Cocaine is a powerfully addictive drug. It provides immediate feelings of euphoria, power, extreme alertness, and mental clarity. Cocaine produces this "high" because it stimulates the central nervous system and interferes with the reabsorption of a chemical called dopamine. Dopamine increases pleasure and affects movement. By preventing the reabsorption of dopamine, cocaine allows for greater than normal levels of dopamine to act on the body, leading to an enhancement of its effects.

Cocaine can be taken orally, inhaled as a powder through the nose (sniffed or snorted), or injected, usually directly into a vein (called mainlining). "Crack" is the street name given to cocaine that has been processed from cocaine hydrochloride to a free base for smoking.

The method of taking cocaine determines how long the high will last. The high from snorting may last 15 to 30 minutes, while that from smoking may last 5 to 10 minutes. Smoking allows extremely high doses of cocaine to reach the brain very quickly and brings an intense and immediate high. Since the cocaine high does not last very long, users take repeated doses to continue the high. And, as a person uses cocaine over and over, a tolerance quickly develops, which means that the high will not last as long. This, in turn, leads to even more frequent use. This vicious cycle can quickly turn a first-time user into an addict. In fact, many addicts report that they seek but fail to achieve as much pleasure as they did from their first exposure. It appears that compulsive cocaine use may develop even more rapidly if the substance is smoked rather than snorted.

Health Hazards

Regardless of how cocaine is taken, there are many serious health effects.

Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter.

Cocaine can cause the following physical effects:

  • Increased temperature, heart rate, and blood pressure, which can lead to heart attack (even in previously healthy people)
  • Constipation
  • Intestinal damage
  • The feeling that something is moving under the skin (cocaine bugs), which is a sign of possible nerve damage
  • Seizures (convulsions)
  • Sleeplessness
  • From prolonged cocaine snorting, ulceration of the mucous membrane of the nose and possible collapse of the nasal septum
  • Miscarriage or fetal damage, if a woman uses cocaine during pregnancy

Those who take cocaine through injections are at risk for infectious diseases including hepatitis and HIV infection , if needles or other injection equipment are shared.

Cocaine can also cause the following mental effects:

  • Extreme nervousness, restlessness, irritability, and anxiety
  • Hallucinations
  • Paranoid delusions
  • Violent behavior
  • Hypersexual behavior

To reduce some of the extreme nervousness caused by cocaine, many addicts also abuse heroin or some other depressant, such as alcohol .

Scientific evidence suggests that cocaine has a powerful neuropsychologic reinforcing property. It drives a person to continued use, despite harmful physical and social consequences. When addicted people stop using cocaine, they often become depressed , and in some cases, suicidal. This may lead to resumption of cocaine use to alleviate depression.

Mixing Cocaine and Alcohol

When people mix cocaine and alcohol, they are compounding the danger each drug poses. Researchers have found that the human liver combines cocaine and alcohol and manufactures a third substance, cocaethylene. Cocaethylene intensifies cocaine's euphoric effects, while possibly increasing the risk of sudden death.

Treatment

The most effective methods of treating cocaine abuse are counseling and psychotherapy. Sometimes the psychologic disorders common to cocaine addicts, depression and manic-depression, are treated with antidepressants or lithium. Several other medications are currently being investigated to test their safety and effectiveness in treating cocaine addiction. Withdrawing from long-term cocaine abuse requires close supervision because the person may become depressed and suicidal. Entering a hospital or a drug treatment center may be necessary.