Cocaine is a highly addictive stimulant drug made from the leaves of the South American coca plant. It is sometimes used in medicine as a local anesthetic, but is primarily sold on the street as an illicit drug that people take to get high. Dealers and users sometimes refer to cocaine by slang terms such as snow, flake, and blow.
Most of the cocaine that is sold in the United States comes from Columbia. The drug is manufactured from coca leaves in jungle laboratories and transported illegally into the U.S.
How people use cocaine
Cocaine is one of the oldest drugs in use today. It is the only drug that acts as both a nervous system stimulant and anesthetic. Ancient South American peoples first discovered both of these properties centuries ago. They chewed the leaves of the coca plant and brewed them into tea to boost their energy, and to treat minor ailments such as headaches and toothaches.
In the late 1800s, doctors began using cocaine as a local anesthetic to prevent pain during surgery. By the early 1900s, it was an ingredient in tonics and elixirs sold to treat a variety of everyday ailments.
Eventually, better and less addictive forms of anesthesia were developed. Synthetic substitutes for cocaine, such as Novocaine and lidocaine, are used as anesthesia in some medical procedures involving the eyes, ears, and throat. A form of cocaine is also used to reduce bleeding in the mucous membranes of the mouth, throat, and nose. But in general, cocaine is rarely used anymore for medical procedures in the United States.
Today, cocaine is primarily sold illegally as a street drug for its stimulant effects. In the 1970s, Congress classified it as a Schedule II drug under the Controlled Substance Act, which means that it has a high potential for abuse.
When the coca leaf is processed, it can produce three forms of cocaine:
- cocaine hydrocholoride—a white, crystalline powder
- freebase—a white powder that is a purer form of cocaine hydrocholoride
- crack—a rock crystal that is formed from boiling cocaine with sodium bicarbonate
Effects on the brain
Cocaine is a stimulant that exerts powerful effects on the central nervous system. It triggers the release of dopamine, a brain chemical that is involved with movement, as well as feelings of pleasure and reward.
The drug produces an initial euphoric, energetic feeling that lasts anywhere from a few minutes to an hour or two, depending on how much a person takes and in what form they take it. Injecting or smoking cocaine produces a more intense but shorter high than inhaling it. This rapid high is sometimes called a "rush." Using these more intense delivery methods also increases the drug's potential for addiction.
When users start to come down from their high, they may experience more unpleasant side effects, such as agitation, irritability, restlessness, anxiety, and insomnia. Some users may "crash," feeling exhausted and depressed for a few days after they take the drug.
The immediate effects of taking cocaine on the body and brain include:
- rapid heartbeat
- narrowed blood vessels
- increased blood pressure
- dilated pupils
- increased body temperature
- reduced appetite
- increased sex drive
The drug can also produce long-term effects such as:
- damage to the nasal cavity, leading to nosebleeds
- loss of the sense of smell
- cough and difficulty breathing (if the drug is smoked)
- nutrient deficiencies
- sexual dysfunction
- muscle damage
- movement disorders, such as Parkinson's disease
- severe paranoia
- liver injury
People who are frequent, heavy users of cocaine can develop a condition known as "cocaine psychosis." They may see and hear things that don't exist (hallucinations), and act aggressively. These symptoms should go away once the person stops using cocaine.
Addiction, overdose, and other risks
Cocaine is a highly addictive drug. Normally, dopamine is taken back up by neurons (nerve cells) after it is released. Cocaine prevents the reuptake of dopamine into nerve cells. This leads to a buildup of dopamine in the spaces between neurons, which can lead to a growing dependence on the drug.
Eventually the brain becomes accustomed to the increased dopamine levels and stops responding as well to this chemical. As a result, people must take increasingly larger amounts of cocaine to achieve the same feeling. This can lead to addiction.
People who try to stop taking cocaine once they are addicted can develop withdrawal symptoms such as irritability, fatigue, anxiety, frightening dreams, and depression. Some may continue to take the drug just to avoid the withdrawal side effects.
Taking too much cocaine can cause an overdose. An overdose can be very serious, leading to a heart attack, stroke, seizures, sudden cardiac arrest, or death.
Health problems can also arise from the additives some dealers mix or cut into cocaine to augment its volume and increase their profits. They may mix it with harmless substances such as flour, sugar, or cornstarch, or add potentially dangerous drugs like amphetamine or synthetic opioids. Cocaine mixed with opioids is more addictive, and more likely to lead to overdose.
Treatment for cocaine addiction
Cognitive-behavioral therapy is one of the main treatments for cocaine addiction. Working with a therapist can help someone who is addicted identify and learn to change the negative thoughts that cause them to use the drug.
Inpatient drug programs provide a safe place, with counseling and support, for people to overcome their addiction. Twelve-step programs and other outpatient community-based programs are also available for treating drug addiction. If you believe you are addicted to cocaine, help is available from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357).