- Classification: Stimulant
- CSA Schedule: Schedule II
- Trade or Other Names: Coke, flake, snow, crack
- Medical Uses: Local anesthetic
- Physical Dependence: Possible
- Psychological Dependence: High
- Tolerance: Yes
- Duration (hours): 1–2
- Usual Method: Sniffed, smoked, injected
- Possible Effects: Increased alertness, excitation, euphoria, increased pulse rate and blood pressure, insomnia, loss of appetite
- Effects of Overdose: Agitation, increased body temperature, hallucinations, convulsions, possible death
- Withdrawal Syndrome: Apathy, long periods of sleep, irritability, depression, disorientation
Source: U.S. Drug Enforcement Administration
Cocaine is a very powerful central nervous system (CNS) stimulant. As the term stimulant indicates, substances in this category can enhance mood, increase alertness, and relieve fatigue.
Cocaine is just one of the substances present in the coca leaf. The primary source of cocaine imported into the U.S. is South America, but the coca plant also grows in the Far East in Ceylon, Java, and India. The plant is cultivated in South America on the eastern slopes of the Andes in Peru, and Bolivia.
There are several varieties of coca plants. The most commonly used substance is Erythroxylon coca var. coca (ECVC). ECVC is the variety that has been used for the manufacture of illicit cocaine. While cultivated in many countries of South America, Colombia, Peru and Bolivia are the world’s leading producers of the coca plant.
The method of isolating cocaine from the coca leaf does not require a high degree of technical expertise or experience. It requires no formal education or expensive scientific equipment or chemicals. The basic process can be taught to someone without any formal experience rather quickly and easily.
Origins of Cocaine Use
The drug cocaine comes from the leaves of the coca plant. People in South America have chewed coca leaves for thousands of years. Among other effects, chewing coca leaves helped people living in Andes Mountain regions to remain energized at high altitudes, where less oxygen was available.
It was not until the 1800s that the coca plant made its way to other parts of the world. In 1850, the first coca tinctures (medical mixtures) were used during throat surgeries to relieve pain as a local anesthetic. A few years later, the pharmaceutical drug maker Merck & Company began to produce cocaine.
In the 1870s, doctors began using cocaine to treat morphine addiction. During that same period, wines that contained cocaine were made and sold legally. Many influential people, including the world-famous psychoanalyst Sigmund Freud, praised the drug and encouraged its use. As demand for cocaine increased, companies invented new ways to purify the drug. Cocaine was even included in a soft drink: Coca-Cola. Introduced in 1886, Coca Cola (Coke) no longer contains cocaine today. The ingredient was removed from the soft drink in the early 1900s after reports began to appear of drug abuse, health problems, and even deaths related to cocaine.
By 1914, the dangers of cocaine had become evident, and it was banned in the United States. In the 1970s, cocaine reappeared in a new form called “freebase cocaine”, “crack cocaine,” or, simply, “crack.” Cocaine also became common at bars, clubs and discos. In the 1980s, the drug became cheaper to buy, and cocaine use exploded.
How Cocaine is Consumed
Stimulants like Cocaine, are often administered orally, sniffed, smoked, or injected. Smoking, snorting, or injecting stimulants produces a sudden sensation known as a “rush” or a “flash.” The high from snorting is relatively slow but can last fifteen to thirty minutes; effects from smoking are more immediate but may last only five to ten minutes. Abuse is often associated with a pattern of binge use, that is, consuming large doses of stimulants sporadically. Heavy users might inject themselves every few hours, continuing until they have depleted their drug supply or reached a point of delirium, psychosis, and physical exhaustion. During this period of heavy use, all other interests become secondary to re-creating the initial euphoric rush.
Cocaine typically enters the bloodstream by being snorted into the nostrils through a straw or rolled paper or from a “coke spoon.”
“Because cocaine is a vasoconstrictor, it inhibits its own absorption, and the time it takes to reach peak concentration gets longer as the dose gets larger” (Karch 1996: 19).
Some abusers will take it intravenously, which is the only way to ingest 100 percent of the drug. Because this is a more efficient method, users with limited funds sometimes buy and inject cocaine as a group, a method that can spread HIV/AIDS. Intravenous use results in an intense feeling of euphoria that peaks in three to five minutes and wanes in thirty to forty minutes.
Cocaine can also be absorbed through the genital or rectal regions. This is an extremely dangerous practice which can lead to seizure, coma, and death. When the drug is inhaled, its effects peak in fifteen to twenty minutes and disappear in sixty to ninety minutes.
Effects of Cocaine Use
Short Term Use Effects
- Loss of appetite
- Increased heart rate
- Increased blood pressure
- Increased body temperature
- Increased rate of breathing
- Dilated pupils
- Violent behavior
- Formication (illusion of bugs burrowing under the skin)
- Sudden death
Chronic Use Effects
- Permanent heart and brain damage
- High blood pressure
- Heart attacks
- Liver, kidney and lung damage
- Destruction of tissues in nose if sniffed
- Respiratory failure if smoked
- Infectious diseases and abscesses if injected
- Tooth decay
- Auditory and tactile hallucinations
- Sexual problems
- Irritability and mood disturbances
- Violent behavior
- Tolerance and addiction
Smoked, snorted, or injected, cocaine rapidly enters the bloodstream and penetrates the brain. The drug achieves its main immediate psychological effect—the high—by causing a buildup of the neuro-chemical dopamine. The drug binds to specific receptor sites on brain membranes and triggers the release of dopamine but also serotonin and norepinephrine. These neurotransmitters enhance mood and, at high enough doses, produce feelings of euphoria by activating the sympathetic nervous system, giving rise to increased heart rate, blood pressure, breathing rate, body temperature, and blood sugar.
A deficiency in serotonin was found to be linked to a desire for cocaine, and genetically altered mice continued to find cocaine rewarding even when it failed to increase their (already high) levels of dopamine. The substance also acts on the hypothalamus to decrease appetite and reduces the need for sleep by inducing the release of stimulant neurotransmitters. In addition to stimulating their release, cocaine blocks or inhibits the reabsorption of dopamine, norepinephrine, and serotonin by the discharging neurons by preventing a reuptake transporter from performing its usual function. As a result, neurotransmitters continue to bombard their receptor sites. The neurons remain in a state of excitement, the brain is stimulated accordingly, and euphoria increases. This initial, short-term effect—a buildup of the neurochemical dopamine—gives rise to euphoria and a desire to take the drug again. As the supply of dopamine depletes, however, depression sets in.
Research has discovered that cocaine-dependent people have fewer dopamine receptors than do normal controls, which also helps to explain why they feel depressed when not on cocaine. Depletion of both dopamine and serotonin in specific brain regions that control drive and affect may contribute to the craving and depression that are evident in the aftermath of cocaine abuse, “but when cocaine is re-administered, frontal brain regions may be reactivated, again contributing to the compulsion to use cocaine”.
In small doses, cocaine will bring about extreme euphoria and indifference to pain, along with illusions of increased mental and sensory alertness and physical strength. The inhalation shortly gives rise to feelings of elation and a sense of clarity or power of thought, feelings that pass away for most people in about half an hour.
At higher doses, however, the drug has the potential “to produce megalomania and feelings of omnipotence in most individuals” (Gold et al. 1986: 44). Cocaine causes the body to feel as if there were an impending threat, a response to stimuli that causes the release of stimulating neurotransmitters (dopamine and norepinephrine).