Cocaine Use, Abuse, and Addiction

Cocaine (coke) is a purified extract from the leaves of the Erythroxylum coca bush. This plant grows in the Andes region of South America. Different chemical processes produce the two main forms of cocaine: powder and crack (rock).

• What is it?
• How is it used?
• What are the effects?
• What are the risks?
• Cocaine in the Brain
• Cocaine Addiction
• Cocaine Treatment

Cocaine – What is it?

• Cocaine Hydrochloride (“coke,” “blow”) is a white powder derived from the leaves of the coca plant, which grows mainly in South America.
• Coca Cola used to contain cocaine (hence the name), and so did many other over-the-counter food and medicine products.
• Cocaine is usually sold is small baggies by the gram.
• Powdered cocaine — commonly known on the street as “coke” or “blow” –dissolves in water. Users can snort or inject powdered cocaine.
• Crack cocaine is made by chemically altering cocaine powder into crystals or “rocks” (its “freebase” form) which are smokable.

Cocaine – How is it used?

• The leaves of the coca plant can be chewed or made into a tea and drunk. Coca leaves are used this way legally in many countries as a mild stimulant similar to caffeine.
• Most often cocaine is snorted in small lines. The effects come on gradually and peak after about 15-30 minutes.
• When smoked in the form of “crack,” the effects come on immediately but wear off much more quickly.
• When injected, the effects are felt immediately and much more intensely.

Cocaine – What are the effects?

• Cocaine is a stimulant drug like meth, but much shorter acting.
• It causes a sudden increase in heart rate, blood pressure and breathing.
• It also leads to feelings of confidence, alertness and euphoria.

Cocaine – Risks

• Cocaine and crack are very short-acting. This can lead to using too much or too often.
• Many users become compulsive in their use of cocaine, which can lead to physical or psychological addiction.
• The after-effects can include depression, agitation, anxiety and paranoia.
• The intensity of these effects depend on how much and how often cocaine is used, and are more intense when cocaine is smoked as crack.
• High or frequent doses have caused seizures, strokes or heart attacks in some people.
• Repeated snorting can damage the membranes of the nose.
• Cocaine is illegal and getting caught with it in your possession can result in long prison sentences. Giving cocaine to someone else, even if no money was exchanged, can result in even longer sentences.
• Since 2007 much of the cocaine sold in the US has been cut with a substance called levamisole which can cause a shutdown in immune system response with frequent use.

Cocaine in the Brain

Cocaine acts by preventing the dopamine from being recycled, causing excessive amounts of dopamine to build up, amplifying the message, and ultimately disrupting normal communication. It is this excess of dopamine that is responsible for cocaine’s euphoric effects.

Cocaine Addiction

With repeated use, cocaine can cause long-term changes in the brain’s reward system and in other brain systems as well, which may eventually lead to addiction. With repeated use, tolerance to the cocaine high also often develops.

Many cocaine abusers report that they seek but fail to achieve as much pleasure as they did from their first exposure. Some users will increase their dose in an attempt to intensify and prolong the euphoria, but this can also increase the risk of adverse psychological or physiological effects.

As with all forms of addiction, context determines in large part whether a person deserves a label of cocaine addiction vs a less severe diagnosis such as cocaine abuse. Someone with an addiction has had numerous relationship, job, physical health, financial, and sometimes legal problems which can be largely attributed to the cocaine use.

Cocaine Treatment

Cocaine abuse and addiction is a complex problem involving biological changes in the brain, as well as a myriad of social, familial and environmental factors. Treatment of cocaine addiction, therefore, is complex and must address a variety of problems.

Many therapists shy away from these complexities and often they will revert to a conservative and traditional cocaine addiction paradigm which involves getting the client to commit to abstinence to address that addiction prior to addressing any coexisting social and emotional issues.

We believe that paradigm is not a fit for everyone and our certified alcohol and drug counselors tackle the complexity in a creative and collaborative fashion to formulate a plan that best meets the needs of the client and serves to enhance overall quality of life.