Cocaine is one of the most powerfully addictive drugs of abuse. Most clinicians estimate that approximately 10 percent of people who begin to use this illegal drug recreationally will go on to serious, heavy use. Once having tried cocaine, an individual cannot predict or control the extent to which he or she will continue to use the drug.

Recent data shows that 6.5 percent of 10th graders had tried cocaine at least once, up from 5 percent in 1995. Additionally, about 4.6 million people had used crack cocaine at least once in their lives, and about 1.3 million people had used crack within the past year.

How Cocaine Works

Cocaine is a stimulant; it speeds up the workings of the brain and the nervous system. This is how it works: The brain "rewards" us for engaging in life-enhancing behaviors -- such as eating or having sex -- by releasing a flood of pleasurable neurochemicals. Dopamine is one of these brain chemicals. This chemical reinforcement makes us want to engage in these behaviors again and again. Cocaine works by tapping into this reward system by triggering the release of dopamine. This makes cocaine extremely addictive, not only psychologically but neurochemically. If given the chance, laboratory animals will dose themselves with cocaine until they die of heart failure.

Cocaine has both a pain-killing effect (because it blocks the transmission of pain impulses from the nerves to the brain) and a "high" (because it stimulates and energizes people to greater alertness, intensifying their mood).

Cocaine is also known as Bump, Coke, Snow, Toot, Lady, Flake, "C," Candy, Charlie, Sherbet, Charles, Blow, Dust, Bernice, Dream, Nose Candy and Stardust. Crack is also known as Rocks, Wash and Freebase.

How Cocaine Is Used

Cocaine use ranges from occasional use to compulsive use, with a variety of patterns between these extremes. The major ways cocaine can be used are:

  • Sniffing or snorting (cocaine powder is inhaled through the nostrils and absorbed into the bloodstream through the nasal tissues)
  • Injecting (after being dissolved in water)
  • Smoking (including freebase and crack cocaine)

Cocaine that can be smoked or injected looks like white powder. It is mixed (or cut) with other chemicals anywhere from one to eight times, thereby producing a drug of unknown strength, adding to the risk of overdose. These chemicals mixers may include fillers such as talcum powder, which are added to make it go further and boost profits for the drug dealers. Freebase cocaine (crack) -- processed differently so it can be smoked -- is an extremely addictive form of cocaine sold in the form of tablets and pellet-sized chips (called "rocks").

Cocaine's Health and Psychological Effects

Any way cocaine is used, there is a great health risk to the user. It appears that compulsive use may develop even more rapidly if the substance is smoked rather than snorted. Smoking allows extremely high doses of cocaine to reach the brain within 10 seconds and brings an intense and immediate high.

Cocaine's effects depend upon the strength of the dose, the blend of chemicals, the physiology of the user and the person's state of mind at the time of taking the drug. The cocaine rush only lasts for a short time, perhaps 15-30 minutes after inhalation. Generally, some of the immediate effects of cocaine are:

  • Short-lived pleasure, then depression and an intense craving for more cocaine
  • Feelings of euphoria, exhilaration, confidence and supremacy
  • Strong feelings of ecstasy, thus creating a craving for the drug
  • Aggressiveness
  • Taking more risks than usual
  • Being excited or upset
  • Increased body temperature
  • A burst of energy
  • Dilated pupils
  • Loss of appetite
  • The urge to have sex
  • Accelerated heart rate and constricted arteries, thus providing less oxygen to the heart than it needs for operation, which may cause a heart attack
  • Disruption of the brain's electrical messages to the heart, thus creating an inconsistent heartbeat that cannot be regulated, which may cause cardiac arrest
  • Increased blood pressure, which may cause the blood vessels in the brain to burst, causing a stroke
  • Overdose: drop in heart rate, slowed breathing and circulation, unconsciousness (the amount needed for an overdose is unknown and is different for everyone)

Cocaine Dependence

As with many other drugs, a user can build up a tolerance to cocaine, which means the user needs to take larger and larger doses to achieve the same high. Some users, however, may experience the opposite effect -- a sensitivity to cocaine -- where even tiny amounts are enough to prompt a rush. Over time, a user's body can come to depend on cocaine to function at its best.

Cocaine's Long-Term Health Effects

  • Severe depression
  • Permanent psychosis
  • Heart problems and cardiac arrest
  • Seizures
  • Aggressive and violent behavior
  • Paranoia
  • Anxiety disorders
  • Memory problems
  • Disturbing hallucinations
  • Nose and sinus disorders
  • Snorting cocaine can cause a stuffy or runny nose
  • Chronic snorting can cause a rupture of the membrane in the nose, causing bloody noses
  • Ulceration of the mucous membrane of the nose
  • Damage to the nasal septum -- enough to cause it to collapse
  • Injecting cocaine puts the user at risk of contracting AIDS, blood poisoning, bacterial infections, hepatitis, damaged blood vessels and skin abscesses, particularly when the injecting equipment is shared or not sterile

If you or someone you know is using cocaine or contemplating its use, call for help.