Cocaine and Cocaine Addiction

What is Cocaine?

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 a local anesthetic for some eye, ear, and throat surgeries.

There are basically two chemical forms of cocaine: the hydrochloride salt and the "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.
Cocaine is generally sold on the street as a fine, white, crystalline powder, known as "coke," "C," "snow," "flake," or "blow." Street dealers generally dilute it with such inert substances as cornstarch, talcum powder, and/or sugar, or with such active drugs as procaine (a chemically-related local anesthetic) or with such other stimulants as amphetamines.

Cocaine abuse and addiction continues to be a problem that plagues our nation. In 1997, for example, an estimated 1.5 million Americans age 12 and older were chronic cocaine users. Although this is an improvement over the 1985 estimate of 5.7 million users, we still have a substantial distance to go in reducing the use of this addictive stimulant. Science is helping. For example, we now know more about where and how cocaine acts in the brain, including how the drug produces its pleasurable effects and why it is so addictive.

Through the use of sophisticated technology, scientists can actually see the dynamic changes that occur in the brain as an individual takes the drug. They can observe the different brain changes that occur as a person experiences the "rush," the "high," and, finally, the craving of cocaine. They can also identify parts of the brain that become active when a cocaine addict sees or hears environmental stimuli that trigger the craving for cocaine. Because these types of studies pinpoint specific brain regions, they are critical to identifying targets for developing medications to treat cocaine addiction.

The principal routes of cocaine administration are oral, intranasal, intravenous, and inhalation. The slang terms for these routes are, respectively, "chewing," "snorting," "mainlining," "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 can also 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. 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.

Source: Parts reprinted from The National Institute on Drug Abuse (NIDA)

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