Cocaine
powder cocaine · coke · charlie
What is currently changing about this drug in the UK?
Cocaine was implicated in 589 Scottish drug use deaths in 2025 (52%, up 23%), the highest in the NRS series since 2008; England and Wales also reached a new high in 2024. NRS mortality does not separate powder from crack. WAND adds an experimental consumption trend, while CSEW and treatment data describe different populations.
Overview
Identity, legal classification, form and pharmacological context
- Drug category
- Stimulants
- Common names
- powder cocaine, coke, charlie
- Typical forms
- Usually a fine white or off-white powder in the UK illicit retail market. Appearance alone cannot establish purity or contents
- Routes
- Most commonly snorted. Powder cocaine may also be rubbed on the gums, swallowed or injected. Smoking is primarily associated with crack or freebase cocaine rather than ordinary powder cocaine
- UK legal classification
- Class ACocaine is a Class A controlled drug.Check government source ↗
- Concise pharmacology
- Increases central nervous system activity through substance-specific effects on monoamine signalling.
Main harms
Concise clinical and polydrug picture
Agitation, anxiety, overheating, chest pain, seizures and cardiovascular strain.
Sleep disruption, mood problems, cardiovascular harm and stimulant-related psychosis may develop.
Fatigue, low mood, sleep disturbance and craving can follow sustained use.
Other stimulants increase cardiovascular and overheating risks; alcohol and depressants can obscure impairment.
Snorting can damage nasal tissue; injecting adds infection and blood-borne virus risks. Smoking risks relate primarily to crack or freebase cocaine.
Current intelligence status
Assessment, confidence and direction
The assessment reflects the latest linked evidence and is not a universal severity rating.
Operational implications
Evidence-supported prompts for professional response
Strengthen stimulant pathways across cardiovascular, mental-health, alcohol and emergency-care services and keep powder cocaine separate from crack indicators.
Record substance, sold identity, route, frequency and combinations; review physical, mental-health and dependence needs.
Use symptom-led assessment and escalate reduced consciousness, seizures, overheating, chest pain or severe agitation.
Link early identification with safeguarding and age-appropriate treatment without presenting population use as individual risk.
Related intelligence
Continue into connected platform evidence
Sources & limitations
Direct evidence links, reference periods and status
Drug-related deaths in Scotland, 2025
Published23 Sep 2026Reference period2025 registrations
NRS calls this series drug use deaths. Substance implication overlaps and does not prove sole causation. Nitazene testing expanded, including etonitazene in May 2025; 2025 versus 2024 rate difference is not statistically significant.Deaths related to drug poisoning in England and Wales
Published17 Oct 2025Reference period2024 registrations
Deaths are counted by registration year; substance mentions overlap and do not prove sole causation.WAND wastewater analysis
Published12 Jun 2026Reference periodComparable sampling · 2021–2025
Site coverage is incomplete and uncertainty intervals are wide; estimates do not identify individual use.Drug misuse in England and Wales
Published11 Dec 2025Reference periodYear ending March 2025
Household survey for England and Wales; it under-represents some high-risk populations and does not cover the whole UK.National Strategic Assessment 2026
Published17 Mar 2026Reference periodLatest national assessment
An intelligence assessment rather than a population survey or a complete count of incidents.