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Substance use - cocaine

Definition

Cocaine is made from the leaves of the coca plant. Cocaine comes as a white powder, which can be dissolved in water. It is available as a powder or liquid.

As a street drug, cocaine can be taken in different ways:

• Inhaling it through the nose (snorting)

• Dissolving it in water and injecting it into a vein (shooting up)

• Mixing with heroin and injecting into a vein (speedballing)

• Smoking it (this type of cocaine is called freebase or crack)

Street names for cocaine include blow, bump, C, candy, Charlie, coca, coke, flake, rock, snow, speedball, toot.

Cocaine's Effects on Your Brain

Cocaine is a strong stimulant. Stimulants make the messages between your brain and body move faster. As a result, you are more alert and physically active.

Cocaine also causes the brain to release dopamine. Dopamine is a chemical that is involved with mood and thinking. It is also called the feel-good brain chemical. Using cocaine may cause pleasurable effects such as:

• Joy (euphoria, or a "flash" or "rush") and less inhibition, similar to being drunk

• Feeling as if your thinking is extremely clear

• Feeling more in control, self-confident

• Wanting to be with and talk to people (more sociable)

• Increased energy

How fast you feel the effects of cocaine depends on how it is used:

• Smoking: Effects start right away, are intense and last 5 to 10 minutes.

• Injecting into a vein: Effects start within 15 to 30 seconds and last 20 to 60 minutes.

• Snorting: Effects start in 3 to 5 minutes, are less intense than smoking or injecting, and last 15 to 30 minutes.

Harmful Effects of Cocaine

Cocaine can harm the body in many ways and lead to:

• Appetite decrease and weight loss

• Heart problems, such as fast heart rate, irregular heartbeat, increased blood pressure, and heart attacks

• High body temperature and skin flushing

• Memory loss, problems thinking clearly, and strokes

• Anxiety, mood and emotional problems, aggressive or violent behavior, and hallucinations

• Restlessness, tremors, seizures

• Sleep problems

• Kidney damage

• Problems breathing

• Death

People who use cocaine have a high chance of getting HIV/AIDS and hepatitis B and C. This is from activities such as sharing used needles with someone who is already infected with one of these diseases. Other risky behaviors that can be linked to drug use, such as having unsafe sex, can also increase the chance of becoming infected with one of these diseases.

Using too much cocaine can cause an overdose. This is known as cocaine intoxication. Symptoms can include enlarged pupils of the eye, sweating, tremors, confusion, and sudden death.

Cocaine can cause birth defects when taken during pregnancy and is not safe during breastfeeding.

Cocaine can be Addictive

Using cocaine can lead to addiction. This means your mind is dependent on cocaine. You are not able to control your use of it and need (crave) it to get through daily life.

Addiction can lead to tolerance. Tolerance means you need more and more cocaine to get the same high feeling. If you try to stop using, you may have reactions. These are called withdrawal symptoms and may include:

• Strong cravings for the drug

• Mood swings that can make a person feel depressed, then agitated or anxious

• Feeling tired all day

• Not able to concentrate

• Physical reactions such as headaches, aches and pains, increased appetite, not sleeping well

Treatment Options

Treatment begins with recognizing there is problem. Once you decide you want to do something about your cocaine use, the next step is to get help and support.

Treatment programs use behavior change techniques through counseling (talk therapy). The aim is to help you understand your behaviors and why you use cocaine. Involving family and friends during counseling can help support you and keep you from going back to using (relapsing) the drug.

If you have severe withdrawal symptoms, you may need to stay at a live-in treatment program. There, your health and safety can be monitored as you recover.

At this time, there is no medicine that can help reduce the use of cocaine by blocking its effects. But, scientists are researching such medicines.

Your Ongoing Recovery

As you recover, focus on the following to help prevent relapse:

• Keep going to your treatment sessions.

• Find new activities and goals to replace the activities that involved your drug use.

• Spend more time with family and friends you lost touch with while you were using. Consider not seeing friends who are still drug users.

• Exercise and eat healthy foods. Taking care of your body helps it heal from the harmful effects of cocaine use. You will feel better, too.

• Avoid triggers. These can be people you used cocaine with. Triggers can also be places, things, or emotions that can make you want to use cocaine again.

Resources

Resources that may help you on your road to recovery include:

• The Partnership for Drug-free Kids -- drugfree.org/

• LifeRing -- www.lifering.org/

• SMART Recovery -- www.smartrecovery.org/

• Cocaine Anonymous -- ca.org/

Your workplace employee assistance program (EAP) is also a good resource.

When to Call the Doctor

Contact your health care provider if you or someone you know is addicted to cocaine and needs help to stop using. Also contact your provider if you are having withdrawal symptoms that concern you.

References

Kowalchuk A, Reed BC. Substance use disorders. Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 50.

National Institute on Drug Abuse website. Cocaine. nida.nih.gov/research-topics/cocaine. Updated March 2024. Accessed May 22, 2024.

United States Drug Enforcement Administration website. Department of Justice/Drug Enforcement Administration Drug Fact Sheet. Stimulants. www.dea.gov/sites/default/files/2020-06/Stimulants-2020.pdf. Updated April 2020. Accessed June 12, 2024.

Weiss RD, Liebschutz JM. Drug use disorders. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 365.

Review Date: 5/4/2024

Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.