Cocaine is a highly addictive and naturally occurring pain blocker (anesthetic). It is extracted from the leaves of Erythroxylon coca, also known as the coca scrub, a plant that grows in the Andean highlands of South America.
Cocaine is the most powerful stimulant of natural origin. When Coca-Cola was first produced, it contained 9 milligrams of cocaine per glass. In 1903, it was removed, but the drink still has coca flavoring.
Karl Koller, an Austrian ophthalmologist, was the first to use cocaine as an anesthetic during eye surgery. It quickly became a popular and widely used anesthetic.
Eventually, the medical profession realized cocaine was addictive, and safer anesthetics were developed. Cocaine, in its basic form, stopped being used clinically as a pain blocker, in favor of newer agents.
Contents of this article:
Fast facts on cocaine
Here are some key points about cocaine. More detail and supporting information is in the main article.
- Cocaine can be smoked, injected, or snorted
- Crack is a type of cocaine
- Long-term cocaine use increases the risk of heart disease
- Cocaine can make changes to the structure of the brain
Cocaine as a recreational drug
Cocaine is the most powerful stimulant of natural origin.
Today, cocaine is commonly used as a recreational drug. It is also known as powder, snow, ski, soft, blow, slopes, coca, marching powder, benzoylmethylecgonine, and nose candy.
It is normally found as a white, crystalline powder or as an off-white, chunky substance.
In powder form, it is usually cocaine hydrochloride (C17H21NO4), which is then diluted with other substances, such as local anesthetic (lidocaine), sugars (lactose), inositol, and mannitol.
By diluting the cocaine in this way, the seller can make more profit by "stretching" the actual amount of cocaine he or she has to sell.
Cocaine can be:
- Snorted - inhaled through the nose. It enters the bloodstream via the nasal tissues
- Injected - where it is released directly into the bloodstream
- Smoking - cocaine is inhaled into the lungs where it rapidly enters the bloodstream
What is crack?
Crack is the street name for a type of cocaine that has had the hydrochloride removed, making it possible to smoke.
When the mixture is heated, it makes a crackling sound, hence the name. Crack is processed with baking soda (sodium bicarbonate) or ammonia and water, and heated to remove the hydrochloride.
The crack-smoker receives large doses of cocaine - the effect is virtually immediate, as with injected cocaine. The extremely intense feelings derived from smoking crack are short-lived.
Overdosing on cocaine can lead to seizures, life-threatening heart failure, cerebral hemorrhage, stroke, and respiratory failure. Even regular usage, without overdosing, raises the risk of negative health consequences.
There is no specific medication for cocaine overdose. Some studies have shown that those who inject or smoke cocaine have a greater risk of complications than individuals who snort it. Also, smokers will typically become compulsive cocaine users more rapidly than those who snort it.
Smoking cocaine increases the risk of developing respiratory problems, such as shortness of breath, coughing, and lung trauma (including bleeding).
Stroke and heart attack risk
Researchers from the University of Sydney, Australia, demonstrated that recreational cocaine users have a significantly higher risk of having a heart attack or stroke compared with those who never use the drug.
Recreational cocaine users tend to have harder arteries, thicker heart muscle walls, and higher blood pressure than people who have never used the drug.
What does cocaine do? How does it feel?
The effects of cocaine are intense but short-lived.
Cocaine has a very powerful stimulating effect on the nervous system; it raises levels of dopamine, a neurotransmitter linked to pleasure, movement, and the brain's reward circuit.
The effects generally last 15-30 minutes, or around 5 minutes for crack.
Normally, neurons release dopamine in response to a pleasurable stimulus, such as the smell of good food. Once the dopamine has passed on its message, it returns inside the neuron and the signal stops.
Cocaine works by stopping the dopamine from getting back into the neuron. This means that the dopamine accumulates and continues to send the pleasurable message to the brain.
The excess dopamine gives the user a feeling of enhanced well-being, euphoria, alertness, motor activity, and energy.
Risk of addiction
Long term use of cocaine can lead to gradual changes in the brain's reward system, which seriously raises the risk of addiction.
In occasional cocaine users, social or physical problems are rare. However, scientists insist there is no safe amount of cocaine.
Cocaine is a highly addictive drug. People who are addicted may eventually prefer taking cocaine to any other activity - their lifestyles may alter completely as the addiction takes hold.
There have been cases of mothers selling their child, professionals spending thousands of dollars on binges costing from $20,000-$50,000. Some may lose their jobs, families, become bankrupt, and even die.
Physical changes in the brain
Scientists at the University of Cambridge in England identified abnormal brain structure in the frontal lobe of the brain of cocaine users due to cocaine-using behavior.
The team scanned the brains of 120 individuals, half of whom were addicted to cocaine. They found that cocaine users had widespread loss of gray matter. The longer the abuse, the greater the loss.
The basal ganglia, a part of the brain that houses the reward system, was found to be much larger among individuals who were dependent on cocaine.
The scientists believe that the basal ganglia was already enlarged before the addiction began. If correct, this means that some people might be more vulnerable to the addictive effects of cocaine.
Other health risks
The consumption of cocaine can have the following effects:
- Constriction of blood vessels.
- Elevated body temperature.
- Accelerated heart rate.
- Hypertension (high blood pressure).
- Abdominal pain.
- Decreased appetite - among chronic users this can lead to malnourishment.
- Regular snorting - loss of sense of smell, nosebleeds, swallowing problems, persistent runny nose, and hoarseness.
- Regular ingestion - severe bowel gangrene caused by a reduction in blood flow.
- Injecting - severe allergic reactions, higher risk of blood-borne diseases, such as HIV and hepatitis.
- Binge pattern cocaine use - irritability, anxiety, and restlessness.
- Severe paranoia. The individual might lose his/her sense of reality and hear things that are not there (auditory hallucinations).
- Heart failure.
People who abuse substances often take more than one drug at the same time. When cocaine and alcohol are used together, the liver produces cocaethylene. Cocaethylene prolongs the euphoric effects of cocaine and makes them more intense.
For that reason, cocaethylene is sometimes taken as a recreational drug itself. However, cocaethylene is linked to a significantly greater risk of sudden death, compared with cocaine alone.
Cocaine-related deaths in Europe
Researchers in southwest Spain found that more than 3 percent of all sudden deaths are related to cocaine use. The investigators stress that a "safe" recreational amount of cocaine does not exist. Out of 668 sudden deaths that occurred between 2003 and 2006, 3.1 percent (21) were linked to cocaine use - they were all male and aged 21-45. In most cases, the deaths were due to problems with the heart or blood vessels.
Treatment for addiction
Treatment for cocaine addiction is completely different from that used for heroin addicts. There are no effective substitute drugs for a patient who is dependent on cocaine. Some medications may be prescribed as part of the treatment, but they will be for symptoms related to withdrawal.
Depending on the nature of the drug abuse, some patients will be advised to attend a residential rehabilitation program, or a structured day program.
According to the National Health Service (NHS), UK, the best results come from counseling, social support, and some specialist medications.
The National Treatment Agency for Substance Misuse (NTA) says that 70 percent of people who go into treatment for powder cocaine problems either stop completely or significantly reduce their consumption within 6 months.
The NHS advises people to visit their doctor, who can direct them to suitable specialists and centers. According to the US Library of Medicine, individuals who stop using cocaine can still feel powerful cravings for the drug, sometimes even years later.