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What is Cocaine?
Cocaine is a highly addictive stimulant extracted from the dried leaves of the coca bush. Like other addictive drugs, it is a psychoactive substance which acts on the brain and central nervous system.
According to the World Health Organization (WHO), cocaine is the third most commonly used psychoactive drug, after cannabis and amphetamine-type stimulants. Cocaine is associated with artists and celebrities, and has been described as the champagne or caviar of illegal drugs. Crack is a cheaper, more accessible form of cocaine.
Prevalence of Cocaine Use
The 2012 National Survey on Drug Use and Health (NSDUH) reports that in the 12 months prior to the survey, 4.7 million people aged 12 and older used cocaine, up from 3.9 million in 2011. The NSDUH also said that 639,000 people used cocaine (or crack) for the first time in that time period, marking a steady decline since 2002. The survey found that 0.6 percent of the population, or 1.6 million people aged 12 or older, are current users, defined as having used cocaine in the past month, similar to the rate in 2011. The average age at the time of first use of cocaine is 20 years old.
The Drug Abuse Warning Network (DAWN) estimates that 505,224 hospital emergency department visits were associated with cocaine in 2011, or 162.1 visits per 100,000 people, more than any other illegal drug.
History of Cocaine
Coca, the raw material for cocaine, grows exclusively in the Andean region of South America, in Colombia, Peru and Bolivia. For thousands of years, the indigenous people in the mountains have used the plant for medical purposes, and chewed coca leaves to relieve fatigue. Cocaine was first extracted from coca leaves around 1859. In the 1880s, the medical community initially focused on its use as an anesthetic and possible treatment for morphine addiction in the 1880s after pharmaceutical companies discovered how to make cocaine hydrochloride. Sigmund Freud was one of many champions of the new drug.
It became increasingly popular as an ingredient in unregulated patent medicines, tonics and elixirs. In 1886, a civil war veteran and morphine addict named John Pemberton created a soft drink, Coca-Cola, that included cocaine as a stimulating ingredient, although cocaine was removed from the soft drink in 1903. In 1914 nonmedical use of cocaine was banned under the Harrison Narcotics Act. However, by 1905, sniffing and snorting cocaine had become popular. Today, cocaine is classified as a Schedule 2 Controlled Substance under the federal Controlled Substances Act and is illegal in most circumstances.
Once it became commercially available in the last quarter of the 19th century, cocaine was initially used as an anesthetic and for treating conditions like depression and alcohol and opioid addiction. However, as its medical use increased, the adverse effects on the mind and body became apparent. Rampant cocaine abuse ultimately led to the restrictions on import, manufacture, sale and possession of the drug early in the 20th century. Despite the ban, cocaine is available illegally throughout the world.
In the late 1970s and early 1980s, a new form of cocaine use called freebasing emerged. The process involved separating cocaine from the hydrochloride to purify it. The process involves heating cocaine hydrochloride in water, and then adding sodium bicarbonate or buffered ammonia, followed by a solvent such as ether or acetone. This process separates the liquid into two layers, one of which contains almost pure cocaine. When dried, that liquid produced crystals of almost-pure cocaine. Smoked by heating the crystals – usually in a pipe – the vapor passes quickly through the lungs into the bloodstream and brain, producing an intense rush and a high literally within seconds. However, if the crystals are not completely dried, the ether can explode when exposed to flames.
Crack cocaine emerged in the mid-1980s. It is manufactured by mixing cocaine hydrochloride with water, ammonia or sodium bicarbonate. When “cooked,” the mixture separates cocaine from hydrochloride and creates chunks or “rocks” that can be smoked. The process is safer than making freebase cocaine. Like freebasing, the vapor produces a rapid rush and a brief but intense high. The name “crack” is derived from the crackling sound this form of cocaine makes when burned.
Crack is less expensive to buy than cocaine powder. That affordability and the rapid short-term high made it attractive and was one reason that it spread rapidly throughout the U.S. until roughly 2005, when its popularity appeared to begin declining.
Usually available in the form of powder or small crystals known as freebase or crack, cocaine users either puff or inject (after mixing with water) powdered cocaine or smoke the crack. No matter how cocaine is taken, its effects are immediate and strong. Cocaine inhaled as a gas (freebasing) is absorbed more quickly into the blood than cocaine powder that is snorted.
What is Cocaine Addiction?
Cocaine is a highly addictive drug. When cocaine gets absorbed in the blood, it reaches the brain where it interacts with the neurotransmitters, making the person feel euphoric, alert, rejuvenated and confident. The user becomes energized and excited. These mood elevating emotions are sometimes coupled with a sense of irritability, anxiety, restlessness or paranoia. This is because cocaine interacts with different neurotransmitter systems, inducing mixed emotions. However, it primarily affects the reward areas of the brain, which are responsible for dopamine release, making the positive feelings dominant. When the temporary effects of cocaine subside, usually in about an hour, there is a sudden crash of emotions that can leave the user feeling sad, exhausted and depressed, sometimes for several days. These feelings of despair further tempt the person to use cocaine.
Another factor that contributes to cocaine addiction is the release and build-up of dopamine in the brain. When a person smokes, injects or inhales cocaine, it travels quickly to the brain. Although all areas are affected, cocaine’s properties are concentrated in the reward system, specifically in a region of the midbrain called the ventral tegmental area (VTA). Reward areas are responsible for releasing dopamine. Normally, dopamine is released by neurons or brain cells in response to potential rewards (like a good smell). It is then recycled back by a specialized protein known as dopamine transporter into the cell that released it, thus shutting off the signal between neurons.
This normal process is disrupted when cocaine enters the brain through the blood supply. Cocaine attaches to the dopamine transporter and blocks the recycle pathway of dopamine. This causes an accumulation of dopamine in the synapse, or junction between neurons, amplifying the dopamine signal and eventually interrupting brain communication. It is this build-up of dopamine which causes euphoria and elation in cocaine users and makes them addicted to it.
With frequent use, cocaine users develop tolerance, so a higher dose and more frequent use of the drug are needed to achieve the desired satisfying feelings of pleasure. Moreover, there are also changes in the brain’s reward system and the person fails to receive positive reinforcement or gratifying feelings from natural rewards (like food, water, and sex). This leads to cocaine dependence and addiction as the person relies on the drug for positive feelings.
Since crack or freebase gets absorbed more quickly in the blood, it tends to have stronger effects and is considered more addictive than powdered cocaine.
Signs of Cocaine Dependency
A person abusing cocaine may exhibit these signs:
- Desire for more cocaine
- Inability to control the urge of having cocaine
- Craving for cocaine despite the physical and mental problems
- Tolerance for initial doses of cocaine
- Spending most of his or her time using cocaine or seeking ways to obtain it
- Spending less time on productive activities and being less social
Short-term Effects of Cocaine Abuse
Cocaine use is associated with short-term as well as long-term health consequences. The short-term effects of cocaine are:
- Elevated energy levels
- Mental alertness
- Decreased appetite
- Feelings of confidence, enthusiasm and delight
- Increased talkativeness
- Dilated pupils
- Increased body temperature
- Increased heart rate and blood pressure
- Constricted heart vessels
- Enhanced sensitivity to touch, sound and sight
In some cases, the immediate and strong effects of cocaine may make a person too impulsive. Such behavior can result in arguments, violence or accidents. Moreover, a single large dose of cocaine can trigger arrhythmias or abnormal heart beats that may prove lethal. If cocaine is used along with alcohol, the liver produces a hazardous compound, cocaethylene, which increases the risk of sudden death. Injecting a mixture of cocaine and heroin, known as ‘Speedballing,’ can also be fatal.
Long-term Effects of Cocaine Abuse
Regular or long-term use of cocaine is associated with serious side-effects on the brain, heart, lungs, gastro-intestinal tract, kidneys, and sexual functioning. Cocaine is responsible for more U.S. hospital emergency department visits than any other illegal drug. Virtually the entire body can be affected by regular use of this stimulant. Potential side-effects from the long-term use of cocaine include:
- Increased heart rate and blood pressure
- High risk of heart attack or fatal arrhythmias
- High risk of stroke due to constriction of blood vessels in the brain
- Seizures and heart failure
- Damage to nasal cartilage and nasal perforation
- Respiratory problems, chest pain and lung damage
- Ulcers and perforation of the stomach and intestine
- Kidney failure
- Impaired sexual function
- Violent, uncanny and aggressive behavior
- Anxiety, depression and panic attacks
- Psychosis, the person loses contact with reality, experiencing delusions and hallucinations
- Injecting drugs can damage veins, causing ulcers and gangrene (localized tissue death)
- Sharing of needles can cause infections like HIV and hepatitis
- Increased risk of contracting tuberculosis due to weakened immunity and cocaine sharing habits
- When used by pregnant women, it can cause miscarriage, premature labor and low birth weight
Recovering from Cocaine Addiction
Cocaine addiction is highly overpowering and attempts to end its use can often fall short. Nevertheless, a comprehensive and recovery oriented program at cocaine treatment centers, such as DTRC, can make the treatment process easy and successful. Every addict has a unique personality and therefore a customized approach is the most suitable for rehabilitation of cocaine users. In addition to addressing the underlying psychological cause or causes of addiction, restoring the cognitive abilities of the patient is equally important in a program at a cocaine rehab center. As part of the holistic treatment process, significant aspects of rehabilitation include empowering the addict with drug refusal and trigger management skills, coping strategies and stress management abilities.
There are currently no drugs for cocaine rehabilitation.. However, research suggests that Topamax (topiramate), a drug approved by the federal Food and Drug Administration (FDA) for the treatment of epilepsy seizures and migraine headaches, may be effective for treating cocaine addiction. A recent study found that it was “significantly associated” with reduced cravings for cocaine. The drug works by modulating the inhibitory action of two different neurotransmitters.
Drug Treatment at our Cocaine Rehab Centers
Drug Treatment and Rehab Centers (DTRC) offers treatment for cocaine addiction. Patients are screened and treated for all underlying and co-occurring conditions in order to reduce the risk of relapse. Through customized programming that combines individual and group psychotherapy and complementary alternative therapeutic activities such as yoga, meditation, art therapy, equine therapy, and music therapy, the programs at DTRC provide balanced, holistic treatment for the person, not the disorder. Call our Admissions team at (646) 666-7461 to learn more about our crack cocaine rehab.