NARCOTIC NEWS
Cocaine Information
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Cocaine is a powerfully addictive stimulant that directly affects the
brain. Cocaine was labeled the drug of the 1980s and ‘90s, because
of its extensive popularity and use during this period. However,
cocaine is not a new drug. In fact, it is one of the oldest known
drugs. The pure chemical, cocaine hydrochloride, has been an
abused substance for more than 100 years, and coca leaves, the
source of cocaine, have been ingested for thousands of years.
Pure cocaine was first extracted from the leaf of the Erythroxylon
coca bush, which grows primarily in Peru and Bolivia, in the mid-
19th century. In the early 1900s, it became the main stimulant drug
used in most of the tonics/elixirs that were developed to treat a wide
variety of illnesses. Today, cocaine is a Schedule II drug, meaning
that it has high potential for abuse, but can be administered by a
doctor for legitimate medical uses, such as local anesthesia for
some eye, ear, and throat surgeries.
There are basically two chemical forms of cocaine: the hydrochloride salt and "Crack Cocaine".
"Crack Cocaine" is referred to as "freebase". The hydrochloride salt, or powdered form of cocaine,
dissolves in water and, when abused, can be taken intravenously (by vein) or intranasally (in the nose).
Freebase refers to a compound that has not been neutralized by an acid to make the hydrochloride
salt. The freebase form of cocaine is smokable. Crack is the street name given to a freebase form of
cocaine that has been processed from the powdered cocaine hydrochloride form to a smokable
substance. The term “crack” refers to the crackling sound heard when the mixture is smoked. Crack
cocaine is processed with ammonia or sodium bicarbonate (baking soda) and water, and heated to
remove the hydrochloride. Because crack is smoked, the user experiences a high in less than 10
seconds. This rather immediate and euphoric effect is one of the reasons that crack became
enormously popular in the mid 1980s. Another reason is that crack is inexpensive both to produce and
to buy. Crack cocaine remains a serious problem in the United States. The National Survey on Drug Use
and Health (NSDUH) estimated the number of current crack users to be about 567,000 in 2002.
Cocaine Use in the U.S.A.
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In 2002, an estimated 1.5 million Americans could be classified as dependent on or abusing cocaine in
the past 12 months, according to the NSDUH. The same survey estimates that there are 2.0 million
current (past-month) users. Cocaine initiation steadily increased during the 1990s, reaching 1.2 million
in 2001.
Adults 18 to 25 years old have a higher rate of current cocaine use than those in any other age group.
Overall, men have a higher rate of current cocaine use than do women. Also, according to the 2002
NSDUH, estimated rates of current cocaine users were 2.0 percent for American Indians or Alaskan
Natives, 1.6 percent for African-Americans, 0.8 percent for both Whites and Hispanics, 0.6 percent for
Native Hawaiian or other Pacific Islanders, and
0.2 percent for Asians. The 2003 Monitoring the Future Survey, which annually surveys teen attitudes
and recent drug use, reports that crack cocaine use decreased among 10th-graders in 30-day, annual,
and lifetime use prevalence periods. This was the only statistically significant change affecting cocaine
in any form. Past-year use of crack declined from 2.3 percent in 2002 to 1.6 percent in 2003. Last year,
the rate increased from 1.8 percent to 2.3 percent, and this year’s decline brings it to approximately its
2001 level.
Data from the Drug Abuse Warning Network (DAWN) showed that cocaine-related emergency
department visits increased 33 percent between 1995 and 2002, rising from 58 to 78 mentions per
100,000 population.
The Way Cocaine is Consumed
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The principal routes of cocaine administration are oral, intranasal, intravenous, and inhalation. The
slang terms for these routes are, respectively, “chewing,” “snorting,” “mainlining” or “injecting,” and
“smoking” (including freebase and crack cocaine). Snorting is the process of inhaling cocaine powder
through the nostrils, where it is absorbed into the bloodstream through the nasal tissues. Injecting
releases the drug directly into the bloodstream, and heightens the intensity of its effects. Smoking
involves the inhalation of cocaine vapor or smoke into the lungs, where absorption into the
bloodstream is as rapid as by injection. The drug also can be rubbed onto mucous tissues. Some users
combine cocaine powder or crack with heroin in a “speedball.”
Cocaine use ranges from occasional use to repeated or compulsive use, with a variety of patterns
between these extremes. Other than medical uses, there is no safe way to use cocaine. Any route of
administration can lead to absorption of toxic amounts of cocaine, leading to acute cardiovascular or
cerebrovascular emergencies that could result in sudden death. Repeated cocaine use by any route of
administration can produce addiction and other adverse health consequences.
A great amount of research has been devoted to understanding the way cocaine produces its
pleasurable effects, and the reasons it is so addictive. One mechanism is through its effects on
structures deep in the brain. Scientists have discovered regions within the brain that are stimulated by
rewards. One neural system that appears to be most affected by cocaine originates in a region located
deep within the brain called the ventral tegmental area (VTA). Nerve cells originating in the VTA extend
to the region of the brain known as the nucleus accumbens, one of the brain’s key areas involved in
reward. In studies using animals, for example, all types of rewarding stimuli, such as food, water, sex,
and many drugs of abuse, cause increased activity in the nucleus accumbens.
Cocaine in the brain — In the normal communication process, dopamine is released by a neuron into the
synapse, where it can bind with dopamine receptors on neighboring neurons. Normally, dopamine is then
recycled back into the transmitting neuron by a specialized protein called the dopamine transporter. If
cocaine is present, it attaches to the dopamine transporter and blocks the normal recycling process,
resulting in a buildup of dopamine in the synapse, which
contributes to the pleasurable effects of cocaine.
Researchers have discovered that, when a rewarding event is occurring, it is accompanied by a large
increase in the amounts of dopamine released in the nucleus accumbens by neurons originating in the
VTA. In the normal communication process, dopamine is released by a neuron into the synapse (the
small gap between two neurons), where it binds with specialized proteins (called dopamine receptors)
on the neighboring neuron, thereby sending a signal to that neuron. Drugs of abuse are able to interfere
with this normal communication process. For example, scientists have discovered that cocaine blocks
the removal of dopamine from the synapse, resulting in an accumulation of dopamine. This buildup of
dopamine causes continuous stimulation of receiving neurons, which is associated with the euphoria
commonly reported by cocaine abusers. As cocaine abuse continues, tolerance often develops. This
means that higher doses and more frequent use of cocaine are required for the brain to register the
same level of pleasure experienced during initial use. Recent studies have shown that, during periods
of abstinence from cocaine use, the memory of the euphoria associated with cocaine use, or mere
exposure to cues associated with drug use, can trigger tremendous craving and relapse to drug use,
even after long periods of abstinence.
SHORT TERM EFFECTS OF COCAINE
Cocaine’s effects appear almost immediately after a single dose, and disappear within a few minutes
or hours. Taken in small amounts (up to 100 mg), cocaine usually makes the user feel euphoric,
energetic, talkative, and mentally alert, especially to the sensations of sight, sound, and touch. It can
also temporarily decrease the need for food and sleep. Some users find that the drug helps them
perform simple physical and intellectual tasks more quickly, while others experience the opposite
effect.
The duration of cocaine’s immediate euphoric effects depends upon the route of administration. The
faster the absorption, the more intense the high. Also, the faster the absorption, the shorter the
duration of action. The high from snorting is relatively slow in onset, and may last 15 to 30 minutes,
while that from smoking may last 5 to 10 minutes.
The short-term physiological effects of cocaine include constricted blood vessels; dilated pupils; and
increased temperature, heart rate, and blood pressure. Large amounts (several hundred milligrams or
more) intensify the user’s high, but may also lead to bizarre, erratic, and violent behavior. These users
may experience tremors, vertigo, muscle twitches, paranoia, or, with repeated doses, a toxic reaction
closely resembling amphetamine poisoning. Some users of cocaine report feelings of restlessness,
irritability, and anxiety. In rare instances, sudden death can occur on the first use of cocaine or
unexpectedly thereafter. Cocaine-related deaths are often a result of cardiac arrest or seizures
followed by respiratory arrest.
LONG TERM EFFECTS OF COCAINE
Cocaine is a powerfully addictive drug. Thus, an individual may have difficulty predicting or controlling
the extent to which he or she will continue to want or use the drug. Cocaine’s stimulant and addictive
effects are thought to be primarily a result of its ability to inhibit the reabsorption of dopamine by nerve
cells. Dopamine is released as part of the brain’s reward system, and is either directly or indirectly
involved in the addictive properties of every major drug of abuse.
An appreciable tolerance to cocaine’s high may develop, with many addicts reporting that they seek
but fail to achieve as much pleasure as they did from their first experience. Some users will frequently
increase their doses to intensify and prolong the euphoric effects. While tolerance to the high can
occur, users can also become more sensitive (sensitization) to cocaine’s anesthetic and convulsant
effects, without increasing the dose taken. This increased sensitivity may explain some deaths
occurring after apparently low doses of cocaine.
Use of cocaine in a binge, during which the drug is taken repeatedly and at increasingly high doses,
leads to a state of increasing irritability, restlessness, and paranoia. This may result in a full-blown
paranoid psychosis, in which the individual loses touch with reality and experiences auditory
hallucinations.
Cocaine is a crystalline tropane alkaloid that is obtained from the
leaves of the coca plant. The name comes from "coca" in addition to
the alkaloid suffix -ine, forming cocaine.