Cocaine is a stimulant that’s classified as a Schedule II narcotic by the Drug Enforcement Agency. Schedule II drugs are “defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.”2 Derived from the leaves of the coca plant, cocaine is snorted, smoked, or injected.
Cocaine is typically either sold in a white powder form or produced as crystals/rocks (known as crack). Cocaine is also known as blow, coke, rock, and/or snow.
Cocaine works to enhance the activity of the body’s central nervous system. There are many reasons why people use cocaine. Many users report that they feel an enhanced sense of self-esteem, higher levels of both mental and physical performance, and higher productivity levels.
Some people find that the enhanced sense of self-esteem they feel when using cocaine makes it easier to enjoy themselves in social situations. Over time, people may feel that they aren’t able to have fun when they’re out with friends or in other social situations unless they use cocaine.
The effects of cocaine set in nearly instantly after the drug is ingested. Effects can include a sense of euphoria, happiness, and pleasure, increased mental alertness, extreme energy, increased desire to talk and socialize, and dilated pupils.
In addition to using cocaine to experience a greater sense of comfort and extroversion in social settings, some people also use cocaine to increase their productivity. Cocaine use is sometimes used by people who need to stay awake for long periods at work, especially if they operate heavy machinery or work in situations where staying alert is a safety issue.3
People who become addicted to cocaine may find that they’re struggling to keep up with the level of productivity that they achieve when they’re high. They may feel that they need to be high to meet the expectations they’ve set for themselves socially or at work, and it can be hard to admit to themselves and others that things have spiraled out of control.
In addition to the effects associated with the high of cocaine use, there are many unpleasant side effects.
While these differ from person to person, side effects may include physical effects such as tremors, muscle twitches, raised blood pressure, raised body temperature, nausea, fast/irregular heartbeat, decreased appetite, and/or constricted blood vessels.
Psychological and emotional side effects may include restlessness, irritability, paranoia, sensitivity to light, sound, and touch, extended wakefulness, and/or aggressive behavior.
Both the high and the short-term side effects of cocaine use pass quickly and can lead the user to use many times over a short period. Users may get high, then use repeatedly within a span of just a few hours.
A single dose of cocaine produces a high that lasts for an hour or less – sometimes, the high can be as short as a few minutes. Many people who use cocaine take their next dose the moment they feel their previous high beginning to fade. This behavior can continue for several hours or even days. Using repeatedly for a period of time can result in a crash, during which the user feels depressed, anxious, and fatigued.
When the body and brain are coming down from several hours or several days of a cocaine binge, the body is not only exhausted from processing cocaine – it’s also exhausted from the lack of sleep experienced during cocaine use. Basic levels of functioning may feel nearly impossible as the body recovers and works to get back to normal during a crash.
There are many different ways that people use cocaine. Some people inhale cocaine through the nose. The drug can also be taken orally, either by rubbing cocaine in powder form on the gums or by swallowing it. When the drug is crystallized into crack, or when cocaine is in freebase form, it can be smoked. Lastly, cocaine can be dissolved in water, heated, and then injected into a vein. Injecting cocaine and smoking crack are the fastest ways to create an intense high.4
Cocaine changes the way the brain handles dopamine, a feel-good chemical. When cocaine is ingested, it stops the brain from getting rid of dopamine. Normally, when the brain gets a surge of dopamine (from activities like eating, having sex, listening to music, sleeping, etc.) it’s quickly processed. The good feeling associated with the positive action doesn’t last for long. Cocaine makes the feeling produced by dopamine last for a much longer time.
Dopamine plays a role in emotions, motivation, and rewards. Long-term use of cocaine can cause changes in the brain that interfere with how dopamine is processed.5 This means that it can be difficult for people who have used cocaine for a long time to experience positive emotions on their own.
Many cocaine dealers mix their cocaine supply with other drugs or substances in an attempt to maximize profit. This can create a dangerous situation for users for several reasons. Sometimes, users are accustomed to a dose of cocaine that’s been mixed with a non-drug substance, like baking soda. This can result in the user being unaware of the amount of cocaine they’re using. If they use their typical amount of cocaine and the substance happens to have a higher cocaine concentration than usual, they could easily overdose.
Another issue with mixing other substances with cocaine is that dealers may mix other drugs with cocaine to increase the substance’s effect. Fentanyl, an opioid far more powerful than morphine, is often mixed with cocaine. Even a small amount of fentanyl can cause an overdose.6
In addition to the risk of ingesting unknown substances, cocaine use carries several health risks on its own, including impaired cognitive function that can impact decision making and ability to perform motor tasks, hyperthermia (high body temperature), stroke, seizure, acute coronary syndrome, and/or severe high blood pressure.
People who smoke crack may experience a condition known as “crack lung.” Symptoms include labored breathing, coughing up blood, fever, and respiratory failure. People who snort cocaine regularly may experience damage to the nasal cavity, chronic runny nose and sinus issues, and loss of their sense of smell.
Injecting cocaine is incredibly dangerous, due to the combination of an increased risk of overdose and the risks associated with intravenous drug use. People who use intravenous drugs are at high risk for skin infections, abscesses, HIV, hepatitis, and endocardidits.7
There are several ways to treat cocaine addiction. Most people begin with detox. This can be a tough process, and it’s important to work with a treatment team. There are currently no medications that are approved to help with cocaine detox, but therapy and comfort medications can be given to help make the process more comfortable.
Forms of treatment for cocaine addiction may include:
Your doctor and/or your treatment team will talk with you about the level of treatment that makes the most sense for your needs. There are many factors to consider, such as whether you need dual diagnosis (mental health) treatment in addition to treatment for cocaine addiction, whether you’re able to attend a residential program, and more.
Levels of treatment for cocaine addiction may include:
Sources:
1National Institute on Drug Abuse. Cocaine Trends & Statistics.
2Drug Enforcement Agency. Drug Scheduling.
3Dini, G., Bragazzi, N.L., Montecucco, A., Rahmani, A., Durando, P. (2019). Psychoactive drug consumption among truck-drivers: a systematic review of the literature with meta-analysis and meta-regression. Journal of Preventive Medicine and Hygiene, 60(2).
4National Institute on Drug Abuse. How is cocaine used?
5Wise, R., Robble, M. Dopamine and Addiction. (2020). Annual Review of Psychology, 79-106.
6Rubin, Rita, American Medical Association. (2017). Illicit Fentanyl Driving Opioid Overdose Deaths.
7Semel Institute for Neuroscience and Behavior. Potential Complications of IV Drug Use.
8Mayo Clinic. Drug addiction (substance use disorder).
9Substance Abuse and Mental Health Services Administration. Treatment of stimulant use disorders.