Cocaine is a highly addictive and a naturally occurring anesthetic, or pain blocker.

It is extracted from the leaves of Erythroxylon coca (E. coca), also known as the coca scrub, a plant that grows in the Andean highlands of South America.

It is the most powerful stimulant of natural origin. When Coca-Cola was first produced, it contained 9 milligrams of cocaine per glass. In 1903, this ingredient was removed, but the drink still has coca flavoring.

In 1884, Karl Koller, an Austrian ophthalmologist, first used cocaine as an anesthetic during eye surgery. It was a popular and widely used anesthetic until the early 20th century.

As the medical profession came to realize that cocaine was addictive, safer anesthetics were developed. Cocaine, in its basic form, is no longer routinely used.

However, cocaine and its derivative, crack cocaine, are widely used as illegal recreational drugs.

Here are some key points about cocaine. More detail 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
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Cocaine is a powdered drug processed from the leaves of the Erythroxylon coca plant.

As a recreational drug, cocaine is 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 usually consists of cocaine hydrochloride diluted with other substances, such as lidocaine, a local anesthetic, sugars (lactose), inositol, and mannitol.

Diluting the cocaine enables the seller to make more profit by “stretching” the amount of pure cocaine they have to sell.

Cocaine can be taken by:

  • Snorting or inhaling through the nose. It enters the bloodstream via the nasal tissues
  • Injecting, which releases it directly into the bloodstream
  • Smoking or 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 producers make crack with baking soda (sodium bicarbonate) or ammonia and water, and it is heated to remove the hydrochloride.

The crack smoker receives large doses of cocaine. The effect is intense and virtually immediate, as with injected cocaine, but the “high” lasts only around 5 minutes.

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Crack cocaine may be smoked and can lead to a shorter but more intense high.

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.

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 stops the dopamine from getting back into the neuron, so it 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.

The effects generally last between 15 and 30 minutes, but shorter with crack.

Cocaine and crack cocaine are illegal drugs. This is because they involve health risks.


Cocaine is a highly addictive drug.

Long-term use can gradually change the brain’s reward system, increasing the risk of addiction.

In occasional cocaine users, social or physical problems are rare, but scientists insist there is no safe amount of cocaine.

People who are addicted may eventually prefer taking cocaine to any other activity. Their lifestyles may alter completely as the addiction takes hold.

The person may lose their job, home, family, and become bankrupt. The consequences can be fatal.


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Cocaine users run a high risk of strokes and heart attacks.

An overdose of cocaine can lead to seizures, life-threatening heart failure, cerebral hemorrhage, stroke, and respiratory failure.

Regular usage, even without overdosing, increases the risk of negative health consequences.

There is no specific medication to treat cocaine overdose.

Some studies have shown that those who inject or smoke cocaine have a greater risk of complications than individuals who snort it. Smokers tend to develop an addiction more rapidly than those who snort.

Smoking cocaine also increases the risk of developing respiratory problems, such as shortness of breath, coughing, and lung trauma, including bleeding.

Physical changes

Scientists at the University of Cambridge in England identified abnormal brain structure in the frontal lobe of the brain of cocaine users.

The team scanned the brains of 120 individuals, half of whom were addicted to cocaine. Results showed a widespread loss of gray matter among cocaine users. The loss was greater among those who had used the drug for longer.

The basal ganglia, a part of the brain that houses the reward system, was found to be larger among individuals who were dependent on cocaine.

The scientists believe that the basal ganglia were already enlarged before the addiction began. This would suggest that some people might be more vulnerable to the addictive effects of cocaine.

Risk of stroke and heart attack

Research indicates that cocaine use can significantly increase the risk of a heart attack or stroke.

Recreational cocaine users have been found to have harder arteries, thicker heart muscle walls, higher blood pressure, and up to a 35 higher risk of a hardened aorta, compared with people who have never used the drug.

Other health risks

Cocaine use can also have the following effects:

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Addiction can lead to damaging lifestyle changes and health risks. Treatment can be the key to preserving relationships and healthfulness.
  • constricted blood vessels
  • high body temperature
  • rapid heart rate
  • high blood pressure, heart failure, and stroke
  • headaches
  • abdominal pain
  • nausea
  • decreased appetite, with a risk of malnourishment among chronic users
  • severe paranoia, an impaired sense of reality
  • hallucinations, or hearing things that are not there
  • upper respiratory tract problems from regular snorting, including a loss of the sense of smell, nosebleeds, nasal septum decay, swallowing problems, persistent runny nose, and hoarseness
  • severe bowel gangrene caused by a reduction in blood flow among those who ingest regularly
  • injecting increases the risk of severe allergic reactions and blood-borne diseases, such as HIV and hepatitis

Binge pattern cocaine use can lead to irritability, anxiety, and restlessness.

Cocaethylene: Cocaine and alcohol

People who abuse substances often take more than one drug at the same time. When a person consumes cocaine and alcohol together, the liver produces cocaethylene.

Cocaethylene prolongs the euphoric effects of cocaine and makes them more intense.

For that reason, drug users sometimes take cocaethylene as a recreational drug itself.

However, cocaethylene use is linked to a significantly greater risk of sudden death, compared with cocaine alone.

Recognizing an addiction is the first step to losing it.

Depending on the nature of the abuse, some patients who seek help will be advised to attend a residential rehabilitation program, or a structured day program.

Medications can treat the symptoms related to cocaine withdrawal, but there is no substitute drug that can effectively help a patient recover from a cocaine dependency.

Individuals who stop using the drug will have powerful cravings that can last for years.

Counseling, social support, and some specialist medications may help.

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.

Anyone who is concerned about cocaine use should see a doctor or a local support group for beating addiction.