What should I do in a cocaine emergency?

Call 999 immediately if the person has collapsed or is unconscious, is having a seizure, has chest pain that will not go away, has difficulty breathing or blue-ish lips, is extremely confused, aggressive or paranoid and cannot be calmed, or has stopped responding to you. Tell the paramedics exactly what has been taken — the crew are there to save a life, in most cases they won't tell the police, and it changes how they treat. While you wait: if they are conscious, keep them calm and sitting upright. If they are unconscious but breathing, put them in the recovery position and monitor their breathing. If they are not breathing, start CPR.

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.

Print this page and keep it somewhere you'd find it One page, A4. Everything below on a single sheet — for a fridge door, a staff room wall, a wallet, or a kit bag. Works in black and white. Download PDF

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 really confused, aggressive or paranoid, and you can't calm them down
They've stopped responding to you

Tell the paramedics what they've taken. Be honest. The crew are there to save a life, not to get anyone in trouble — in most cases they won't tell the police. They need to know, because 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, get one from HaRRT or Renfrewshire ADP. Anywhere in Scotland, Scottish Families 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 out of rhythm, not just fast but all over the place
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

Really paranoid: sure people are watching them, following them or out to hurt them
Seeing or hearing things that aren't there
Feeling like insects are crawling under their skin
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

Do not put them in a cold bath or shower

Do not give them water if they're unconscious

Do not leave them alone "to sleep it off"

Do not give them coffee, energy drinks, or more stimulants

Do not try to make them vomit

Do not hesitate to call 999 because you're scared of police — the ambulance crew's only job is to save their life

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.