Cocaine, commonly referred to as snow, coke or blow, is a dangerous and illegal stimulant that can be found in both powdered and crack rock form. Cocaine is snorted through the nose and crack is usually smoked but can be injected. It is made from the leaves of a coca plant native to South America and is commonly abused because it enhances mood, increases energy and produces euphoria. These effects appear almost immediately after a single dose and disappear from within a few minutes to an hour. These short-lasting effects often lead to a binge and crash pattern. This binge and crash pattern mean that the individual will take several doses back to back.
Cocaine Use Disorder
Cocaine use disorder can wreak havoc on your relationships, physical health, professional life and mental health, and it can also cause serious financial hardships. There is no medical indication for the use of
cocaine, and therefore it is a very expensive, addictive street drug in its purest form. Cocaine can be cut or mixed with impure ingredients making it less expensive and even more dangerous.
Risk Factors for Cocaine Abuse
- Low socioeconomic status
- Lower levels of education
- Peer pressure
- Easy availability of the drug
- Accessible in areas with high crime or drug use
- High family conflicts
- Male gender
- Caucasian ethnicity
- Late adolescent age
- Thrill-seeking behaviors
The solid crystal form of cocaine is known as crack cocaine. Crack can be smoked or heated down to liquid to be injected. Crack cocaine is made by mixing baking soda or ammonia into the powder form of cocaine and is then heated into a solid “crystal form.” Crack cocaine’s name comes from the cracking or popping sound it makes when heated.
Crack is the strongest form of cocaine and, therefore, the most dangerous. Individuals who use crack cocaine for their first time are at a high risk of overdose. Since crack is smoked rather than snorted through the nose, it produces a much more potent and immediate high compared to pure cocaine. Because crack is impure, it is much cheaper and more addictive than pure cocaine, making it even more accessible to the population. Individuals who are addicted to cocaine will turn to crack because it is more potent and costs less.
Cocaine Abuse Statistics
- According to SAMHSA, cocaine is the second most common drug-related emergency room visit after alcohol.
- Cocaine is the second most trafficked illegal drug in the world.
- The National Survey on Drug Use and Health (NSDUH) indicates that in 2018, 1.9 million individuals aged 12 or older used cocaine.
- The number of cocaine deaths in 2015 (6,800) was the second highest since 1999.
Signs and Symptoms of Cocaine Use Disorder
Cocaine alters the circuits and chemical makeup in the brain, creating an increase in dopamine. Dopamine creates a sense of pleasure and is known as the “happy neurotransmitter.” When cocaine is absent from the body, the individual will crash, displaying signs of depression and irritability. Additionally, cocaine destroys the area of the brain that is responsible for impulse control and decision-making. Individuals who engage in chronic use will have decreased inhibitions and lack insight and judgment.
- Rapid changes in mood
- A drastic change in friends
- Manipulates others
- Appearance of white powder residue around the nose and mouth
- Needle marks on the arm (if intravenous use)
- Participates in stealing
- Deterioration of personal hygiene
- Withdraws from loved ones
- Fails to meet obligations at home, school or work
- Increased sense of power, physical strength and mental strength
- Emotionally unstable
- Increased sexual promiscuity
- Weight loss
- Tolerance (need for more of the drug to produce the same high)
Signs and Symptoms of Cocaine Toxicity
Acute signs and symptoms appear immediately and generally last between a few minutes to an hour. Depending on the purity and dosage, a deadly overdose can occur within minutes to an hour. These are signs and symptoms of acute cocaine toxicity:
- Dilated pupils
- Profuse sweating
- Runny nose
- Chest pain
- Elevated heart rate
- Elevated blood pressure
- Muscle twitching
- Pseudo hallucinations (cocaine bugs)
- Bruxism (grinding of the teeth)
- Emotional lability
- A heart attack resulting in cardiac arrest
- An impending sense of doom
- Generalized seizures
- Cardiac arrhythmias
- Severe hyperthermia (high body temperature)
- Violent behavior
How Does Cocaine Abuse Affect the Body?
Cocaine can cause severe medical complications and can result in:
- Loss of smell
- Deviated nasal septum
- Sexual dysfunction
- Altered mental status
- New-onset seizures
- Intracranial hemorrhage (bleeding into the brain)
- Myocardial infractions (heart attack)
- Bloodborne diseases such as HIV and hepatitis (if injected)
- Crack lung syndrome
Crack lung is a term used by medical professionals to describe lung findings in individuals who smoke cocaine. Diffuse swelling and bleeding in the lung tissue are characteristic of crack lung syndrome. Individuals will present with pneumonia, cough up blood (hemoptysis) or respiratory failure. Individuals with crack syndrome are very sick and require hospitalization, oftentimes in the intensive care unit and on a ventilator.
A common myth is that cocaine is not addictive because it lacks the physical withdrawal symptoms seen in alcohol or opioid use disorder. Cocaine is physiologically addictive because it re-wires the brain. As a result, when you stop using cocaine, you will experience emotional and mental withdrawal symptoms. These include:
- Lack of concentration
- Drug cravings
- Inability to feel pleasure
- Suicidal thoughts
Withdrawal symptoms can begin within 90 minutes of the dose and usually resolve in seven to 10 days. Unlike other substances of abuse, there are no FDA-approved medications that can prevent or relieve cocaine withdrawal side effects. Individuals are encouraged to seek treatment if they are experiencing withdrawals so they can be monitored for any dangerous behavior or severe mood changes. Suicide is the most serious withdrawal side effect associated with cocaine use disorder. After you stop using cocaine, your brain becomes depleted of dopamine, resulting in severe low moods. For mood changes that last longer than seven to 10 days, antidepressants and anti-anxiety medications can be useful to stabilize mood and reduce depression.
Seeking Help for Cocaine Abuse
Cocaine abuse is life-threatening, and if stopped, can result in suicidal thoughts. Seeking professional treatment for cocaine abuse is necessary to prevent further complications. Family members and significant others are generally the first to notice when their loved one needs professional help. The following are signs you should seek treatment for your cocaine abuse:
- Financial hardships due to drug use
- Cocaine cravings
- Use of crack cocaine
- Injections of cocaine
- Inability to fulfill professional, personal or academic obligations
- Changes in mood due to cocaine use
- Social isolation
- Irritable moods due to cocaine use
- Poor decision-making skills, such as driving while under the influence
- Increased sexual promiscuity
Psychotherapy is the mainstay treatment for cocaine use disorder. Therapy techniques teach you how to prevent cravings and channel your energy into other positive thoughts and hobbies. In a medical setting for acute cocaine intoxication, medications such as benzodiazepines can be given to prevent heart attacks. Often times, co-occurring mental health or substance abuse disorders can be present with cocaine use disorder, and both conditions must be treated simultaneously. Depending on the severity and the duration of the addiction, higher levels of care, such as residential treatment, is necessary. The majority of individuals will need long-term outpatient care or community care, such as Narcotics Anonymous.