Frontline workers: what you need to know about cocaine.

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 knowing. First, where naloxone comes from: HaRRT, Renfrewshire ADP, or SFAD by post. Cocaine is more and more often mixed with opioids. Second, if you're worried about someone's use but not sure, that's enough to phone 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: nitazenes and other lab-made opioids may be in the cocaine. So may sedatives like xylazine and medetomidine, which naloxone won't reverse. Give naloxone anyway. Opioids are usually in the mix too.

Anyone can refer to RCA Trust, including the person themselves. No referral letter needed. If you'd rather just hand over a card or a link, that works too.

Use our paraphernalia guide to know what you're looking at. In assessments, ask about cocaine on its own. Plenty of people don't count it as "drug use". Ask: "How often do you use cocaine, including socially?" Not: "Do you use drugs?"

Be curious, not in charge. "I've noticed a few things. I'm not judging, I just want to check in." Young people respond to straight talk about risk. The cocaine and alcohol section and the "what it's cut with" section are good ways in. Lecturing shuts them down.

Nose problems, chest pain with no clear cause, anxiety, broken sleep, weight loss. With any of those, think cocaine. Ask like it's routine, because it is: "Some of my patients in similar situations have told me they've used cocaine. Is that something that applies to you?"

Refer to RCA Trust for a specialist assessment. No referral letter needed. A phone call or email is enough.

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.