New evidence shows that coke is overtaking ecstasy as the social drug of choice. As scientists warn that its use is reaching 'epidemic' levels, David Hayles and Sophie Goodchild report on why cocaine is suddenly so popular - but as dangerous as ever

Cocaine used to be for rock stars and rich kids on tour buses and yachts. Now Jerry, a regular at an ordinary bar in south London, is moaning because he can't "powder his nose" in the gents'. Coke is so commonly used here that the management have covered the toilet cubicle shelves with a spiky artex coating. "I suppose I could use the toilet seat," says Jerry. "It would mean getting down on my knees."

The drift towards white powder has become a snowstorm, with use of coke trebling in the last seven years. Estimates have previously been based on drug seizures, convictions and self-reported use - but now an NHS study has produced hard evidence that cocaine is replacing ecstasy as the everyday social drug of choice.

"The arrival of the cocaine epidemic has now started to become a reality in the UK," says Dr Steve George of City Hospital, Birmingham. His team studied 80,000 samples from drug dependency units, GP surgeries and other hospitals and found that nearly one in four suspected drug users tested positive for cocaine, compared to one in 10 in 1997. Coke use is almost a tradition in pressurised workplaces such as the City of London, (three dealers were recently jailed after selling tens of millions' worth to the Square Mile including £7.6m of cocaine in one 13-month period) but the anecdotal evidence of greater social acceptability is all around: one newspaper recently referred to the beleaguered cigarette smoker as "a less glamorous cocaine user".

Coke is widely seen as a pick-me-up after a hard day at the officeand, at some dinner parties, an alternative to a pudding - or even to a starter. "It's so easy to get hold of," says Jon, 27, a musician. "I could ring one of two dealers, and they'd be here like that ... " He clicks his fingers. "It's taken over from ecstasy, because it's more controllable, more sociable. You don't turn into a gurning goon. Plus, cocaine's got that bling about it. We see so much about celebrity lifestyles - cocaine lets you live how the other half live. For a little while, you're the man. It enhances your night - but not your life."

The NHS report says the greater popularity of cocaine - equivalent to a 50 per cent increase in use every three years - may be partly due to greater availability. "Cocaine is seen as preferable to amphetamine for clubbers because the effects following cocaine use, and their duration, [are] more controllable," says the report. "This, coupled with the diminishing quantity of ecstasy available and the increased availability of cocaine following its importation to produce crack, has resulted in cocaine use in the 16- to-29-year-old group rising."

Mike Trace, the Government's former deputy drugs tsar, says increasing numbers of recreational users of powder cocaine are now experimenting with crack cocaine, which is highly addictive. It can also create more psychological problems. "The divisions we have had between recreational drug users of powder cocaine and street crack users are becoming increasingly blurred," he says.

The NHS study backs up findings from the British Crime Survey. Police are particularly concerned about crack, which is linked with a rise in violent crime. There are an estimated 45,000 crack users just in London and last year officers from the Metropolitan Police closed 516 crack dens. The Independent on Sunday revealed earlier this year that the street price of cocaine had dropped dramatically with some dealers offering the drug at £45 a gram compared with £70 six years ago.

Cocaine's potential harmful side effects can be devastating - psychologically, it can lead to psychosis and permanent dementia; heart attacks, strokes; there's even the risk of hepatitis C from blood on a shared rolled banknote. According to medical research, long-term abuse is the equivalent of kicking the heart around a squash court and expecting it to cope - and, even if you quit, the damage may already have been done.

At St Mary's Hospital in Paddington, north London, medics now suspect that around 10 per cent of chest pain cases are cocaine-related, although many patients who turn up in emergency wards refuse to admit it. When cocaine is taken, dopamine (literally "happy juice") is released into the brain and egos inflate to the size of bouncy castles. Silence is the enemy, the lull that signals the effect has worn off. Cocaine is moreish - once the experience has peaked, the user wants it again, and again. Then there is the comedown: like stepping off a cliff into an empty, hair trigger irritable mood. Heavy drinkers get the DTs, cocaine fiends get STs - Suicide Tuesdays - when the weekend's excesses really come tumbling down. This is often the trigger for coke use during the week, to ward off the comedown.

So why indulge in a drug whose honeymoon period doesn't even last the trip to the airport? Jason, a fashion stylist, has only good things to say about coke. "It makes you feel horny," he says. "I can deal with a few days' paranoia if I'm feeling horny. It's dirty, a sex drug. You're the bee's knees with women. I used to wake up in a sea of debauchery."

Katey, 23, a catering student, is another advocate: "It's great - like being close to an orgasm. And there's not such a comedown for women - we're used to it: it's like PMT." She adds, "It's still a rich person's drug - who can afford to get addicted?", as if not being able to afford an indulgence ever stopped anyone pursuing it.

Perhaps cocaine's reckless, hedonistic instant thrills act as a counterpoint to relentlessly doom-laden times, where alcohol alone can't fit the bill. As Jerry at the bar concludes, "I'm not worried about a heart attack 20 years down the road. We might all get blown to hell tomorrow anyway." With that he makes his way to the gents', not the first person to be brought to his knees by cocaine.

Additional reporting by Roger Dobson

THE WEEKEND USER: Jason, 28

'Sex on it is amazing. And you feel more confident all round'

Cocaine is as acceptable as lighting up a cigarette in many circles. It makes you hyperactive; you stay awake until your body shuts down through exhaustion. There are other less pleasant side effects: it attacks your central nervous system, so you want to defecate, urinate or throw up as soon as you take it. There are also the chest pains which are unbearable at times. I blister on my lips and become edgy, slightly paranoid the next day. In spite of all that, there are benefits that make it worthwhile. My girlfriend uses it too and both of us swear that sex is amazing on it. And you generally feel more confident all round. If I didn't take coke I'd be in the minority; my boss uses it, my brother uses it and so do most of my friends. As long as I can take it or leave it and enjoy the buzz, I see no reason why I should stop.

THE MOTHER, Melissa, 36

'Friends gave me coke as a diet aid. It worked. But I became an addict'

Girlfriends at my son's nursery told me it was the best diet aid ever. It cut my appetite completely from the first time I used it. Within a few weeks I was taking coke every Wednesday, when we mums would meet for a meal. I was more comfortable with myself than I could ever remember. For about six months I was smoking coke most days. By the time my weight dropped to seven stone and I was literally a shell. My husband knew something was up. I became devious and dishonest to a degree I can't comprehend now. I was in debt, living on credit cards and still swearing there was nothing wrong. You become paranoid. I would get uncontrollable urges to search the rugs, carpets and bedclothes to see if I had dropped some. That's when I knew I had really hit rock bottom. In the end I broke down and admitted I needed help.

THE CASUALTY, David, 26

'Your muscles start to seize up, and your sight becomes blurred'

When you do large quantities of coke, your muscles begin to seize up. Your vision becomes blurred. You get hot and begin to "gurn" - the continual movement of tensing and untensing the jaw muscle. For the 18 months that I was addicted at university I was permanently aggressive and irritable. Relationships with girlfriends, family and friends hit rock bottom. I went from being athletic and sporty to an 11-stone bag of bones. I suffer spinal misalignment which causes me daily pain and I get muscle spasms in my shoulders, neck and face. I need treatment, but if you tell the NHS you have used drugs they lose interest. The negative effects made me seek help. Thankfully, I was able to take a year out and then go back to finish my degree. There was a time when I thought I would never be this person again.

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