Cocaine
Maclay Rehabilitation Center
Cocaine

Cocaine is a powerfully addictive stimulant that directly affects the brain. Cocaine is
not a new drug. In fact, it is one of the oldest known drugs. The pure chemical,
cocaine hydrochloride, has been an abused substance for more than 100 years, and
coca leaves, the source of cocaine, have been ingested for thousands of years. Pure
cocaine was first extracted from the leaf of the Erythroxylon coca bush, which grows
primarily in Peru and Bolivia, in the mid-19th century. In the early 1900s, it became
the main stimulant drug used in most of the tonics/elixirs that were developed to treat
a wide variety of illnesses. Cocaine abuse has a long history and is rooted into the
drug culture in the U.S. It is an intense euphoric drug with strong addictive potential.
With the increase in purity, the advent of the free-base form of the cocaine ("crack"),
and its easy availability on the street, cocaine continues to burden both the law
enforcement and health care systems in America. The powdered, hydrochloride salt
form of cocaine can be snorted or dissolved in water and injected. Crack is cocaine
that has not been neutralized by an acid to make the hydrochloride salt. This form of
cocaine comes in a rock crystal that can be heated and its vapors smoked. The term
“crack” refers to the crackling sound heard when it is heated.

Short-Term Effects

Cocaine’s effects appear almost immediately after a single dose, and disappear
within a few minutes or hours. Taken in small amounts (up to 100 mg), cocaine
usually makes the user feel euphoric, energetic, talkative, and mentally alert,
especially to the sensations of sight, sound, and touch. It can also temporarily
decrease the need for food and sleep. Some users find that the drug helps them
perform simple physical and intellectual tasks more quickly, while others experience
the opposite effect.

The duration of cocaine’s immediate euphoric effects depends upon the route of
administration. The faster the absorption, the more intense the high. Also, the faster
the absorption, the shorter the duration of action. The high from snorting is relatively
slow in onset, and may last 15 to 30 minutes, while that from smoking may last 5 to
10 minutes.

The short-term physiological effects of cocaine include constricted blood vessels;
dilated pupils; and increased temperature, heart rate, and blood pressure. Large
amounts (several hundred milligrams or more) intensify the user’s high, but may
also lead to bizarre, erratic, and violent behavior. These users may experience
tremors, vertigo, muscle twitches, paranoia, or, with repeated doses, a toxic reaction
closely resembling amphetamine poisoning. Some users of cocaine report feelings
of restlessness, irritability, and anxiety. In rare instances, sudden death can occur on
the first use of cocaine or unexpectedly thereafter. Cocaine-related deaths are often a
result of cardiac arrest or seizures followed by respiratory arrest

Long-Term Effects

Cocaine is a powerfully addictive drug. Thus, an individual may have difficulty
predicting or controlling the extent to which he or she will continue to want or use the
drug. Cocaine’s stimulant and addictive effects are thought to be primarily a result of
its ability to inhibit the reabsorption of dopamine by nerve cells. Dopamine is
released as part of the brain’s reward system, and is either directly or indirectly
involved in the addictive properties of every major drug of abuse.

An appreciable tolerance to cocaine’s high may develop, with many addicts reporting
that they seek but fail to achieve as much pleasure as they did from their first
experience. Some users will frequently increase their doses to intensify and prolong
the euphoric effects. While tolerance to the high can occur, users can also become
more sensitive (sensitization) to cocaine’s anesthetic and convulsant effects, without
increasing the dose taken. This increased sensitivity may explain some deaths
occurring after apparently low doses of cocaine.

Use of cocaine in a binge, during which the drug is taken repeatedly and at
increasingly high doses, leads to a state of increasing irritability, restlessness, and
paranoia. This may result in a full-blown paranoid psychosis, in which the individual
loses touch with reality and experiences auditory hallucinations.

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