Drug Class: CNS stimulant
Cocaine is a highly addictive stimulant derived from the coca plant, which is grown primarily in Bolivia, Peru, and Colombia. Since the 1880s, cocaine has been used in eye, nose, and throat surgeries as a local anesthetic for its ability to constrict blood vessels and limit bleeding. In many countries, these are the only legal uses of the drug today.
Cocaine (benzoylmethylecgonine) is a central nervous system stimulant, a vasoconstrictor, an appetite suppressant, and a local anesthetic producing effects similar to other “caine” drugs (novocaine, benzocaine, lidocaine, etc.). Specifically, it is a serotonin–norepinephrine–dopamine reuptake inhibitor, which mediates functionality of these neurotransmitters. Because of the way it affects the mesolimbic dopamine reward pathway, cocaine has a significant addictive liability and is therefore illegal in most countries for non-medical uses.
The Different Forms of Cocaine
Cocaine is sold and abused in two forms:
- It can be found as a fine white powder (cocaine hydrochloride), which users either snort or mix with water and inject intravenously.
- Crack is cocaine hydrochloride powder that has been processed to form a rock crystal that is then smoked.
Some common street names for cocaine are blow, cola, freeze, rock, nose candy.
Cocaine can be ingested by snorting, injecting, and smoking. All three methods of cocaine ingestion can lead to addiction and other severe health problems, including increasing the risk of contracting HIV/AIDS and other infectious diseases.
Not only is cocaine hazardous to users’ health, but cocaine is also illegal in all states: Possession, even for first-time offenders, can carry a penalty of jail time and fines.
What Cocaine Looks Like
Who Uses Cocaine?
Cocaine is one of the most widely abused narcotics in history, especially during the “cocaine boom” of the ’80s and ’90s. U.S. Drug Enforcement Administration reports about 10 percent of Americans age 12 and older have tried cocaine at least once in their lifetime.
- According to the White House Office of National Drug Control Policy:
- Cocaine is the second most commonly used illicit drug in the United States.
- In 2000 there were an estimated 2.7 million chronic cocaine and an estimated 3 million occasional cocaine users in the U.S.
- In 2000, Americans consumed 259 metric tons of cocaine.
- In 2000, Americans spent about $36 billion on cocaine.
- Ages 18 to 25 have the highest rate of cocaine use than any other age group.
How Cocaine is Used
When snorted, cocaine powder is inhaled through the nose where it is absorbed into the bloodstream through the nasal tissues.
When injected, the user uses a needle to release the drug directly into the bloodstream.
Smoking involves inhaling cocaine vapor or smoke into the lungs where absorption into the bloodstream is as rapid as by injection.
All three methods of cocaine abuse can lead to addiction and other severe health problems, including increasing the risk of contracting HIV/AIDS and other infectious diseases.
Researchers have reported that heavy users of cocaine use 70 percent of all cocaine used in the United States.
How Cocaine Works
Cocaine is a stimulant, or “upper,” which makes the user feel euphoric and energetic. It’s this intense feeling that creates the addiction.
According to the National Institute on Drug Abuse, cocaine increases levels of dopamine, a brain chemical (or neurotransmitter) associated with pleasure and movement:
Specific brain cells, or neurons, use dopamine to communicate. Usually, dopamine is released by a neuron in response to a pleasurable signal (e.g., the smell of good food), and then recycled back into the cell that released it, thus shutting off the signal between neurons. Cocaine prevents the dopamine from being recycled, causing excessive amounts of the neurotransmitter to build up, amplifying the message to and response of the receiving neuron, and ultimately disrupting normal communication. It is this excess of dopamine that is responsible for cocaine’s euphoric effects. With repeated use, cocaine can cause long-term changes in the brain’s reward system and in other brain systems as well, which may lead to addiction.
The high from snorting cocaine takes longer to achieve, but may last 15 to 30 minutes; the high from smoking is almost immediate but only lasts 5 to 10 minutes.
Millions of cocaine addicts steal and commit immoral acts to obtain money for cocaine, as it is still a relatively expensive drug.
Short-term Effects of Cocaine Use
Cocaine makes the user feel euphoric, energetic, talkative, alert, and more sensitive to sight, sound, and touch. It can also temporarily decrease the need for food and sleep. Some users find that the drug helps them perform simple physical and intellectual tasks more quickly, although others experience the opposite effect. But it can lead to erratic, bizarre behavior, as well as paranoia, restlessness, irritability, and anxiety.
It is not just the physical effects of cocaine abuse that are dangerous, but also the life choices made once under the influence of cocaine. Many addicts engage in dangerous social and sexual activity under the influence of cocaine.
Cocaine addicts experience very low crashes when the cocaine high wears off, sending many into depression and an intense state of aggravation. While no noticeable physical withdrawal symptoms exist, the craving for cocaine is overwhelming when it is absent in the brain.
An added danger with cocaine is that users often mix it with alcohol, causing a chemical chain reaction in their bodies. According to the National Institute on Drug Abuse, the human liver combines cocaine and alcohol to produce a third substance, cocaethylene, which intensifies cocaine’s euphoric effects. However, cocaethylene is associated with a greater risk of sudden death than cocaine alone.
Long-term Effects of Cocaine Use
Repeated exposure to cocaine causes changes in the brain, making it less sensitive to natural reinforcers and even to cocaine itself. Tolerance may develop, meaning higher or more frequent doses of cocaine are needed to register the same “high.”
Cocaine “binges” can lead to panic attacks, and paranoia – even psychosis, in which the individual loses touch with reality and experiences auditory hallucinations.
Symptoms of regularly snorting cocaine can include:
- Nasal irritation
- Loss of sense of smell
- Problems with swallowing
Over time, ingesting or injecting cocaine can cause:
- Severe bowel gangrene
- Allergic reactions to the drug or additives
- Significant weight loss or malnourishment.
Treatment for Cocaine Addiction
Behavioral interventions such as cognitive behavioral therapy are effective in decreasing cocaine use and preventing relapse. Some 12-step programs like Cocaine Anonymous provide the social supports necessary to maintain sobriety.
Currently, there are no FDA-approved medications for treating cocaine addiction.
There is no cure for cocaine addiction – only treatment, including counseling, therapy, and support. Treatment provides tools to abstain when faced with stressors, triggers, and the temptation. Learn more about cocaine addiction and treatment.
Reputed to aid intelligence and alertness, cocaine use is also commonly associated with erratic behavior, paranoia, and anxiety. As the high wears off, addicts often experience very low crashes, overwhelming users with a depressive state and intense level of aggravation. Although physical withdrawal symptoms may be hard to notice, the drug’s absence sparks an overwhelming craving for cocaine.
The impact of cocaine use stretches far beyond the dangerous physical effects to social decisions and dubious choices made while under the influence, such as risk-taking, promiscuous sexual activity, and criminal activity.
Cocaine Addiction Warning Signs
Some of the psychological effects of cocaine use are mental alertness, paranoia, and illusions of invincibility. Once cocaine is absorbed into the bloodstream, users will feel more uninhibited and impulsive. Even first-time cocaine users can experience fatal seizures or heart attacks.
Physical effects of cocaine use
- Increased body temperature
- Increased blood pressure
- Increased heart rate
- Decreased appetite
- Dilated pupils (eyes look like black holes)
Psychological effects of cocaine use
- Intense euphoria
- Mental alertness
- Illusions of invincibility
- Irritability or restlessness
Cocaine addicts experience very low crashes when the cocaine high wears off, sending many into depression and an intense state of aggravation. As with most drugs, the crash or withdrawal is the part of what motivates addicts to continue their drug use.
Risks associated with cocaine addiction
Abusing cocaine has a variety of adverse effects on the body. Not only is the drug itself dangerous, but the substances used to dilute it for increased street profit – cornstarch, sugar, talcum powder, or other substances – make it impossible for the user to know what he is ingesting.
Over time, tolerance to the cocaine high may develop, leading users to increase their dose to intensify and prolong the euphoria.
Repeated exposure to cocaine causes the brain to adapt, making it less sensitive to natural reinforcers, and creating a tolerance to develop.
Health risks for the cocaine user
- Abdominal pain
- Decreased appetite
- Loss of the sense of smell
- Nosebleeds and a chronically runny nose
- Problems with swallowing
- Heart attacks
- Respiratory failure
- Sudden death
Social risks associated with cocaine use
- Engaging in dangerous social and sexual activity
- Stealing or committing crimes to obtain money for cocaine
- Low “crashes,” or states of severe depression, when the cocaine high wears off
- Combining cocaine use with the use of alcohol or other drugs
- Overwhelming craving for cocaine once its effects wear off in the brain.
According to the National Institute on Drug Abuse, cocaine is so powerfully addictive that an individual cannot “predict or control the extent to which he or she will continue to want or use the drug.”
Cocaine addiction treatment
The treatment process for crack and cocaine parallels treatment for most other drugs.
Detox is defined as the removal of the substance from the body, and it is vital to the recovery process. Virtually all addiction treatment centers require detoxification before treatment can begin.
The most important part of the treatment process is complete commitment to sobriety from the addict.
Depending on the length of abuse and severity of the addiction, there are different drug rehab programs to treat the specific addiction. Most drug rehab centers offer at least outpatient and residential drug rehab programs.
For addicts with less severe addictions, outpatient drug rehab may be appropriate, allowing the addict to return home at the end of the day.
Some users may have more severe cocaine addictions, requiring more intensive drug rehab programs, such as residential drug treatment. In residential drug rehab programs, addicts live in a drug- and alcohol-free environment with other addicts while receiving high-intensity drug rehab treatment under the care and supervision of trained addiction professionals and counselors.
Researchers are trying to develop medications to alleviate the severe craving associated with cocaine addiction, as well as a vaccine that would sequester cocaine in the bloodstream and prevent it from reaching the brain.