of control increase the dangers for you, friends and acquaintances, as well as other road users, especially in road traffic. Furthermore, the mixture of cocaine and alcohol produces cocaethylene in the body, a substance that puts additional strain on the cardiovascular system.
• Cocaine & other "uppers"
  The mixture with other stimulants (e.g. speed, high amounts of caffeine or energy drinks) places a great strain on the cardiovascular system. This can lead to life-threatening conditions.

If you use cocaine despite the health and criminal law risks, you should be aware of the following points in addition to the general information on risk reduction:

• Because of its high price, cocaine is often mixed with cutting agents. Without a chemical analysis, you cannot know exactly what and how much you are taking. Take little and avoid quick or frequent redosing.
• Use drug checking if possible.
• If your use becomes regular, you should take longer breaks to avoid developing a psychological dependency. If you have problems controlling your consumption, contact a counselling centre.
• The most harmful way to take cocaine is to inject it, especially when it is combined with heroin ("speedballs").
• When using injectables, you should use clean syringes because of the risk of infection with hepatitis B and C and HIV. You can get syringes and injecting equipment at some drug counselling centres, in Vienna for example at Jedmayer or change.
• The least harmful form of cocaine consumption is snorting: the effects start gradually and last longer than with other forms of consumption.

Cocaine is a white, crystalline, bitter-tasting powder. It is made from coca leaves with the addition of water, lime or sodium carbonate, paraffin and ammonia. On the black market, cocaine is often cut with other substances. In addition to the usual cutting agents (e.g. milk powder), vasoconstrictors or synthetic, painkilling or anaesthetising agents (e.g. lidocaine or novocaine) are also used. Cocaine is usually snorted, but can also be administered intravenously (injected). Cocaine can be converted into smokable forms (crack or free base) through chemical conversion. The psychological effects triggered by these two forms set in within a few seconds and only last for a maximum of 10 minutes. Crack and free base lead more quickly to a strong psychological dependence than other forms of cocaine.

Levamisole
Levamisole is an anthelmintic (used in veterinary medicine to treat worm infestations), which was previously also used in human medicine. The substance has become more common in recent years as an additive to cocaine. Various side effects that have been reported in connection with levamisole include: allergic reactions (difficulty breathing, swelling of the lips, tongue, face) and impairment of the central nervous system (e.g. confusion or unconsciousness, extreme tiredness). The most worrying side effect of levamisole is the change in the blood count, known as agranulocytosis. This leads to a reduction in white blood cells, which can subsequently - due to immunodeficiency - lead to life-threatening infections.

The symptoms that can occur are chills, fever, septicaemia, inflammation of the mucous membranes, tongue and throat, upper respiratory tract infection, infections in the anal area, anal region and superficial death of areas of skin. The probability of developing agranulocytosis increases with the regularity of levamisole intake, regardless of the dose taken. Agranulocytosis occurs most frequently when levamisole is taken continuously for 3-12 months. However, there are also known cases in which the disease was diagnosed less than three weeks after the first levamisole intake.

Agranulocytosis is treated with a suitable antibiotic. If the symptoms described occur after cocaine use, we strongly recommend that you consult a doctor, as the disease can only be cured with medical treatment.

The frequent occurrence of levamisole in cocaine samples throughout Europe has led to various speculations about the reasons for the admixture. A recent study by the Medical University of Vienna in collaboration with checkit! comes to the following conclusion: Levamisole is converted in the body to aminorex, which triggers both cocaine-like effects and amphetamine-like effects at receptors in the brain. It can be assumed that after the effects of cocaine have worn off, the effects of Aminorex set in and Levamisole is therefore used as a cutting agent to prolong the effects of cocaine.

Local anaesthetics
Local anaesthetics such as Lidocaine and Procaine are added, as the taste and local anaesthetic effect leads users to mistakenly believe that the substance is pure cocaine when "testing" it. There is evidence that the combination of cocaine with local anaesthetics causes significantly more damage to the heart than cocaine alone (cardiotoxicity). The risk of cardiac arrhythmia and heart attack is significantly increased, especially in users with pre-existing cardiovascular conditions.

Phenacetin
Phenacetin is an aminophenol derivative that was used to treat pain and reduce fever until 1986. Due to its carcinogenic and particularly kidney-damaging effects in combination with other painkillers, it was withdrawn from the market. Phenacetin has a slightly euphoric and stimulating effect and is presumably therefore used as a cutting agent.

In the Andean countries of South America - where the coca bush originated - coca leaves have been consumed for centuries for religious, mystical, social and medicinal reasons. The consumption of coca leaves increases stamina, suppresses hunger and increases well-being. The psychoactive substance of the coca bush was first chemically isolated by Albert Niemann in the middle of the 19th century.

The founder of psychoanalysis, the Viennese doctor Sigmund Freud, was so enthusiastic about the euphoric and activating effect of cocaine after a few self-experiments that he praised it as a new "wonder drug" in his article "On Coca". Freud's opinion was soon to change: a good friend of the Viennese doctor, who wanted to free himself from his morphine addiction with cocaine, increased his daily dose of cocaine to over one gram and eventually died as a result of his cocaine consumption.

In medicine, cocaine was used as a local anaesthetic. In 1888, a drink based on coca and cola nut extracts was launched on the market, which was marketed as a remedy for headaches and as a stimulant for adults - the drink was called Coca-Cola. However, as early as 1906, the addition of cocaine to drinks and over-the-counter medicines was banned by law in the USA.

Cocaine consumption rose sharply during the 1920s, but declined again in the 1930s with the advent of amphetamines. Amphetamines are easier and cheaper to produce - the psychological effects of amphetamine last longer than those of cocaine.

Cocaine and crack are subject to the Narcotic Drugs Act. The acquisition, possession, import and export, transfer to and procurement for others (transfer and sale) are punishable by law. Consumers who violate the SMG must expect a mandatory visit to a public health officer (in Vienna: the outpatient centre of the Addiction and Drug Coordination). There, health-related measures may be ordered and a drug test can be expected. If you adhere to these requirements, there will be no court proceedings.