Cocaine: Use, Abuse, Addiction and Other Facts to Know

First discovered to have medical uses as a topical numbing agent in the late 1800s, cocaine was glamorized and rose to be the ‘it’ party drug in the 1980s. Despite its ranking as one of the most dangerous drugs in the world, millions of people use both crack and powder cocaine to achieve a euphoric high and mental alertness, regardless of the crippling crash that follows.

Due to the addictive nature of the stimulant, many users turned to self-destructive behavior to achieve the same or even better effect. The journey of overcoming this addiction generally requires professional help and can involve depression, fatigue, and even unpleasant dreams and insomnia.

What Is Cocaine?

Derived from the coca plant of South America, indigenous people in the Amazon Rainforest and Andes Mountains has chewed the leaf of this narcotic stimulant for thousands of years to get an energetic high.

With many states legalizing cannabis, cocaine is becoming the most popular illegal drug in the US, and therefore in high demand. To meet this demand, it is common for cocaine to have unlikely additives to dilute the substance. Dealers are known to mix in similar-looking white powder to extend their product.

These additives may include everyday pantry items like baking soda, flour, cornstarch, or sugar, household items like laundry detergents, boric acid or talcum powder. Some dealers may even use crushed laxatives, local anesthetics, or amphetamines to make their product go a little further and maximize their profit. While pure cocaine will appear white, the mixed variety will have an off-white color or a white powder with a pink or brown tint.

Cocaine is readily absorbed through the thin membrane lining of the nose, gums, anus, private parts, and through the intestines after ingesting. Other users may dissolve the powder, injecting the concoction directly into the bloodstream.

Another method, which produces a faster effect is to smoke cocaine that has been processed to make a hard crystal-like rock. As the crystal is heated, it makes a cracking sound, earning its nickname of “crack cocaine.” The vapors are then inhaled into the lungs.

Though the high may be short-lived, ingesting cocaine sends high amounts of dopamine to the brain, giving an increased state of euphoria. With such a short high and crash cycle, users tend to fall into addiction at a faster rate, trying to achieve that high again. Many users who may have gotten hooked on the powder later turn to the less expensive crack cocaine variety to maintain their addiction at a lower cost.

A Brief History of Cocaine Use

From the mid 1800s and into the 20th century, there were many common medical and recreational uses for cocaine, to the point where it was found on a mass-market scale. Cocaine provided a breakthrough in eye surgery in 1884 when it was discovered that a few drops of cocaine solution would not only desensitize the eye but also make it immovable.

Cocaine went on to be used in additional procedures for the nose, throat, and sinus as an anesthetic, some of which still use cocaine to this day. Oral cocaine drops were a common remedy for toothaches in adults and children as well.

With the onset of the new century, cocaine was a regular additive to soda, wine, and other beverages, most famously known to be a key ingredient in Coca-Cola. Though banned for a time, it was still found illegal in small pockets of the population, disproportionately among those who dealt with stressful jobs and had easy access, like doctors, dentists, and pharmacists.

The drug resurfaced in the 1960s and 70s party scene, with the rise of disco and rock ‘n roll and the onset of cocaine parties like those held at Studio 54. Like marijuana and alcohol today, cocaine was commonplace in many social settings. Usage took a significant surge in the 1980s. In just four years, the number of regular users increased by 1.6 million users, reaching 5.8 million in 1989.

During a time that was deemed “the crack epidemic,” crime increased in many of the cities where cocaine was prevalent. The Bureau of Justice Statistics found that of the 414 homicides between March and October 1988 in New York City, 40 percent of all homicides and nearly 75 percent of all drug-related homicides were somehow connected to crack.

Increased awareness for the drug, coupled with action from political and police leaders, the popularity of the drug saw its first dip. Despite the information on the drug and increase response from leaders, 2017 still saw more than 14,500 cocaine-related overdose deaths, coming in third behind opioid- and heroin-related deaths, not to mention those struggling with the addiction on a daily basis.

What Does Cocaine Look Like?

Cocaine has two forms: the crack cocaine or freebase and the hydrochloride salt. The freebase variety is heated, and the vapors it creates are inhaled while hydrochloride salt comes in powdered form and is soluble in water.

Typically, cocaine is white, but its color can also vary from a yellow or off-white color to whitish or clear color. Further characteristics of what cocaine looks like are given below.

• Crack Cocaine. It comes in a crystal-like rock form. The crack cocaine’s color can range and vary from opaque to clear, and yellow to white. The shape and size of a cocaine rock also differ.

One of the reasons why the color of crack cocaine or cocaine powder changes is the substance used to cut it with. Occasionally, different additives are added to make it more potent or heavier so dealers can multiply their profits.

When a person abuses or overdoses crack cocaine, he/she will usually use to smoke it. Some prefer to use it in a freebase style or the method of heating the drug first before inhaling its fumes directly into the lungs.

• Cocaine Powder or Hydrochloride Salt. It’s the most common version that people buy, use, and abuse on a recreational basis. Cocaine powder or hydrochloride salt also have different street names such as blow and snow.

The cocaine powder comes in a white, crystalline, and fine powder when sold so users can directly snort it through their nose. When a cocaine powder is snorted, it passes through the nasal membranes before reaching the brain which usually takes for about 3 to 5 minutes.

For other users, they prefer to dissolve it then inject to their bodies. When a cocaine powder is dissolved and injected, the euphoric effect is faster compared to when its snorted. It only takes seconds to reach the brain. Hence, it’s high is also immediate.

Using freebase cocaine or smokes cocaine is already addictive enough, more so with a cocaine powder. Further, people who consume cocaine through these have a high likelihood of experiencing acute crashes after the high effect wears off. The crashes that result from freebase cocaine or crack cocaine use may include anxiety, depression, and worst, paranoia.

What Does Cocaine Smell Like?

Cocaine has a distinct smell. But it depends on the form of the drug being used as crack cocaine and as powdered cocaine have different odors. Also, some users prefer bath salts or synthetic cocaine whose smell also differs from other forms of cocaine.

Cocaine Powder. For powdered and pure cocaine, the smell is somewhat floral with a hint of sweetness. This type of smell is natural which make it difficult for people to recognize as it can be sometimes mistaken for incense or perfume. When the cocaine is not pure, it gives off a chemical-like odor.

Crack Cocaine. Although it’s considered as the purer form of the product, it’s odor is more synthetic or heavily chemical compared to its powdered counterpart. The smell can be likened to a burning plastic or rubber. Its scent is also comparable to bath salts but is more medicinal.

Just How Addictive Is Cocaine?

Cocaine is one of the most addictive and habit-forming substances known to man. In its absence dopamine is recycled into the cell that released it, shutting off the signal between nerve cells. However, when cocaine is introduced into the cycle, it stalls the sequence and dopamine is not reintroduced into the cell that released it, causing large amounts of dopamine to build between two nerve cells, stopping their regular communication.

While it may vary how long the high lasts (15 to 30 minutes when snorting cocaine and 5 to 10 minutes when smoking it), the effects of cocaine appear almost immediately. Like many other drugs, cocaine users often have an onset of cravings during high-stress periods of their life and self-medicate with cocaine.

With the quickness of the high and the flood of dopamine to the brain, the association of these positive and pleasurable memories is connected with the drug use, and users desire another high in hopes of feeling that way again, recreating the euphoric state again and again.

It’s hard to know when exactly cocaine addiction wraps its tentacles around a user’s pleasure center. A single use of cocaine, especially crack cocaine, can lead to addiction. The seemingly euphoric and clear-headedness users experience while high can lead to increased anxiety and restlessness when waiting for the next fix.

A friend or family member misusing the drug may have lapses in judgment or a change in behavior, miss school, work or personal engagements, or out-spend their means, as seeking out their next hit takes priority in their lives.

Another scary result of overusing cocaine is that as a tolerance begins to build, the user will seek out more or a stronger dose to get the same high they had at first. Unlike other drugs, this tolerance can remain, even if there has been an extended period of abstinence.

Throughout the weeks or months of initial use, an addiction to cocaine typically takes over a person’s professional and social life, along with emotional or logical reasoning, leaving their life a shell of what it was.

Those addicted to cocaine may find themselves in a binge session, where enormous amounts of cocaine are consumed to compensate for a stressful week or as a reward. It’s easy during a binge to lose track of how much has actually been consumed, putting themselves and others at physical risks or even an overdose.

A strong psychological addiction and chronic use can lead to a more severe physical dependence, which would bring on intense withdrawal symptoms.

Cocaine Use Disorder DSM 5 (Diagnostic and Statistical Manual of Mental Disorder)

According to DSM 5, substance-associated disorders may result from the use and abuse of these different classes of drugs;

• Amphetamine-type substances, cocaine, and other stimulants

• Alcohol

• Cannabis

• Caffeine

• Tobacco and other or unknown substances

• Other hallucinogens such as LSD

• Sedatives

• Opioids

• Inhalants

• Hypnotics or anxiolytics
• Hallucinogens such as phencyclidine or arylcyclohexylamines

Although there’s a specific identification on the grouping for psychoactive substances, the use of unknown or other substances can also create the basis of addictive or substance-related disorders. Such is the case for cocaine use.

Using cocaine in an episodic manner may lead autonomic arousal which could be short-lived. Chronic use, on the other hand, can lead to myocardial hypertrophy as well as myocardial remodeling and scarring of the heart tissue. These changes also compose the substrate for the manifestation of lethal arrhythmias.

Further, cocaine merges the ERG (rapid repolarizing potassium) channel, which damages the normal process of depolarization process in the heart muscle. Hence, cocaine shouldn’t be used together with drugs that can prolong  QT (ventricular activity) interval.

Chest pain may be a common reason for seeking medical care as one of the consequences of using cocaine, using it occasionally rarely leads to acute myocardial infarction (AMI), except when a coronary artery disease is pre-existing.

When delving about psychosis, using and abusing cocaine may also cause the user, especially the chronic ones, to experience isolated condition such as excited delirium. It is an agitated confusional state associated with potentially lethal hyperthermia.

On the flip side, there’s no evidence yet that support the theory of using antipsychotic agents to treat dependence with cocaine. In fact, antipsychotic agents have been shown to possibly cause a prolonged QT interval. And when these drugs are concomitantly used with cocaine, the risk of sudden death doubles.   

Effects of First Time, Recreational and Binge Cocaine Use and the Feelings Associated With Cocaine High

Cocaine intoxication or cocaine high is one of the most commonly known adverse effects of using cocaine. Ironically, it’s also the main reason why many use it. The high feeling that a user gets is what drives him/her to use it whenever he/she can.

Such a case is true among people who use and experiments with cocaine, be it first-timers, recreational users, and even binge users. There’s also a so-called social cocaine use which is equally harmful.

The cocaine intoxication or cocaine entails physical and psychological changes, especially on how the person thinks and he/she may feel extra emotional. Some of these changes are generated by the damaging effects of cocaine on the nervous system and the brain. Some are also due to the personal feelings the user have while using the cocaine.

As a result, the effects vary among users, although the cocaine high that users experience have similarities. Cocaine intoxication or cocaine may be frequent among users, but it doesn’t mean they get to experience all of these cocaine high effects. Nevertheless, the side-effects are still dangerous.

 

Extra (False) Self Confidence

Users may have the illusion of feeling better and happier about themselves while under cocaine high. It may also create a false sense of superiority about themselves. This kind of effect appeals to people who need an extra dose of confidence such as performers or those with low self-esteem.

Unbeknownst to users, this fake confidence is just one of the many side-effects of cocaine. It has no actual basis. When it gets worst, too much confidence or superiority may lead to social troubles.

When the cocaine high wears off,  the users are likely to feel worse than ever and may set themselves for another dose. The effects of cocaine high become short-lived as the cycle continues.

Sense of Euphoria

It is the particular kind of intense pleasure that cocaine users want to experience. Cocaine actually prompts the brain in a similar manner that a real achievement does. It then creates a rewarding feeling which makes it very addictive for people who wants to get never-ending cocaine high.

Upgraded Sociability

Another powerful effect of cocaine is that users may feel more sociable and energetic. Such effects make cocaine appealing to people with shyness, social anxieties, or lacks the energy to do things, especially those who struggle from depression.

When a person is high on cocaine, he/she may become gregarious and talkative. However, it can sometimes lead to restlessness, hyperactivity or difficulty with self-calming, angry outbursts, and anxiety. Getting high on cocaine may even result in hearing, seeing, or feeling things that don’t really exist, also known as or hallucinations or perceptual disturbances.

The Opposite Effects

Using cocaine for an extended period of time may yield the opposite results. Long-time users may no longer feel the effects they hoped for. Instead, they feel sad, aloof, and tend to withdraw from other people.

It can be frustrating, especially for the users who take cocaine to socialize, feel happier, to give themselves more confidence, and to self-medicate.

The Adverse Effects of Using Cocaine

Cocaine is a dangerous and potent drug. Its long-term and short-term effects are equally severe and destructive. The dangers of having seizures or cardiac arrest followed by respiratory failure are the same for both long and short-term abuse.

• Loss of appetite

• Insomnia

• Vomiting

• Blurred vision

• Irritability

• High anxiety

• Dilated pupils

• Constricted blood vessels

• Nosebleeds

• Nasal infections

• Sweating

• Rapid breathing

• Twitching

• Violent behavior

• Chest pain

• Hallucinations

 

According to the Diagnostic and Statistical Manual of Mental Disorders, the long-term effects using cocaine may foster depression, violent mood swings, extreme agitation,and depression. Further, continuous snorting of cocaine may cause holes in the barrier separating the nostrils and ulcerations in the mucous membrane of the nose.

Cocaine abuse can also result to extreme insomnia, loss of appetite, and sexual problems. Respiratory failure, gastrointestinal problems, heart attacks, heart disease, seizures, and strokes are also common among users of cocaine.

Cocaine Addiction Statistics

Data from a recent study from the National Survey on Drug Use and Health found that the number of young Americans who admitted using cocaine for the first time rose significantly from 2013 to 2015 – an astounding 61 percent.

The survey also reported in 2015, one in 20 American adults ages 18 to 25 used cocaine, with New Hampshire reporting 10 percent of young adults used cocaine in 2015. It is this population, the 18-25 year olds, that cocaine use seems to be concentrated.

In the spring of 2018, the CDC released new statistics on the growing trend of drug-related overdose deaths. The report stated that drug overdoses killed 63,632 Americans in 2016, an increase of by 21.5 percent for overdose deaths.

Overall, cocaine-related overdose deaths increased by more than 50 percent in 2016. While no region is immune to the drug, Washington D.C., Rhode Island, and Ohio reported having the highest increase of deaths as a result of a cocaine overdose.

Cocaine Abuse Treatment Options

Treatment for cocaine addiction must address the changes in brain chemistry and any possible mental disorders, as well as social, familial, and other environmental factors.

Currently, there are no pharmaceutical approaches to cocaine abuse treatment on the market that are approved by the FDA. Neurobiologists are exploring a variety of medications that interact with the dopamine receptors in the emotion and reward centers of the brain. Already approved medications for other diseases have shown to help reduce cocaine use in clinical trials.

Exciting research is also in the works to develop a cocaine vaccine, which would create cocaine-specific antibodies to prevent cocaine from reaching the brain and ultimately help reduce the risk of relapse.

More often than not, behavioral therapies are more readily available and more effective, in both a residential or an outpatient setting. Contingency management (CM), or motivational incentives, have shown positive results with the use of a voucher or prize-based system: positive reinforcement for abstaining from cocaine and other drugs.

When it comes to relapsing, cognitive-behavioral therapy (CBT) is a highly effective approach in which patients learn critical skills to identify situations where they are most likely to fall into cocaine use again. They learn how to avoid these situations and find more appropriate ways to cope with them.

The caring and skilled team at the Southern California Addiction Center has extensive experience in treating cocaine addiction. Each guest receives services that match all of their treatment needs with a tailored, comprehensive treatment program that is collaborative and individualized to fit our guest’s needs to ensure the most effective path and best opportunity for recovery.