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Substance Use: Cocaine/Crack

Cocaine 101

  • Derived from the leaves of the coca plant, cocaine functions as a highly potent central nervous system stimulant known mainly for its energizing, appetite-decreasing, and euphoria-inducing capabilities.

    Cocaine is able to block the re-absorption of dopamine, norepinephrine, and serotonin within the brain. This causes a temporary influx of the chemicals, producing the euphoria that is felt. Initially, cocaine stimulates hyperactivity, increased blood pressure, increased heart rate, and elation in a user. Sexual arousal may also be heightened. A user may be jittery, paranoid, or impotent, and with extremely large doses, a person may hallucinate, become delusional, or experience tachycardia (rapid heart rate), which may be fatal if it causes a tachyarrhythmia (usually a symptom of overdose). In fact, the risk of a heart attack is nearly seven times greater for a chronic user than a non-user. Cocaine highs usually wear off in anywhere from 20 minutes to several hours. Since normal levels of dopamine and serotonin are depleted during the high, most users will feel depressed. A chronic user may feel withdrawal symptoms such as fatigue, insomnia, increased appetite, anxiety, agitation, and depression. The summation of these withdrawal symptoms and the particularly depressing effects of a comedown may lead to a user becoming mentally addicted and tolerant over time.

  • South American indigenous peoples claimed that chewing on the leaves of the coca plant resulting in increased energy and strength. When the Spaniards came to the Americas, they eventually adopted the practice, legalizing and taxing the leaf for the Roman Catholic Church. In 1855, the cocaine alkaloid was isolated from the coca plant. The purification process was improved over time, and eventually it became known for its analgesic properties. It was also used medically as a treatment for morphine addiction and was distributed as an over-the-counter drug in many forms. Eventually, people began to abuse cocaine, which led to an end in its legality through the Harrison Narcotics Tax Act. Cocaine later became a wildly popular recreational drug in the U.S., and with the development of "crack," the drug branched out to a poorer market furthering the epidemic.

  • Cocaine hydrocholoride, in its purest form, exists as a white crystalline powder with a pearl-like appearance. However, on the street, cocaine is usually cut with various other substances such as baking soda, sugar, local anesthetics, ephedrine, strong toxins, or other drugs like meth giving the drug a pinkish or off-white coloring of different textural appearance.

    Crack cocaine is a form of cocaine base. Its preparation involves dissolving cocaine in sodium bicarbonate and water. The solvents are then boiled away leaving the solid "crack" behind. Crack cocaine’s appearance is much more variable due to impurities and preparation; however, it will normally be a brown-ish crumbly or hard crystalline substance.

    Cocaine sulfate, which may be smoked along with tobacco, is an intermediary step in the production of cocaine hydrochloride. Freebase is the base form of cocaine. It is not suitable for snorting, injecting, or drinking as it does not dissolve in water. Freebase is therefore generally smoked as it gets a person high quickly and vaporizes at a low temperature. It is much more pure than crack as it is filtered and chemically separated from adulterants.

  • Eaten (chewing the leaves of the coca plant): Has a mildly stimulating effect.

    Snorting (also known as blowing): Most common method of usage. Drug is absorbed through the sinuses. May damage nasal passages. A dose is usually considered a line, but lines vary widely based on who is cutting the cocaine and the occasion.

    Injection: Very quick, short-lasting high. Risks include blood clots from adulterants and infection due to the sharing of needles.

    Speedball (injection of heroin and cocaine): The stimulant and depressive natures of the two drugs may result in the masking of overdose symptoms, particularly of the signs of a heroin overdose.

    Smoked (done with freebase or crack; involves using a glass pipe): Short amount of time to get high.

  • Alcohol: Increases the strain put on the heart. Increases toxicity.

    Amphetamines: Since they have virtually the same stimulating effects on the heart, the strain is multiplied and could lead to heart attack.

    Ketamine: Only safe in low amounts.

    Heroin: (known commonly as a speedball) Incredibly dangerous due to increased strain on the heart as well as the masking of overdose symptoms since the drugs have opposing effects.

  • As cocaine became a more common club drug due to its stimulatory effect, it became popular in the gay dance club community. Due to its euphoria inducing effects as well as its ability to increase sex drive, it may lessen inhibitions, leading men to engage in more sex than they normally would which may spread disease, especially HIV. Using shared needles may also increase the spread of disease. It is important to keep condoms handy and to change needles every time to avoid the spread of STI’s and HIV.

    For information about treatment and resources for help with an addiction please check out our resources page.