What is it?
Cocaine is a mind-altering (psychoactive) drug that affects how we think and behave. It is a stimulant that speeds up our breathing, heart rate, thoughts and actions It is made from the processed leaves of the coca bush, which is native to South America. Most cocaine available today comes from unregulated growing and refining operations. The drug is sold on the street in three main forms:
Cocaine hydrochloride salt (fine white powder that is often mixed with similar-looking substances such as cornstarch and then rubbed into the gums, dissolved in water and injected or, most commonly, sniffed into the nostril or “snorted”)
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Freebase cocaine (a smokable substance that is created when the hydrochloride salt is removed through heating and an alkaline solution is added)
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Crack cocaine (a type of freebase that comes in chunks or rocks and can be heated and vaporized for smoking, or dissolved in water and ascorbic acid for injection)
How does it work?
When cocaine is snorted, it is absorbed into the bloodstream through membranes in the nose, and when smoked, it is absorbed across the linings in the lungs. The effects usually last for an hour or more. When cocaine is injected, it goes directly into the bloodstream and reaches the brain in seconds. The rush comes faster and with more intensity, but it goes away in about 20 minutes. When freebase cocaine or crack is smoked, the drug is absorbed in the lungs and produces a quick, intense high. The sensation lasts only a few minutes.
Once in the bloodstream, cocaine travels to the brain where it triggers an increase in naturally occurring brain chemicals (neurotransmitters) associated with pleasure, such as dopamine. Cocaine also prevents reabsorption of dopamine and causes a buildup between nerve cells. Users may experience intense pleasure and even exhilaration, but may also feel anxious or restless. As a stimulant, cocaine increases your heart rate and blood pressure. It also activates the area of the brain involved in memory and learning. Users often become more talkative and anxious.
Some of the factors that can influence how cocaine will affect you include: your past experiences with the drug, present mood and surroundings, and mental and physical health condition.
Aboriginal people in South America have been chewing coca leaves for centuries for various reasons including increased physical stamina and reduced appetite. In the mid-19th century, cocaine was isolated from the coca leaf and manufactured as a local anaesthetic and as a tonic in medicines and beverages. While no longer prescribed today, some people continue to use the drug to feel more confident and outgoing and to help them focus. Others use it to cope with life pressures or a problem such as anxiety or depression. But like any drug, cocaine can be harmful.
Many people choose not to use cocaine or to use the drug in moderation, because being less in control of your behaviour increases the likelihood of making unwise choices such as spending too much money or having unsafe sex. (About 11% of BC residents have tried cocaine but in certain populations, such as urban club-goers, use is more common.) Using cocaine may help you feel more outgoing at a party, but repeatedly using the drug to address social anxiety may lead to harms to your health or relationships.
What are the associated risks and health effects?
Small amounts of cocaine can make you feel energetic and more confident when socializing. But using more than moderate amounts may lead to agitation and irritability or overdose. And purchasing any drug in an unregulated market is always risky because you can never know for sure what you are using or buying.
Cocaine is often mixed with substances that look similar to the drug. A user is always at risk of consuming something toxic or using a mix with a higher-than-usual concentration of cocaine. This can lead to overdose and death. If you are coming down from a high, or “crashing,” you may feel depressed, tired or irritable. Symptoms of withdrawal (“crashing”) also include restlessness and agitation, leading to panic attacks, and a strong craving to use cocaine again. You may become paranoid and suffer from severe mood swings, hallucinations and delusions. Attention and memory lapses are also common.
Frequent cocaine use may lead to temporary psychotic symptoms such as feeling suspicious of others or hearing things that aren’t there. Ongoing use also increases our risk of heart problems. Frequent use of large amounts of cocaine can cause twitching, spasms and convulsions. Combining cocaine with heroin (called “speedballing”) is highly dangerous and can lead to overdose. Mixing cocaine with other substances is also risky.
Heavy chronic users who are crashing or trying to stop using the drug may experience headaches, seizures, heart problems including cardiac arrest, sleeping difficulties, weight loss, constipation and problems with sexual performance.
If you are pregnant and use cocaine you may give birth prematurely, or the baby may have a low birth weight, sleeping or feeding problems. Cocaine can be transferred to a baby through breast milk.
Using cocaine is a problem when it negatively affects your life or the lives of others. You may think this refers only to people who regularly use large amounts, but even a single occasion of use can lead to a problem. For instance, if you share pipes, straws or needles, you are at risk of infection. Using too much might lead us to make poor decisions that result in problems with relationships or the law. What’s important to recognize is the potential for adverse consequences of use in any context and over time.
If you use cocaine frequently, or binge for several days, you are more likely to develop cocaine tolerance. Your body therefore would require an increasing amount of the drug to achieve the same effects. This means feeling like you need the drug to function and feel normal. Heavy regular use of cocaine can result in dependence If you develop a dependence on cocaine you may experience signs of withdrawal. Withdrawal symptoms include tiredness sleeping disturbances, anxiety, depression, and a craving to use cocaine again. Some people develop cocaine cravings so strong they continue to use the drug even when it causes physical, psychological, social, legal or financial problems. Some even do risky things in order to sustain their habit.
Using cocaine involves a risk of overdose. How much and how often you use it affects your degree of risk. And since it is not possible to know the purity and content of the drug, you can accidentally use too much. Cocaine causes the heart to beat faster and blood pressure to rise. Signs of overdose include:
• fast or no pulse
• fast or no breathing
• hot, sweaty skin
• confusion, anxiety
• vomiting
If someone you know overdoses on cocaine, call 911 right away. Remain with the person. If the person is conscious, try to walk them around or keep them awake. If the person is unconscious, roll them onto their side into the recovery position so they won’t choke if they throw up.
Acknowledgments
[2014] This fact sheet was produced by the
Centre for
Addictions Research of BC
on behalf of the BC Partners for Mental Health and Addictions Information. An excerpt
has been reproduced here with permission. To read the full fact sheet and for more
helpful substance use and mental health resources, please visit
www.heretohelp.bc.ca