Cocaine FAQs

What Is Cocaine?

Cocaine is a short-acting, highly addictive alkaloid stimulant drug derived from the coca leaf. Taking cocaine makes users feel more awake, energized, talkative and euphoric.

What Does Cocaine Do in the Brain?

After ingesting the drug, cocaine works directly on the pleasure centers of the brain by reducing the re-absorption of the neurotransmitter dopamine.

Cocaine binds to the dopamine re-uptake transporters in the brain. As a result, when dopamine is released, these re-uptake transporters are unable to remove the excess pleasure-inducing neurotransmitter from the synaptic gap (the gap between neurons). Over time, as dopamine is continually released but not “cleaned out” of the synaptic gap, the level of dopamine rises greatly, causing a euphoric reaction.

Cocaine works similarly with the neurotransmitters serotonin and norepinephrine, blocking the re-uptake transporters and increasing the quantities available in the synaptic gaps.

Cocaine is a relatively short-lived drug. For a brief period, cocaine causes a dramatic increase in dopamine stimulation, but as the cocaine wears off, the brain finds itself temporarily depleted of dopamine. Extra dopamine in the brain feels good, but the flip side is that depleted levels of dopamine in the brain feel very bad. After cocaine wears off there is a temporary period of dysphoria, a low to match the high. People often respond to this “low” by using more cocaine, as in a binge.

The regular use of cocaine can lead to a neural adjustment. The brain is not hard-wired for continuous pleasure and attempts to create this state of continual pleasure invariably cause the brain to “rewire.” Heavy regular cocaine use can lead to a reduction in the number of dopamine receptors in the brain. With fewer dopamine receptors, a person needs to use cocaine regularly just to experience normal levels of pleasure, and any time without cocaine use is a time of dysphoria. The neural changes that occur as a result of cocaine addiction make the drug difficult to quit.

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How Long Have People Been Using Cocaine?

People have chewed coca leaves for their energizing properties in Brazil and Peru for well over 4,000 years. In the mid-19th century doctors learned how to extract pure cocaine from coca leaves and discovered that the drug could be used as a local anesthetic. In the late 19th century, Sigmund Freud extolled the virtues of the drug as a treatment for everything from opioid dependence to fatigue and depression.

Cocaine was widely used as an additive in tonics and patent medicines, including Coca Cola, at and around the turn of the century. Wider usage led to an awareness of its dangers and eventual prohibition of sale in most countries in the early 20th century.

How Is Cocaine Used?

Cocaine is either snorted intranasaly (up the nose), injected or smoked (as crack cocaine).

  • Smoking crack cocaine induces an almost instant and very intense high that lasts only a few minutes.
  • Injecting cocaine induces a high that begins within minutes and lasts for between 20 minutes and an hour.
  • Snorting cocaine induces a high that begins within a few minutes and lasts for between about an hour and an hour and a half.

What Does Cocaine Do (Short Term)?

Shortly after taking cocaine, a user starts to feel energized, talkative, euphoric (high), confident and mentally alert. A perceived need for sleep or food diminishes.

As the cocaine wears off (as little as 5 or 10 minutes later, in some cases) the user starts to feel symptoms opposite to the effects of the high, such as anxiety, dysphoria and irritability.

What Does Cocaine Do (Long Term)?

With long-term heavy use, cocaine users develop a tolerance to the drug, needing ever increasing amounts to achieve a high. Some people, after lengthy heavy use, become sensitized to some of cocaine’s less pleasurable effects, feeling anxiety or experiencing psychotic episodes after relatively small doses of the drug.

See below for information on the long-term health risks.

How Addictive Is Cocaine?

The National Institute of Drug Abuse calls cocaine “powerfully addictive.” Cocaine is one of the more difficult drugs to quit using.

Crack cocaine has long been considered more addictive than other forms of the drug, although some experts are now challenging this assertion.

When cocaine addicts quit using the drug, they experience withdrawal symptoms that include:

  • Depression
  • Lethargy
  • Dysphoria
  • Irritability and restlessness
  • Nightmares
  • Increased hunger
  • Suicidal thoughts
  • Drug cravings

According to the National Institutes of Health, cocaine withdrawal symptoms (particularly depression and drug cravings) can persist for months after last use.

What Is Cocaine Addiction Treatment?

No single form of addiction treatment will work for every cocaine addict; the treatment must be well-matched to the individual and their situation for the best chances of lasting recovery.

Some treatment options available include:

  • Medication
  • Counseling
  • Cognitive behavioral therapy
  • Residential addiction treatment programs
  • Longer term sober living environments
  • NA
  • Participation in support groups

What Are the Health Risks of Cocaine?

Cocaine is a very dangerous drug. Chronic use can lead to sudden death from cardiac arrest and a host of secondary conditions. In some rare cases, cocaine can kill even a first-time user.

Some of the health risks of cocaine use include:

  • Infections of the sinus cavities, including a possible loss of the sense of smell
  • Cardiac arrest or stroke (cocaine causes thickening of the arteries and rapid heart beat, an often deadly combination)
  • Hypertension
  • Overdose can cause seizures or heart/respiration failure
  • Lung problems, including lung pain and difficulty breathing from smoking crack
  • An increased risk of HIV or Hepatitis C infection
  • Skin abscess (from injection drug use)
  • Skin loss, from users picking off the skin while high
  • An increased risk of psychosis, panic attacks and depression
  • Malnutrition
If you feel that you are in crisis, or are having thoughts about hurting yourself or others, please call 9-1-1 or go to the nearest emergency room immediately.

Will Using Cocaine During Pregnancy Harm the Baby?

Prenatal exposure to cocaine does harm the fetus and can result in long-term cognitive deficits in exposed children. Children exposed prenatally to cocaine can face deficits in ability to concentrate, general IQ and motor skills.

Cocaine use during pregnancy can also:

  • Affect the normal growth rate of the fetus
  • Cause a smaller than normal head circumference at birth
  • Cause a low birth weight
  • Put the fetus at risk of contracting HIV or Hepatitis C
  • Increase the risk of miscarriage

How Many People Use Cocaine?

The White House Office of National Drug Control Policy reports that as of 2007, almost 36 million Americans had tried cocaine at least once and in 2007, just under one million people tried cocaine for the first time.

How Can I Know if Someone I Love Has a Problem with Cocaine?

There is no single give-away sign of cocaine use, but the following symptoms are often associated with cocaine use.

  • Regularly having nosebleeds or a runny nose
  • Having red eyes and dilated pupils
  • Unexplained financial problems, frequently borrowing money or spending an unusual amount of cash with little to show for it
  • Changes in sleeping or eating patterns
  • Person seems high or overly talkative
  • Having a new set of seemingly less savory friends or associates
  • Problems at school or at work
  • Periods of depression and lethargy alternating with periods of extreme activity and excitability
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