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Cocaine is an intoxicating alkaloid chemical derived from the coca plant. Learn about abuse and treatment options.
The drug is most commonly found as a white powder, although crack cocaine comes as brownish-white rocks that are melted down and injected or smoked. Powdered cocaine is typically snorted directly.
Cocaine is one of the most powerful stimulants found in nature, and it can lead to changes in the brain and body over time as it is abused.
Although cocaine is considered by many to be an addictive substance of abuse, it is actually a Schedule II medication, according to the Drug Enforcement Administration (DEA). Other drugs that fall into Schedule II include oxycodone and hydrocodone, two powerful and addictive narcotic painkillers. Cocaine has some limited medical use, although it also has a high potential for abuse and addiction. In medical settings, it is used to reduce bleeding from the mucous membranes in the throat, nose, and mouth; it is also used as a topical anesthetic for the upper respiratory tract when mixed in an appropriate, low-dose solution.
Most people are familiar with cocaine as a street drug, both as a white powder and as crack cocaine rocks. Cocaine is typically cut with other substances, such as other drugs and substances like cornstarch and talcum powder. It is sometimes abused in combination with other intoxicating substances like alcohol or heroin.
Reports suggest about 14 percent of adults in the United States have tried cocaine, and one in 40 of those people used cocaine at least once in the last year.
The people most at risk of developing an addiction to cocaine are young men, between the ages of 18 and 25.
In 2014, about 1.4 percent of young adults, regardless of gender, reported at least one instance of cocaine abuse in the past month, according to the National Institute on Drug Abuse (NIDA).
Among most other groups, cocaine abuse rates are declining. For example, among 8th, 10th, and 12th graders surveyed for past 30-day cocaine use between 2002 and 2015, rates of abuse steeply declined. Peak abuse of cocaine among this age group occurred in the 1990s.
Cocaine affects the brain by stimulating areas of the mesolimbic dopamine system, which is the reward center of the brain. By preventing the removal of dopamine, cocaine produces amplified signals in the brain, leading to euphoria, elevated mood, and increased energy. However, when dopamine is not removed from the brain, it can also create other mood changes and hallucinations.
The stimulant drug’s effects begin within 15-20 minutes of the first dose when snorted and typically disappear within a few hours. When smoked or injected in the form of crack cocaine, the effects begin as quickly as five minutes after the first dose but wear off within the hour. However, because the brain releases dopamine, which elevates mood, when cocaine is ingested, the system is likely to create a feedback system that leads the person to take another dose as soon as the primary effects wear off. This can quickly lead to abuse, addiction, or overdose. Initial effects of cocaine include:
Physical side effects of cocaine abuse include:
Risks specifically related to smoking cocaine include:
Long-term abuse of cocaine in any form can lead to tolerance, meaning the body is used to a specific dose and needs more to get the original effects, and dependence, as the body requires the drug to release neurotransmitters like dopamine. Although these effects are not the same thing as addiction, the sensations can reinforce addiction, including cravings and drug-seeking behavior.
When a person uses cocaine for a long time, the drug can change brain and body systems. Some of these long-term side effects and risks affect specific organs.
Cocaine withdrawal is typically not dangerous, but it can be very uncomfortable. Many people who experience withdrawal without medical help and social support can relapse due to intense cravings. Symptoms of cocaine withdrawal include:
Withdrawal from cocaine is rarely dangerous, although suicidal thoughts should be monitored closely by therapists and physicians. Continued abuse of cocaine causes many serious, long-lasting effects that can dramatically shorten life, if it doesn’t lead to overdose and death. As a result, it is important to get help to safely overcome cocaine addiction as soon as possible.
When a person ingests too much cocaine, they experience cocaine overdose, also sometimes called acute cocaine toxicity. Medical professionals report three phases of this condition. It is important to call 911 immediately for a person in any of these stages. There are no drugs that can reverse a cocaine overdose, so the only way to improve a person’s chances of survival is to get immediate medical attention.
The first phase of cocaine toxicity includes:
Many of these symptoms are very similar or slightly more extreme versions of the cocaine high. However, in the second phase of cocaine toxicity, symptoms change to:
The third phase is the most extreme, and it can quickly lead to death. Symptoms include:
A combination of detox, medications, long-term psychotherapy, and social support is the typical treatment when a person works to overcome cocaine addiction. In order to enter some rehabilitation programs, the individual is required to successfully detox from the drug; some rehabilitation programs offer in-house detox programs. Once the individual has detoxed, they should continue into a comprehensive rehabilitation program so they can begin the bulk of addiction treatment.
There are no specific medications used to treat cocaine withdrawal or to help overcome the addiction. Some medications may be prescribed on an off-label basis, such as:
A supervising physician or psychiatrist may also prescribe mood-stabilizing medications, including anti-anxiety or antidepressant drugs. These can help ease psychological tension as the individual enters therapy, and in some instances, they can also help overcome cravings for the drug.
The most common forms of therapy to help a person overcome cocaine addiction include:
There are several inpatient and outpatient rehabilitation programs that offer significant help for people overcoming cocaine addiction. These programs typically offer therapy for individuals, groups, and families, as well as other forms of support. Some rehabilitation programs offer job and life skills training, while others include offerings of alternative or complementary therapies.
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