Cocaine is popular because it often gives users feelings of tremendous energy, confidence and illusions of invincibility and euphoria. But its risks are incredibly high, including irregular heartbeat, brain seizures, hypertension, heart attack, stroke, addiction, stimulant-induced psychosis and in rare cases, even death.
What is cocaine?
Cocaine, along with amphetamines, is the most widely used illegal stimulant. Derived from coca bushes (primarily in Peru and Bolivia), it's usually processed as a white powdery substance known as "coke," "snow" or "blow."
South Americans have chewed cocaine in its milder leaf form for thousands of years. In the United States, cocaine was used in various medicines -- and even in Coca-Cola -- during the late 1800s until reports of use and death prompted a ban under the 1914 Harrison Narcotic Act. Doctors occasionally still use powder cocaine as a local anesthetic, but non-medical use is illegal.
Cocaine use reached its peak in 1982, when the National Household Survey on Drug Abuse (NHSDA) revealed that 10.4 million Americans said they had used it. While the number of Americans using cocaine dropped to 4.8 million in 2021, as with heroin and some other illicit drugs, the stakes are higher today.
Cocaine available on the street now is much more concentrated and addictive than the coke used in the early 1980s. What people don't realize is that due to cocaine's potency today, young people who use it are more likely to become addicted and suffer serious health problems, both short- and long-term.
How is cocaine manufactured and used?
People usually either inhale cocaine through the nose (known as snorting) or inject it. Both methods take the drug directly into the bloodstream and produce an immediate high that can last 10 to 30 minutes. Street dealers generally dilute pure cocaine with cornstarch, talcum powder, sugar or other drugs such as amphetamines or procaine (a chemically-related local anesthetic).
"Free-basing" cocaine is a method of using chemicals such as ether to convert the powder into a solid, smokable substance similar to "crack" cocaine.
What are the effects of cocaine use?
Cocaine causes the brain to release large amounts of a chemical known as dopamine, which creates the euphoria that draws many people to the drug. While using cocaine, people feel:
More alert
Overwhelmingly energetic
Euphoric
Invincible
Paranoid
Extremely nervous
The flood of dopamine is also responsible for the "crash" and depression that you may feel when the drug's effect wears off. Large amounts of cocaine can kill the neurons that make dopamine, which may explain the chronic depression that some users endure, even long after quitting.
Meanwhile, other changes are taking place in the body:
Increased blood pressure
Increased heart rate
Increased body temperature
Loss of appetite
Sleeplessness
Irritablity
Wanting to regain the high and needing increasing amounts of cocaine to feel that way, you can become addicted in a short amount of time. This insidious "behavior-reinforcing" quality leads people to binge on cocaine for hours -- and sometimes days -- on end.
How can I tell if someone is using cocaine?
Someone high on cocaine will likely:
Have dilated pupils
Sniff frequently
Rub their noses
Speech may be loud, sped up and "chattery"
Use frenetic gestures
What are the risks of cocaine use?
Vascular problems. Cocaine has "vasoconstrictive" effects that can result in hypertension (high blood pressure), heart attacks, strokes and damage to other organs such as the kidneys due to a loss of blood flow.
Nasal problems. People who snort cocaine may permanently injure their nasal membranes, which can bleed and develop ulcers. In some cases, a hole forms in the nasal septum, the skin between the nostrils.
Infectious disease. People who inject cocaine and share needles with other users are more likely to contract infectious diseases such as AIDS and hepatitis.
Pregnancy complications. Using cocaine while pregnant can cause premature births, low birth weights and can contribute to congenital disabilities in newborns.
Psychological problems. Using coke regularly can cause depression, mania, paranoia, anxiety, compulsively repetitive acts, bizarre hallucinations, schizophrenia-like behavior and even violent psychotic disorders.
Liver damage. This is rare but can be very serious.
Death. In rare instances cocaine has caused deaths due to heart attacks, disturbances in heart rhythm ("arrhythmia"), brain seizures and respiratory failure -- even in people using for the first time. In addition, researchers say that when a person uses cocaine while drinking alcohol, the two substances combine to form an even more toxic product in the body. Cocaine and alcohol is the most common two-drug combo in drug-related deaths, according to NIDA.
What is crack cocaine?
Illegal manufacturers mix powder cocaine with water and ammonia or baking soda to form pellets or "rocks" of crack cocaine, which is smoked. Crack enters the bloodstream very quickly (in 8 to 10 seconds), producing a sudden and intense high that lasts only a few minutes. Crack -- so called because of the crackling noise it makes when heated and smoked -- was developed in the mid-1980s as a quicker, cheaper alternative to traditional cocaine.
While crack use is down to 0.2% in 2020, it is one of the most addictive substances ever created.
What are the effects and signs of crack use?
The symptoms are generally the same as someone high on powder cocaine, although some researchers say that crack cocaine is more likely to produce paranoid, aggressive behavior. The "binge and crash" pattern is also the same as that found in regular powder cocaine users. Because crack is smoked, regular users may also experience wheezing and chest congestion.
What are the risks of crack use?
Crack abuse carries the same health problems associated with powder cocaine use, but these risks are magnified because it is more potent and because it is smoked. The possibility of fatal brain seizures and heart attacks increases, and chronic lung and liver damage is common among users. Aggressive and suicidal behavior among people addicted to crack is also widespread.
Crack has proven even more addictive than powder cocaine, and in the 1980s and '90s crack use resulted in epidemic levels of "crack babies" -- babies born afflicted by cocaine.
How are crack and cocaine addictions treated?
Long-time cocaine users show a strong tendency towards relapse -- the intense craving and vivid memories of the high seem to last even years. Although no medications have yet been approved for treating cocaine dependence. Ultimately, the National Institute on Drug Abuse (NIDA) believes that a combination of drug and behavior therapy will prove the most effective means of treatment in the future.
One thing that seems apparent, however, is that immediate and enduring abstinence is essential to treatment success. The drug's effects are too powerful, and the "binge and crash" cycle too risky, to attempt the kind of "maintenance therapy" used with heroin addicts.
Many users seeking treatment are suffering from other problems as well, including addiction to other drugs and psychological disorders, which further complicate matters. Therapy, drug counseling and support groups such as Narcotics Anonymous can help many people deal with these problems.
Source: HealthDay
