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.