Overview: Cocaine is almost two drugs in one, blending
stimulant and anesthetic effects in a single molecule. Derived
from the leaves of the coca bush (Erythroxylum coca), which
grows in Bolivia and Peru, powder cocaine is sniffed, injected,
or converted into smokeable forms of the drug, called crack and
freebase. The introduction of crack, which triggers an intense,
brief high, caused cocaine use (and related problems) to surge
during the 1980’s and ’90s.
Street Names: Blow, caine, coke, cola, freeze, snow (powder); base, rock (crack).
Actions/Effects: Cocaine is absorbed into the bloodstream
through the mucous membranes of the nose, when sniffed; via the
alveoli in the lungs, when smoked. In the brain, it pumps up
the volume by increasing the activity of two main neurotransmitters,
norepinephrine and dopamine. At low doses, its
effects include feelings of excitement and alertness, combined
with decreased appetite and fatigue. Physical effects include
dilated pupils, constricted blood vessels, and elevated heart
rate, respiration, and blood pressure. Higher doses (or use over
a long period of time) can cause anxiety, paranoia, and toxic
Duration: Depends on dose and mode of administration;
typically 5-30 minutes, but can be (and often is) extended by
Medical Uses: Once commonly used as a local anesthetic
and as a treatment for depression, cocaine has been replaced
almost entirely by less-toxic drugs. Today, it’s used only as
a topical anesthetic in the respiratory tract.
Risks/Side Effects: Cocaine’s rush quickly fades, which adds
to the risk of continuous use and toxic effects. Overdose can
develop so quickly (regardless of how the drug is used) that
users can die before help arrives. Overdose symptoms include
delirium; rapid, irregular, shallow breathing; unconsciousness;
and cardiac arrest.
Trends: Cocaine use was limited during much of the 20th
Century, but exploded during the 1970’s as the supply of other
stimulant drugs declined. Prior to that time, cocaine was considered
fairly harmless, due to its scarcity and high price. Problems
skyrocketed with the appearance of freebase and crack in the
Demographics: Cocaine use has fallen sharply since
its peak during the 1980’s. In 2009, the number of Americans
admitting past-month use stood at 1.6 million less than a third
of the 5,686,000 who reported such use in 1985.