What are ‘nose beers’? Exploring cocaine use in Australia

Coke, blow, snow, nose beers, and nose candy are all slang names for cocaine.

But what is cocaine and how common is use in Australia? And how can the harms be reduced?

In this article, we’ll explore these questions.

What is cocaine?

Cocaine is a stimulant. Stimulants speed up the messages travelling between the brain and the body. They can make a person feel more awake, alert, confident, or energetic.¹

Cocaine is most often used by snorting, injecting, smoking, or swallowing it. In Australia, snorting is the most common way people use cocaine.^{2, 3}

Where does cocaine come from and what’s the history behind it?

Cocaine comes from the coca plant, which grows naturally in parts of South America.⁴

For thousands of years, Indigenous communities have chewed coca leaves or made them into tea for social, cultural and medicinal purposes. And, with far fewer harms than those linked to modern cocaine use.⁴

In the mid-1800s, German scientists learned how to extract and concentrate cocaine from the coca plant. This made it easier to transport and sell, and it quickly became popular for its medicinal qualities and as a commercial product.⁴

Similar to energy drinks or alcohol advertising today, creative marketing had great success in selling ‘coca wine’ and other cocaine-derived products, often with the help of celebrity and medical endorsements.⁴

As use spread in the early 1900s, so did harms. This lead governments to restrict, and eventually ban, its non‑medical use by the mid-1900s.⁴

Cocaine production then shifted to illegal markets (the black market), where availability and strength increased. This was especially common during the 1980s.⁵

Its use and availability has risen again in recent years. Global illegal cocaine production doubled between 2014 and 2019 – reaching the highest levels ever recorded.⁶

How does cocaine work?

Cocaine affects chemicals in the brain called neurotransmitters, which help send messages around the body.

It mainly acts on dopamine, serotonin and noradrenaline (norepinephrine), causing these chemicals to increase in the brain.^{5, 7}

The increase in these chemicals produce cocaine’s effects:

• dopamine, the ‘feel-good’ chemical, is linked to pleasure and reward
• serotonin influences things like sleep, appetite and body temperature
• noradrenaline affects heart rate, blood pressure and appetite.^{5, 7}

Together, these changes can explain the ‘high’ you may feel and many of the physical effects from cocaine.

How common is cocaine use in Australia?

In Australia, the use of cocaine has been increasing in recent decades.

It’s now overtaken MDMA and methamphetamine (ice) to become the second most commonly used illicit drug, after cannabis.⁸

Among Australians aged 14 years and older in 2022-23:

• 13.5% had used cocaine at least once in their lifetime, an increase from 4.4% in 2001
• 4.5% reported using it at least once in the past year – up from 1.3% in 2001
• around 0.7%  reported using cocaine regularly (monthly or more frequent).⁸

Almost a third of people who used cocaine in the past year reported high levels of psychological distress.⁸

Who uses cocaine?

There’s no single ‘type’ of person who uses cocaine. But according to survey data use is more common among people who:

• identify as male
• are aged in their 20s
• are currently employed
• live in higher-income areas
• identify as gay, lesbian, or bisexual.⁸

While men are still more likely than women to report cocaine use, rates among women has increased in recent years, narrowing the gap.⁸

Treatment for cocaine dependence

Most people who use cocaine don’t develop a dependence (addiction) to it. But some people do.

In 2023-24, cocaine was reported as a main drug of concern in 2,626 Australian alcohol and other drug (AOD) treatment episodes. This is a significant increase from the 558 treatment episodes in 2014-15.⁹

Seeking help for cocaine dependence was more commonly reported among people who:

• identify as male
• were aged in their 20s
• identify as Aboriginal or Torres Strait Islander.⁹

People who seek help for their cocaine dependence most often engage with counselling services for around four weeks. And most (65%) successfully complete their treatment program.⁹

How many cocaine-related deaths are there in Australia?

From 2001 to 2021, there were 884 cocaine-related deaths in Australia, and the rate of deaths has increased substantially since 2011.⁶

Cocaine-related deaths were more commonly reported among people who:

• identify as male
• are aged in their 30s
• have underlying health or mental health conditions
• have also used other drugs at the same time or within the last 24 hours (most commonly opioids, alcohol, or benzodiazepines).⁶

What are the risks of cocaine – and how can they be reduced?

Being informed and taking steps to reduce harm can make a difference.

Heart and body

Using cocaine puts strain on your body. It can increase heart rate, blood pressure, and body temperature, and lead to dehydration.

Higher doses of cocaine can cause stimulant overdose death.⁵

To reduce the risks:

• know the signs and how to respond to stimulant overdoses
• ‘start low, go slow’ – pace yourself by taking a small amount to start with, leave time between doses and take regular breaks between ‘sessions’
• make sure you are drinking water and eating regularly
• take a moment to cool down if you feel too hot
• take breaks to rest if you have been doing strenuous exercise or dancing
• avoid or take less if you or your family have a history of heart problems, high blood pressure, or stroke risk.^{5, 10}

Mental health

Cocaine use can increase the risk of mental health harms, including anxiety and psychosis. This is especially true for people with a personal or family history of mental health conditions.⁵

To reduce the risks:

• aim to be in a good state of mind, with trusted friends and in a safe environment when you’re using cocaine
• avoid or take less if you or your family have a history of mental health conditions, such as anxiety, psychosis or bipolar disorders.^{5, 10}

Cocaethylene – mixing cocaine with alcohol

When both alcohol and cocaine are used together, your body produces a new drug called cocaethylene.

This makes the effects more euphoric and longer lasting, but also increases the strain on your mental health, heart and liver, and increases the risk of death.⁵

To reduce the risks:

• avoid drinking alcohol and using cocaine at the same time
• use less of both and avoid mixing with any other drugs.

Mixing cocaine with some other drugs can also increase the risk of harms. To learn more, visit our cocaine Drug Facts page.

Potential contaminants

Drugs sold as cocaine may also contain other drugs, like synthetic cathinones, or it may not contain cocaine at all.¹¹ This can make effects unpredictable, and potentially dangerous.

There are also additives (‘cutters’), like levamisole or lignocaine (lidocaine), which increase the risk of other harms.⁶

To reduce the risks:

• ‘start low, go slow’ – pace yourself by taking a small amount to start with, and leave time between doses
• never use alone, make sure someone nearby has naloxone on hand and a phone to call for help if needed
• check for drug alerts and use drug checking (pill testing) services, where available.¹⁰

How it’s consumed

Different ways of taking cocaine can have different risks.

Snorting or sniffing cocaine can damage your nose, especially with frequent or heavy use.⁵

To reduce the risks:

• crush into a fine powder
• rinse your nose with water before and after
• switch nostrils and give your nose regular breaks to heal
• never share straws or snorting equipment and avoid using money notes. They increase the risk of infections or transmission of blood-borne viruses.¹⁰

Injecting cocaine can cause vein damage and increase the risk of blood-borne viruses.

To reduce the risks:

• always use new and sterile equipment (needles, barrels, filters, water, swabs)
• learn about safer injecting practices
• wash or sanitise your hands thoroughly before and after
• never share needles or other equipment
• safely store used needles in a sharps container
• visit a needle and syringe program for sterile equipment, disposal of used needles, health advice or service referrals.¹⁰

Help and support

If your use of cocaine is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone, there is help and support.

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs
• Call the Stimulant Treatment Line on 1800 101 188 for free counselling and support for people who use stimulants, such as cocaine
• Use the Path2Help portal to get matched with information and services specific to your needs.
• Search our Help and Support directory to find your preferred support, by adding your location or postcode and filtering by service type.