Key takeaways:

  • Cocaine is derived from coca leaves, most commonly grown in Central and South America. The leaves are chemically treated and processed to be turned into the powdered white substance sold as cocaine
  • Cocaine abuse provides euphoria to occur by affecting the central nervous system and producing high levels of dopamine. The intensity and speed of cocaine's effect on the mind depend on the way in which it is taken
  • Risk factors do not guarantee a person will become an addict to drugs such as cocaine, but their presence statistically increases the likelihood. For powdered cocaine, there are a variety of risk factors that determine how likely a person is to become addicted

Cocaine‌ ‌is‌ ‌a‌ ‌highly‌ ‌addictive‌ ‌illegal‌ ‌substance‌ ‌that‌ ‌falls‌ ‌under‌ ‌the‌ ‌stimulant‌ ‌category.‌ ‌Untreated,‌ ‌cocaine‌ ‌addiction‌ ‌can‌ ‌lead‌ ‌to‌ ‌serious‌ ‌and‌ ‌lasting‌ ‌effects,‌ ‌and‌ ‌can‌ ‌even‌ ‌lead‌ ‌to‌ ‌fatal‌ ‌overdose.‌

Understanding cocaine

Cocaine, most commonly found as a white powder substance, is a stimulant that affects the central nervous system (CNS) causing feelings of euphoria as well as increased energy. Ingestion of cocaine is most commonly done by snorting, but it can also be smoked (usually as crack cocaine) or dissolved in water and taken intravenously. Cocaine is widely abused in the US and other nations and is highly addictive in nature.[1, 2]

Cocaine origins

Cocaine is derived from coca leaves, most commonly grown in Central and South America. The leaves are chemically treated and processed to be turned into the powdered white substance sold as cocaine.[1, 2] Almost 90 percent of the cocaine that comes into America is produced in Colombia, and almost all of it is smuggled across the Mexican border by members of dangerous drug cartels. 

Cocaine is rarely pure and is often cut to increase profits. Sometimes, it is cut with dangerous drugs or chemicals that can be toxic for the brain and body and can even lead to accidental poisoning or overdose.[2]

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Effects of cocaine abuse

Cocaine affects the central nervous system by stimulating high levels of dopamine, a neural chemical associated with pleasure and reward. Prolonged use of cocaine has a negative effect on the entire body and the potential for severe adverse side-effects is high if taken for long enough. It can cause permanent changes to the brain and also has the potential to damage vital organs and an increased risk of heart problems and stroke.[2]

Short-term effects of cocaine use

Cocaine abuse provides euphoria to occur by affecting the central nervous system and producing high levels of dopamine. The intensity and speed of cocaine's effect on the mind depend on the way in which it is taken. Smoking or intravenous injection causes cocaine to reach the brain in a matter of seconds, with a rapid build-up in intensity. This causes the ‘rush’, the rapid onset of euphoric sensations. 

The duration of the rush from cocaine also differs depending on the intake method, with snorting normally lasting a total of 30 minutes and smoking or intravenous injection only 10 minutes. This short duration of effect is what commonly drives the user to take cocaine frequently and can lead to overdose (more so when injecting than snorting). 

Short term adverse effects of cocaine use include:[1, 2, 4]

  • Restlessness, agitation, and irritability

  • Loss of appetite and weight loss

  • Insomnia or trouble sleeping

  • Twitching and muscle spasms

  • Irregular or fast heart rate and increased BP

  • Paranoia or heightened anxiety

  • Feeling alert, happy, or euphoric

  • Increased impulsivity and risky decisions

  • Extreme alertness and hypersensitivity to touch, light, and sound

  • Extreme overconfidence or inflated sense of ego

  • Raised body temperature

  • Nausea or G.I. upset

  • Dilated pupils

Long-term effects of cocaine use

The brain develops a tolerance to cocaine quickly, meaning people who abuse cocaine regularly will require more for it to take effect. Using more cocaine to overcome tolerance increases the risk of becoming addicted to the drug. 

Once a cocaine addiction forms, it is difficult for a person to stop using on their own, especially without treatment. Once addicted, people tend to experience negative effects on their physical and mental health, as well as at work, in relationships, and other important areas of life.[5]

Long-term psychological effects of cocaine use

Long-term use of cocaine can cause paranoia, irritability, insomnia, mood swings, and other mental health problems.[2] The crash or come down from cocaine is usually experienced as physical and mental exhaustion, intermittent sleep, and depression often lasting a few days or a week.[6]

After they come down, users often experience cravings to use the drug, making it difficult to quit, especially once a dependence has formed. Many people also experience trouble focusing and concentrating and difficulty thinking clearly when withdrawing from cocaine. Some users will experience these symptoms for a few days to a week, while others may find their symptoms linger for months or even longer after stopping.[6]   

Long-term physical effects of cocaine use

The long-term consequences to the body caused by prolonged cocaine use are more severe, including:[1, 2, 4]

  • Heart problems, irregular heart rate, and increased risk of stroke and heart attack

  • Coughing, asthma, pneumonia, lung conditions (for people who smoke crack)

  • Nosebleeds, running nose, and problems swallowing (for people who snort cocaine)

  • Increased risk of infections like HIV and Hepatitis (especially for those who inject)

  • Bowel decay or G.I. problems (for oral users)

  • Increased risk for addiction and overdose (especially for heavy users or poly-drug users)

Addiction to cocaine

Cocaine is highly addictive and it is not always apparent when an addiction has formed. Ignoring the come down that occurs after cocaine usage and then craving it again are strong indicators of addiction. Once addicted to cocaine, it is very difficult to stop taking it. This is because the increased levels of dopamine caused by taking cocaine can permanently change the reward system in the brain.

This is classed as a psychological addiction and is very hard to overcome, though the physical symptoms of cocaine addiction are undeniably challenging as well. Frequent cocaine use will very easily become a dependency, meaning the user will require cocaine in order to feel a sense of normality. As the effects of cocaine are short-lived, it is not always easy to spot the warning signs of addiction and abuse. 

Cocaine use disorder (the clinical name for cocaine addiction) can only be diagnosed by a licensed health, mental health, or addiction specialist during a formal assessment. Cocaine use disorder will often be diagnosed if a person displays two or more of the following criteria:[5]

  • Hazardous cocaine use

  • Social or interpersonal problems related to cocaine use

  • Neglected major responsibilities to use cocaine

  • Experiencing cocaine withdrawal symptoms

  • Developing a tolerance

  • Using larger amounts

  • Repeated attempts to quit or control cocaine use

  • Excessive time spent using cocaine

  • Physical or psychological problems related to cocaine use

  • Activities replaced by cocaine use

  • Cocaine craving

Factors that influence cocaine addiction

Risk factors do not guarantee a person will become an addict to drugs such as cocaine, but their presence statistically increases the likelihood. For powdered cocaine, there are a variety of risk factors that determine how likely a person is to become addicted. These include:

  • Environmental risk factors like community crime and unemployment

  • Social risk factors such as cocaine exposure from friends or partners

  • Minority status risk factors like discrimination and generational assimilation

  • Family risk factors like parental cocaine abuse and parental neglect

  • Constitutional risk factors like physical or learning disabilities

  • Behavioral risk factors like low self-esteem and delinquency

Common questions about cocaine

What are common street names for cocaine? 

Some of the most common terms used for cocaine are coke, blow, snow, nose candy, or powder. Sometimes, cocaine is mixed with other drugs like heroin (called speedballing) or other chemicals to make methamphetamines.

What does cocaine look like?

Cocaine is normally sold as a crystalline powder that is white or off-white in color and odorless. Crack cocaine comes in the form of small chunks, often referred to as rocks, that have an off whitish color and are normally smoked.

Are crack and cocaine the same thing?

Crack and cocaine are chemically identical but are processed differently to result in either a snortable powder or in hard smokable rocks called crack. According to the Manual of Substance Abuse Treatment, Crack is the most potent and addictive form of cocaine. The high is fast and intense, and due to the low cost can be highly addictive. 

Is cocaine pure?

No. In most cases, cocaine is diluted, or cut, with different substances such as anesthetics, laundry detergent, caffeine, and boric acid. The reason it is cut is to stretch the amount of product sold by dealers while still offering a high to the buyer. 

Is it safe to use cocaine with alcohol?

Cocaine and alcohol consumed together produce a metabolite reaction known as cocaethylene. Cocaethylene has a toxic effect on the heart and liver, increasing the risk of strokes and heart attacks. Combining cocaine and alcohol is highly dangerous and often increases the risk of physical and psychological damage, as well as heightening the risk for addiction.

What happens when you mix cocaine and heroin?

Mixing cocaine and heroin is often referred to as speedballing, as the former is a CNS stimulant and the latter an opioid depressant. Cocaine causes the body to use more oxygen and heroin slows breathing, starving the brain and body. This can lead to aneurysm, stroke, loss of motor skills, and fatal respiratory failure.  

Is it safe to use cocaine with any other drug?

Combining substances, or poly-drug use is highly common with cocaine abusers and is extremely dangerous as it increases the chance of overdose. Often, these drugs have dangerous interactions when combined, leading to more serious health and mental health effects.

What is fentanyl and is it dangerous?

Fentanyl is a synthetic opioid pain reliever that is 50 times more potent than heroin and 100 times more than morphine, according to the Centers for Disease Control and Prevention. If cocaine is contaminated with fentanyl it can cause permanent brain damage, cardiac arrest, and even death. Fentanyl contamination is becoming more common, and there is no way for the average user to determine if their cocaine is contaminated.

Is cocaine illegal?

Yes. Cocaine is a Schedule II drug under the Controlled Substances Act, meaning it has a high potential for abuse and has an accepted medical use for treatment in the United States. Possessing even small amounts of cocaine is illegal and can lead to prosecution and even jail time.[7]

Treating a cocaine addiction

Like any drug addiction, cocaine addiction can be hard to overcome, especially alone. Though some people are able to stop and conquer cocaine addiction on their own, most will require rehab or a cocaine detox treatment program. Cocaine addiction treatment greatly increases the likelihood of overcoming an addiction to cocaine, and a number of options may be available to you, some at little or no cost. Reaching out to an addiction treatment center or licensed addiction specialist is the best way to determine your options for cocaine treatment and help you determine which is right for you.