What Is Cocaine?

Cocaine is a highly addictive stimulant drug. Cocaine most often comes in a powdered hydrochloride salt form that can be snorted or dissolved in water and injected.

Crack cocaine is cocaine base that has not been neutralized by an acid to make the hydrochloride salt. This form of cocaine comes in a rock crystal. The rock is heated to produce a vapor that is smoked, usually in a special pipe. Rock cocaine earned the name “crack” because it makes a crackling sound when “cooked.”

Methods of Cocaine Abuse

The most common ways that cocaine is abused are by snorting, injecting, and smoking the drug.  When cocaine is snorted through the nose, it is absorbed into the bloodstream through the nasal tissues. Injecting the drug releases it directly into the bloodstream. Smoking releases the drug as rapidly as injection because it is absorped into the bloodstream via the lungs.

All three methods of cocaine abuse can lead to addiction and other severe health problems. Snorting can lead to breakdown of the nasal tissues and in some cases complete destruction of the barrier between the nasal passages and the brain. Shooting cocaine increases the risk of injection-site infections, and of contracting HIV and other infectious diseases.

Cocaine causes increased energy, reduced fatigue, and mental alertness. The faster cocaine is absorbed into the bloodstream and delivered to the brain, the more intense the high. Therefore, injecting or smoking cocaine produces a quicker, stronger high than snorting cocaine.

However, the faster the high comes on, the shorter the duration of the high. Snorting leads to a high that lasts between 15 and 30 minutes. The high from smoking cocaine rarely lasts more than 10 minutes. To sustain the high, a cocaine abuser wil administer the drug again and again. For this reason, cocaine abuses are often binge users who take repeated doses over and over, increasing the risk of overdose.

Cocaine and the Brain

Cocaine is a strong central nervous system stimulant that increases levels of dopamine. Dopamine is a brain chemical associated with pleasure and movement  – part of the brain’s reward circuit. Dopamine is typically released in healthy, non drug using people when they experience something pleasurable.  For example, it is typically released during sexual activity. Have you ever felt a little “high” after a fun group gathering with friends?  Intensely positive experience can result in a release of dopamine, as well as other neurotransmitters (seratonin, norepinephrine). The brain essentially uses dopamine to communicate – when you smell good food your brain might release dopamine to communicate that yes, this is something good to eat.   In healthy releases, dopamine is simply recycled back into the cell.  Cocaine prevents dopamine from being recycled, which allows dopamine to build up and increase the euphoric feeding. However, you are disrupting a normal brain process, and ultimately you are disrupting normal communication between neurons.

With repeated use, cocaine causes long-term changes in the brain’s reward system and it can alter brain chemistry in ways that are emotionally devastating. Many addicts report that it takes them close to a year after quitting cocaine to be able to feel pleasure, which is one reason cocaine addicts have a hard time quitting and why they often have an alarmingly high relapse rate even after treatment.

What Adverse Effects Does Cocaine Have on Health?

Cocaine constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure. It can cause headaches and gastrointestinal complications such as abdominal pain and nausea. Because cocaine tends to decrease appetite, chronic users can become malnourished.

Ingesting cocaine can cause severe bowel gangrene as a result of reduced blood flow. Binge patterns of cocaine use may lead to irritability, restlessness, anxiety, and paranoia. Cocaine abusers can suffer a temporary state of full-blown paranoid psychosis, in which they lose touch with reality and experience auditory hallucinations.

Regardless of how or how frequently cocaine is used, a user can experience acute cardiovascular or cerebrovascular emergencies, such as a heart attack or stroke, which may cause sudden death. Cocaine-related deaths are often a result of cardiac arrest or seizure followed by respiratory arrest.

Alcohol and Cocaine Increasing the Danger by Creating Cocaethylene
When people take cocaine and drink alcohol, they compound the danger of each drug. By combining cocaine and alcohol, you create a chemical reaction that can produce a third substance, cocaethylene. Cocaethylene intensifies cocaine’s euphoric effects, but it is also associated with a greater risk of sudden death than taking cocaine alone.

What Treatment Options Exist?

Cognitive-behavioral therapy has been shown to be an effective therapeutic option people who are abusing or are addcited to cocaine. The best treatment is tailored to the individual’s needs using a combination of therapy, social support, community support such as 12 step program involvement, and related services.

Because of the high potential for relapse, many cocaine addicts start with a residential treatment program so they do not have easy access to the drug.  A good drug rehab will help move the addict back into the community slowly by introducing them to support systems that will help them stay away from cocaine, especially during the first year when the addict may feel depressed, listless, or anxious as the brain’s neurotransmitters re-learn how to communicate and send pleasure signals.

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