Cocaine is everywhere and someone you love may be hiding a secret habit
January is traditionally the month of fresh starts. Dry January, gym memberships, ambitious resolutions: We collectively decide to rein things in after the excesses of Christmas. But for some people, the party doesn’t stop. In fact, looking at drug use and in particular, cocaine use, it spirals. Across the UK, the use of cocaine has reached epidemic proportions, and the festive season is peak time for it. The UK is now the largest consumer of cocaine per capita in Europe, and the second largest in the world (behind Australia), according to a 2023 report by the OECD. Kristian Vanderwaeren, head of Belgium’s customs and excise department, memorably described December as ‘White Christmas – the period in which the white powder falls en masse from the sky’ after his officers seized ten tonnes of the drug destined for Europe’s festive party season on a single cargo ship at Antwerp. Ten tonnes. So as January arrives and we’re supposed to be turning over new leaves, it’s worth asking: Is someone you love struggling to stop? Would you even know if they had a cocaine habit? In my years as a psychiatrist, I’ve seen cocaine destroy lives, relationships, and careers. Yet it’s a drug that often hides in plain sight. Unlike heroin or crack cocaine, which we associate with obvious physical deterioration, cocaine users can appear perfectly functional, at least at first. They hold down jobs, maintain relationships, and seem fine. Until they’re not. The festive season is the peak time for cocaine use. Here are the signs that could mean a loved one is addicted to the drug. So what are the signs? The most obvious is frequent sniffing or a constantly runny nose. Cocaine damages the nasal passages, so users often have irritated nostrils or nosebleeds. But there are other, more subtle indicators. Watch for sudden bursts of energy and talkativeness followed by crashes of exhaustion and irritability. Cocaine is a stimulant, so users experience dramatic peaks and troughs in their mood and energy levels. Financial problems are another red flag. Cocaine is expensive – a habit can easily cost hundreds of pounds a week – so someone struggling with addiction may suddenly seem short of money, borrowing cash, or selling possessions. They might become secretive about their spending or defensive if questioned. Changes in sleep patterns are common too. Users might stay up all night, then sleep for enormous stretches. Their appetite may fluctuate wildly. And watch for personality shifts: Increased confidence bordering on arrogance when high, followed by anxiety, paranoia, or depression in the comedown. What particularly concerns me is when cocaine use shifts from being a social activity to something done alone. If someone is using at parties with friends, that’s worrying enough. But when they’re using at home, by themselves, on a Tuesday evening, that’s a serious warning sign. It suggests the drug has moved from recreation to self-medication, often for underlying mental health issues like depression or anxiety. There’s also a seasonal pattern worth understanding. We know that rates of depression increase during winter, what’s sometimes called Seasonal Affective Disorder or SAD. For vulnerable individuals, cocaine can feel like a short cut to the energy and positivity they’re lacking. The December party season provided both the opportunity and the social permission to use, and for some, that use tips into something far more problematic with devastating consequences. So how can you help that person in 2026? Set boundaries about what you will and won’t tolerate, and consider seeking support for yourself through organisations such as Adfam, which helps families affected by drugs. January may be a month of new beginnings, but for those trapped in addiction, it’s just another day of struggle. If you suspect someone you love is using cocaine, the kindest thing you can do is let them know they don’t have to face it alone.
In This Article:
- Cocaine can destroy lives while users appear perfectly functional at first
- Warning signs to watch for in a loved one
- From social use to self-medication – the danger grows
- Winter depression, SAD and cocaine's lure
- How to help in 2026
- Adam Peaty’s mother speaks of loss after not being invited to the wedding
- Estranged parents and the therapy culture that drives distance
- A&E sees more through the winter and what we can do
- Finch app helps you build healthy habits
- HRT and dementia risk: no impact found
Cocaine can destroy lives while users appear perfectly functional at first
In my years as a psychiatrist, I’ve seen cocaine destroy lives, relationships, and careers. Yet it’s a drug that often hides in plain sight. Unlike heroin or crack cocaine, which we associate with obvious physical deterioration, cocaine users can appear perfectly functional, at least at first. They hold down jobs, maintain relationships, and seem fine. Until they’re not. The festive season is the peak time for cocaine use. Here are the signs that could mean a loved one is addicted to the drug. So what are the signs? The most obvious is frequent sniffing or a constantly runny nose. Cocaine damages the nasal passages, so users often have irritated nostrils or nosebleeds. But there are other, more subtle indicators. Watch for sudden bursts of energy and talkativeness followed by crashes of exhaustion and irritability. Cocaine is a stimulant, so users experience dramatic peaks and troughs in their mood and energy levels. Financial problems are another red flag. Cocaine is expensive – a habit can easily cost hundreds of pounds a week – so someone struggling with addiction may suddenly seem short of money, borrowing cash, or selling possessions. They might become secretive about their spending or defensive if questioned. Changes in sleep patterns are common too. Users might stay up all night, then sleep for enormous stretches. Their appetite may fluctuate wildly. And watch for personality shifts: Increased confidence bordering on arrogance when high, followed by anxiety, paranoia, or depression in the comedown. What particularly concerns me is when cocaine use shifts from being a social activity to something done alone. If someone is using at parties with friends, that’s worrying enough. But when they’re using at home, by themselves, on a Tuesday evening, that’s a serious warning sign. It suggests the drug has moved from recreation to self-medication, often for underlying mental health issues like depression or anxiety. There’s also a seasonal pattern worth understanding. We know that rates of depression increase during winter, what’s sometimes called Seasonal Affective Disorder or SAD. For vulnerable individuals, cocaine can feel like a short cut to the energy and positivity they’re lacking. The December party season provided both the opportunity and the social permission to use, and for some, that use tips into something far more problematic with devastating consequences. So how can you help that person in 2026? Set boundaries about what you will and won’t tolerate, and consider seeking support for yourself through organisations such as Adfam, which helps families affected by drugs. January may be a month of new beginnings, but for those trapped in addiction, it’s just another day of struggle. If you suspect someone you love is using cocaine, the kindest thing you can do is let them know they don’t have to face it alone.
Warning signs to watch for in a loved one
The most obvious is frequent sniffing or a constantly runny nose. Cocaine damages the nasal passages, so users often have irritated nostrils or nosebleeds. But there are other, more subtle indicators. Watch for sudden bursts of energy and talkativeness followed by crashes of exhaustion and irritability. Cocaine is a stimulant, so users experience dramatic peaks and troughs in their mood and energy levels. Financial problems are another red flag. Cocaine is expensive – a habit can easily cost hundreds of pounds a week – so someone struggling with addiction may suddenly seem short of money, borrowing cash, or selling possessions. They might become secretive about their spending or defensive if questioned. Changes in sleep patterns are common too. Users might stay up all night, then sleep for enormous stretches. Their appetite may fluctuate wildly. And watch for personality shifts: Increased confidence bordering on arrogance when high, followed by anxiety, paranoia, or depression in the comedown. What particularly concerns me is when cocaine use shifts from being a social activity to something done alone. If someone is using at parties with friends, that’s worrying enough. But when they’re using at home, by themselves, on a Tuesday evening, that’s a serious warning sign. It suggests the drug has moved from recreation to self-medication, often for underlying mental health issues like depression or anxiety.
From social use to self-medication – the danger grows
What particularly concerns me is when cocaine use shifts from being a social activity to something done alone. If someone is using at parties with friends, that’s worrying enough. But when they’re using at home, by themselves, on a Tuesday evening, that’s a serious warning sign. It suggests the drug has moved from recreation to self-medication, often for underlying mental health issues like depression or anxiety. There’s also a seasonal pattern worth understanding. We know that rates of depression increase during winter, what’s sometimes called Seasonal Affective Disorder or SAD. For vulnerable individuals, cocaine can feel like a short cut to the energy and positivity they’re lacking. The December party season provided both the opportunity and the social permission to use, and for some, that use tips into something far more problematic with devastating consequences.
Winter depression, SAD and cocaine's lure
There’s also a seasonal pattern worth understanding. We know that rates of depression increase during winter, what’s sometimes called Seasonal Affective Disorder or SAD. For vulnerable individuals, cocaine can feel like a short cut to the energy and positivity they’re lacking. The December party season provided both the opportunity and the social permission to use, and for some, that use tips into something far more problematic with devastating consequences.
How to help in 2026
So how can you help that person in 2026? Set boundaries about what you will and won’t tolerate, and consider seeking support for yourself through organisations such as Adfam, which helps families affected by drugs. January may be a month of new beginnings, but for those trapped in addiction, it’s just another day of struggle. If you suspect someone you love is using cocaine, the kindest thing you can do is let them know they don’t have to face it alone.
Adam Peaty’s mother speaks of loss after not being invited to the wedding
My heart went out to Caroline Peaty, mother of Olympian Adam who shared her anguish after not being invited to his wedding to Holly Ramsay. ‘I won’t end this year pretending everything was fine,’ she said. ‘I lost a piece of myself this year that I will never get back.’
Estranged parents and the therapy culture that drives distance
Caroline’s pain speaks to a growing phenomenon: adult children cutting off contact with their parents. While these adult children often report feeling liberated, it’s the parents who typically suffer most. The research is clear on this. Estranged parents experience profound grief. Abuse, toxicity, and genuine dysfunction are real in families. But I worry about the influence of US-style therapy culture. This curious belief that life should be perfect, and anyone who causes us discomfort or fails to add to our ‘happiness’ should be swiftly excised. But the answer isn’t always to build walls. Sometimes it’s to keep talking, even when it’s hard.
A&E sees more through the winter and what we can do
Millions are attending A&E for minor ailments including coughs, blocked noses and – wait for it – hiccups. Now, before I sound unsympathetic: a cough that won’t shift might need looking at and persistent hiccups can occasionally indicate something serious. But A&E? Really? Yet, the solution to this isn’t more finger-wagging. It’s making GP appointments accessible, expanding pharmacy services and properly funding NHS 111.
Finch app helps you build healthy habits
If you struggle to maintain healthy habits and New Year resolutions, this clever app can help. Set daily goals such as drinking water, taking a walk, going to bed on time and as you complete each one, you nurture a virtual bird, a finch. It sounds childish, but I recommended it to younger patients. And it’s free to download at finchcare.com.
HRT and dementia risk: no impact found
Good news for women on HRT: A major review of studies involving more than one million females has found hormone replacement therapy has no impact on dementia risk. If HRT helps you feel better, there’s no dementia-related reason to stop.
