What is cocaine?
Cocaine
hydrochloride (coke, snow, blow) is a central nervous system stimulant
that interferes with the reabsorption of dopamine, a neurotransmitter
associated with pleasure and movement. It is a white powder manufactured
from the leaves of the coca plant found in South America. It may
also be found in crack cocaine, a preparation of cocaine that chemically
converts the drug into crystals, which are smoked.
How is cocaine used?
Cocaine
may be snorted, smoked, or injected. When it is snorted the effects
begin after a few minutes and last between 15 and 30 minutes depending
on the size of the dose and the tolerance of the user. When smoked,
either in the form of crack or free-base, the effects come on intensely
and immediately, but wear off quickly. When cocaine is injected
the effects are immediate and intense. The immediacy and intensity
of smoking and injecting cocaine make those methods more dangerous
because of the high potential for addiction and overdose.
Why do people take cocaine?
Cocaine
prompts the release of dopamine, a neurotransmitter responsible
for pleasure and movement, and inhibits the reabsorption of it,
overstimulating the brain. Users report feelings of euphoria, hyper-stimulation,
confidence, and alertness. Cocaine also reduces the user's appetite
and makes her talkative. Cocaine's pleasurable effects begin to
wear off quickly. Once they do, withdrawal symptoms can include
irritability, anxiety, restlessness, physical pain, insomnia, depression,
paranoia, or aggression as the drug's effects wear off.
Are there short-term dangers of taking
cocaine?
Cocaine
has a number of short-term effects, including the unpleasant withdrawal
symptoms mentioned above. Cocaine users frequently report that coming
down from the drug is difficult, leading them to take more to prolong
the high and avoid withdrawal. This is one of the reasons cocaine
is so rapidly addictive. Many users report depression immediately
after taking the drug and for days after.
Because
cocaine gives the user a sense of power and confidence, users frequently
think of themselves as functioning far better than they are. It
is dangerous to drive a car on cocaine, especially when combined
with alcohol. Because of the stimulant effects of cocaine, users
drink more than they are accustomed to without feeling the depressant
effects of alcohol. Cocaine, however, wears off much more rapidly,
leaving the user more intoxicated than he thought he was. This situation
increases the chance of suffering the worst of alcohol's debilitating
effects, including slowed respiration, vomiting, and loss of consciousness.
Alcohol and cocaine also combine in the human liver manufacturing
a third substance, cocaethylene, which, while intensifying cocaine's
euphoric effects, also increases the strain on the heart and the
risk of sudden death.
At high
doses, users of cocaine can become:
erratic
delusional
paranoid
violent
psychotic
As with
other stimulants, cocaine raises blood pressure, heart rate, and
respiration. This increases the chances of respiratory arrest or
stroke. High or frequent doses have caused seizures, strokes or
heart attacks in some people. In rare cases sudden death (from cardiac
arrest or seizures following respiratory arrest) occurs on the first
use of cocaine or unexpectedly thereafter. It is impossible to determine
who might have such an immediately fatal reaction to cocaine.
Are there long-term consequences to taking
cocaine?
Most users
don't imagine when they first try cocaine that they will become
addicted to it, but this is always a possibility. It is very difficult
to predict who will become addicted to cocaine. Other long-term
risks include:
Cardiovascular
problems, including irregular heartbeat, heart attack, and heart
failure
Sleeplessness
or sexual dysfunction
Diminished
sense of smell or perforated nasal septum
Nausea,
and headaches
Neurological
incidents, including strokes, seizures, fungal brain infections,
and hemorrhaging in tissue surrounding the brain
Pulmonary
effects, such as fluid in the lungs, aggravation of asthma and
other lung disorders, and respiratory failure
Psychiatric
complications, including psychosis, paranoia, depression, anxiety
disorders, and delusions
Increased
risk of traumatic injury from accidents and aggressive, violent,
or criminal behavior
For
intravenous (IV) cocaine users, there is increased risk of hepatitis,
HIV infection, and endocarditis.
Is cocaine addictive?
Yes, cocaine
is both physically and psychologically addictive because of its
interaction with the brain's dopamine levels. People develop tolerance
to cocaine and greater quantities of the drug are needed to produce
euphoric effects. In lab experiments, animals will continue to take
cocaine until they kill themselves.
Did Freud use cocaine?
Yes, and
he was an early advocate of what he thought were its medically beneficial
properties. However, when his friend and patient, Ernst von Fleischl-Marxow
died from cocaine addiction, Freud was disgraced and backed off
of his original claims for cocaine's medicinal uses. He was forced
to base his career on a different invention: psychoanalysis.
How do I help a friend who's having trouble
with drugs?
If you
are concerned about a friend's drug or alcohol use, this page contains
information about different ways to help them.
Dance
Safe is a harm-reduction web site centered on drugs found in nightclubs
and raves. The site offers drug information, a risk assessment,
ecstasy testing kits and e-news.
NIDA drug
pages have research reports, statistics and information on addiction.
This British
harm-reduction web site provides extensive information on cocaine,
including the basics, dangers, mixing with other drugs and links.
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