During its production, various toxic chemicals are used to extract coca alkaloids from the coca leaves. In countries where cocaine is illicitly produced, an intermediate product known as cocaine paste—often referred to as “poor man’s cocaine”—is frequently smoked in impoverished communities. The U.S. is the world’s largest consumer of cocaine, while South America, as a continent, ranks third in terms of consumer market size. Concurrently, record levels of cocaine production have enabled traffickers to enter new markets across Asia and Africa, reflecting the expanding global reach of cocaine trafficking.
Long-term cocaine use dulls thinking processes and the ability to remember information. Over time, cocaine use may change other brain functions. The 2021 (U.S.) National Survey on Drug Use and Health (NSDUH) concludes 4.8 million people age 12 and older used cocaine in 2020. People use crack cocaine by heating it in a glass pipe or adding it to marijuana or tobacco. More commonly, people use cocaine to boost feelings like being energized, happy and alert.
Cocaine
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In 2024, a systematic review of human studies concluded that, despite some inconsistencies in the findings, the co-use of cocaine and alcohol poses a significantly greater risk of cardiovascular fatalities compared to cocaine use alone. Alcohol interacts with cocaine in vivo to produce cocaethylene, another psychoactive substance which may be substantially more cardiotoxic than either cocaine or alcohol by themselves. In 2024, drug-related deaths in England and Wales reached their highest level in three decades, with a notable increase in fatalities involving cocaine and experts urging urgent government intervention to address the crisis.
The 2021 survey found no differences in rates of cocaine use among different ethnic and racial groups in the U.S. A cocaine binge is when someone uses cocaine repeatedly in higher and higher doses. It’s absorbed through the tissues in your nasal passages and moves into your bloodstream.
Cocaine Effects
Concurrent use with alcohol produces cocaethylene, a metabolite that significantly increases the risk of sudden death. Assessment tools like the Obsessive Compulsive Cocaine Use Scale (OCCUS) may be employed to quantify obsessive and compulsive thoughts related to cocaine consumption. Additionally, stimulants like cocaine, methamphetamine, and even caffeine cause dehydration and dry mouth. A 2018 review found little evidence that chronic cocaine use causes widespread cognitive impairment. These findings suggest that some cocaine-related cognitive deficits are reversible, especially if use begins later in life. Cocaine constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure.
How Cocaine Is Made and Its Dangers
- Swabbing can reveal traces of cocaine or other illicit substances, providing evidence of recent drug handling or use.
- This irritation leads to symptoms such as a runny nose, nasal congestion, and excessive or thickened mucus.
- The drug disulfiram, which is used to treat alcoholism, has shown some promise for cocaine addiction.
- If you use a lot of cocaine, or the batch you use is stronger than you expect, you could overdose.
- Concurrent use with alcohol produces cocaethylene, a metabolite that significantly increases the risk of sudden death.
- Her clinical experience has included inpatient and outpatient treatment, and severe mental illness in residential and community settings.
Cocaine is known to suppress hunger and appetite by increasing co-localization of sigma σ1R receptors and ghrelin GHS-R1a cell surface receptors, thereby increasing ghrelin-mediated signaling of satiety and possibly via other effects on appetitive hormones. Further specific receptors it has been demonstrated to function on are NMDA and the D1 dopamine receptor. Cocaine has been demonstrated to bind as to directly stabilize the DAT transporter on the open outward-facing conformation. Cocaine and its major metabolites may be quantified in blood, plasma, or urine to monitor for use, confirm a diagnosis of poisoning, or assist in the forensic investigation of a traffic or other criminal violation or sudden death. Cocaine overdose may result in hyperthermia as stimulation and increased muscular activity cause greater heat production. When nasal damage is too severe for reconstruction, a nose prosthesis may be used to restore appearance and quality of life.
Cognitive-behavioral therapy (CBT)
The most important part of any treatment plan is to give up the drug right away. Seek treatment to reduce these risks. Using cocaine during pregnancy can cause problems for both the parent and the developing baby.
Coca leaves have been used by indigenous South Americans for thousands of years, both as a stimulant and for medicinal purposes. The CCDB challenges optimistic views of drug interdiction effectiveness and underscores the need for new policy approaches, yet remains underutilized in research despite being unclassified. Because the glyphosate is sprayed from the air, there is a much higher chance of human error when spraying suspected illegal coca plantations. There is increasing support for shifting toward drug policies that focus on sustainable development and human rights instead of punitive measures. Drug war policies in Latin America and the Caribbean have led to more violence, higher incarceration rates, health crises, and deeper poverty, while undermining trust in institutions and worsening inequality. Farmers are able to use unregulated and highly toxic pesticides due to the clandestine nature of drug production.
Cocaine FAQs
For example, those who identify as LGBTQ are more than twice as likely to use illicit drugs as heterosexual people. In a 2021 national survey, about 4.8 million people in the U.S. ages 12 or older said they had used cocaine in the past year. That’s one reason crack cocaine became popular in the Cocaine and Alcohol Mix 1980s. To make crack, you cook cocaine powder with baking soda. A German chemist named Albert Neiman first isolated the drug from coca leaves in 1860. Research indicates that people who are committed to abstinence, engage in self-help behaviors, and believe that they have the ability to refrain from using cocaine (self-efficacy) are more likely to abstain.
How can I help someone who is addicted to cocaine?
This substance is favored in these areas primarily because it is inexpensive and more accessible than refined cocaine. In the National Survey on Drug Use and Health, white respondents reported a higher rate of powdered cocaine use, and Black respondents reported a higher rate of crack cocaine use. The Anti-Drug Abuse Act of 1986 mandated the same prison sentences for distributing 500 grams of powdered cocaine and just 5 grams of crack cocaine. In 1914, The New York Times published an article titled “Negro Cocaine ‘Fiends’ Are a New Southern Menace,” portraying Black people who used cocaine as dangerous and able to withstand wounds that would normally be fatal. In Peru, for example, legal coca cultivation is monopolized by the state company National Coca Company (ENACO), yet approximately 90% of coca leaves produced in the country are diverted to illegal actors for cocaine manufacturing. Approximate cocaine purity can be determined using 1 mL 2% cupric sulfate pentahydrate in dilute HCl, 1 mL 2% potassium thiocyanate and 2 mL of chloroform.
Need Help With Cocaine Addiction?
Some of the side effects of cocaine depend on how you take the drug. Sometimes, people use cocaine and an opioid drug, such as heroin, at the same time. Instead of using baking soda as you would with crack, you add ammonia to “free” the cocaine base from its natural form. Freebase cocaine is also a solid form of the drug.
Long-term effects
In other cultures the active alkaloid is chemically extracted from coca leaves and is converted into the hydrochloric salt of cocaine, cocaine hydrochloride. More importantly, cocaine when ingested in small amounts produces feelings of well-being and euphoria, along with a decreased appetite, relief from fatigue, and increased mental alertness. Read about the history of cocaine in the U.S., from its early use in medicine to the crack cocaine epidemic in the late 20th century.
- While domestic clandestine laboratories could theoretically reduce reliance on offshore production and international smuggling—as seen with illicit methamphetamine—manufacture and synthetic production of cocaine remains rare.
- Although the chemical synthesis of cocaine is technically feasible, it is generally considered impractical due to its high cost, low efficiency, and challenges in stereoselective synthesis compared to extraction from natural plant sources.
- This can lead to increased irritability, restlessness, panic attacks, paranoia, and even psychosis, in which the individual loses touch with reality and experiences auditory and visual hallucinations.2 With increasing doses or higher frequency of use, the risk of adverse psychological or physiological effects increases.2,3
- Due to the illegal nature of coca production, farmers make little effort in soil conservation and sustainability practices as seen in the high mobility and short life of coca plots in Colombia.
Impact of illicit cocaine
Globally, in 2019, cocaine was used by an estimated 20 million people (0.4% of adults aged 15 to 64 years). Cocaine acts pharmacologically as a serotonin–norepinephrine–dopamine reuptake inhibitor (SNDRI), producing reinforcing effects such as euphoria, increased alertness, concentration, libido, and reduced fatigue and appetite. Coca leaves are processed into cocaine paste, a crude mix of coca alkaloids from which cocaine base is isolated and converted to cocaine hydrochloride.
The rate and extent of absorption from inhalation of cocaine is similar or greater than with intravenous injection, as inhalation provides access directly to the capillary bed. The opioid epidemic now involves more overdose deaths with both opioids and cocaine, especially among non-Hispanic Blacks who are twice as likely to die from combined opioid-stimulant overdoses compared to non-Hispanic whites. The cause of “cocaine nose” can be traced to the chemical process that occurs when cocaine hydrochloride is insufflated (snorted). Numerous medications have been investigated for use in cocaine dependence, but as of 2015update, none of them were considered to be effective.
In 1989 Fulton County, 40% of homicide victims had cocaine metabolites, especially Black and firearm victims. A considerable proportion of cocaine addicts exhibit hypomanic personality traits that are ego-syntonic with their pattern of cocaine abuse. Cocaine is considered neurotoxic due to its damaging effects on the brain and nervous system.
