Experimentation with cocaine can easily lead to addiction. Cocaine misuse and abuse can also cause many different mental and physical health problems.
Professional treatment can help people who can’t stop using cocaine on their own. A closer examination of the nature of cocaine, how it can hurt people, and separating fact from fiction helps clear the way for effective treatment.
Cocaine (a/k/a coke) and crack cocaine (a/k/a crack) stimulant use in the United States affects many Americans. The publication Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health reported that:1
Approximately 2.2 million people, ages 12 and older, were using cocaine
Of these, about 473,000 were using crack
The breakdown of cocaine use by age groups is as follows:
Ages 12-17: 26,000
Ages 18-25: 665,000
Ages 26 and above: 1.5 million
First-time coke use in 2017:
About 1 million people ages 12 and older have tried cocaine for the first time.
Of these, about 98,000 were children under the age of 18.
With high numbers like these, it’s clear that more education, prevention, and treatment programs are needed to help those struggling with coke misuse and abuse.
Cocaine comes from the leaves of the coca plant. For thousands of years, people who lived where the plant grows naturally have been chewing on its leaves. They do so for the stimulant effects the plant gives.
Cocaine was first developed from the coca plant in 1859. In the 1880s, it was widely used for medicines. The famous psychoanalyst Freud used and prescribed coke.
The popular soft drink Coca-Cola got its name because its original recipe included cocaine. Under public pressure to remove cocaine, the company did so in 1903.
In the early 1900s, snorting cocaine gained popularity. In 1912, about 5,000 deaths in the United States were connected to coke use. In 1922, the federal government banned the drug.
The 1970s in the United States saw a reemergence of cocaine as a fashionable drug for successful people. South American drug traffickers saw the opportunity to make big money. Cartels began exporting large amounts of the drug into the United States. By 2008, coke became the second most trafficked illegal drug in the world.
Due to the highly addictive properties of the stimulant, it is currently classified as a Schedule II drug.
Slang or street names for cocaine include:
Cocaine can be used in various ways. The most common way powdered cocaine is used is by snorting into the nose. Cocaine is also abused by being:
Rubbed on the gums in the mouth
Smoked as a powder
Smoked in the form of crack cocaine
‘Freebased’ after the powder has been processed into a ‘base’ rock form (crack cocaine is formed using a different method than this ‘base’ method)
Smoking coke permits it to reach the brain more quickly than other ways. Smoking crack or base gives users intense and immediate highs in seconds. Smoking coke makes it even more addictive due to the rapid effects.
As cocaine use approaches addiction, these signs begin to develop:
The sense of euphoria or pleasure the person experiences lessens as the drug use continues. This motivates the person to take more and more of the stimulant to gain the desired effects.
The person becomes obsessed with thoughts of the drug. The importance of finding and using the drug grows to higher and higher levels, disrupting relationship with family, friends, and at work.
The person’s body comes to rely on cocaine. The body cannot function normally when the drug is not being taken.
Once dependent on the drug, distressing symptoms and feeling sick occurs if the individual stops or tries to cut down on the drug.
The largest sign of addiction is having a main focus of obtaining and using the drug. To avoid questions about behavior, the person may isolate themselves from those showing concern.
As physical and mental health problems develop, drug use may increase. In many cases, professional rehab is needed to successfully recover from drug addiction.
The immediate and powerful high from cocaine lasts from 5 to 30 minutes when snorted. When smoked, the high lasts about 5 to 10 minutes. The lingering stimulant effects can go on for several hours, including:
Increased body temperature
Elevated heart rate
Stress on the heart
High level of stimulation
Narrowing of the blood vessels
High blood pressure
Stress on circulation system
Increase in risky behaviors (unsafe sex, sharing needles)
Use for long periods can cause:
Overdose (even from one use)
Damage to the nasal structures from snorting
Sudden death (even from one use)
People who are dependent on cocaine may experience withdrawal symptoms when they reduce the amount or suddenly stop using the drug. Withdrawal symptoms can appear in just a few hours and last up to 7 days or more. Signs and symptoms of withdrawal can include:
Pain or discomfort
If the person used large amounts of the drug for a long time, cravings and depression may continue for several months.
The mental effects of cocaine use include:
Violent thoughts and tendencies
Cognitive problems like not being able to remember things or pay attention
Cocaine abuse can cause serious or lasting physical health problems, such as:
Brain Damage: Using the drug for months or years can injure the nervous system and the brain. These injuries can cause seizures, strokes, and brain bleeds. Movement disorders such as tremors and tics can arise from cocaine use. Coke use can also cause a significant loss of gray matter in the brain, which is in involved in muscle control, memory, and self-control among other important functions. 2
Cardiac Problems: Using the drug stimulates the heart, which can place great strain on it. Abusing cocaine puts users at risk for heart disease. One research study reported that in the first hour after cocaine use, the risk of heart attack increases close to 24 times. Chronic abuse can also lead to heart inflammation and more severe cardiac issues.
Dangers of Mixing Cocaine and Alcohol: Cocaine and alcohol are commonly abused together. The ‘come down’ that comes from coke wearing off is commonly offset by drinking alcohol. Unfortunately, combining the two drugs in the body can create a life-threatening toxic chemical called cocaethylene. The combination of alcohol and cocaine can cause overdose and sudden death.
Dangers of Mixing Cocaine, Opioids, and Alcohol: The combination of coke, opioids, and alcohol can be deadly. This particular mix has been cited as a leading cause of accidental overdose.3
Dangers of Snorting Cocaine: Repeatedly snorting coke can damage the soft nasal tissues inside the nose. It can also damage the bones that make up the nasal cavity sidewalls. This can cause nasal structures to collapse. Other side effects can include nosebleeds and sinus infections. It can also lead to a loss of the sense of smell.
Overdose can cause:
Other symptoms of overdose include:
High blood pressure
High body temperature
High levels of anxiety
There is an especially high risk for overdose during a binge or when taken with other substances, such as alcohol.
Contrary to popular belief that you can safely try coke with no risk of addiction, just one dose can be addictive for some people. Coke is an extremely powerful stimulant. The short feeling of euphoria, followed by depression, can hook a person quickly.
While most people know that cocaine comes from a plant, they may not realize that it is mixed with many other drugs and chemicals. Cocaine in the United States is very different than chewing coca leaves in South America. Also, you can’t determine exactly what is in street drugs, which makes them quite dangerous.
Medical care may be needed for individuals who have a severe cocaine addiction. An inpatient or outpatient medical detox program can provide the comprehensive medical care needed. A detox program delivers medical care and medications to address physical issues and relieve withdrawal symptoms. A detox program also provides nutrition and hydration for anyone who is malnourished or dehydrated from cocaine abuse.
Medical detox is not a standalone treatment. Once the detox is completed, counseling sessions are recommended for a successful recovery from substance use disorder. Therapy sessions teach the individual valuable coping skills for maintaining sobriety. Therapists who show compassion, support, and encouragement also help ease any fears and anxiety the person may be experiencing.
An inpatient rehab center provides the highest level of care on an around-the-clock basis. Residential rehab may be the best choice for someone who is severely addicted or has been taking the drug for a long period of time. Inpatient rehab is also best for anyone who has medical problems. An outpatient program may be best if the person is not severely addicted or has little or no medical problems.
Look for an addiction treatment program that addresses relapse. Recovering individuals, even those who are sober for long periods of time, are at a high risk for relapse. A comprehensive relapse prevention plan for cocaine should be part of the program you choose.
Behavioral therapy is a big part of cocaine addiction treatment.
CBT (cognitive behavioral therapy):
CBT helps participants reduce their cocaine use at the start and for months after treatment. CBT counselors help the client identify the thoughts, feelings, and events that come before and after each episode of cocaine use. They then use these findings to develop and practice coping skills. These skills are related to avoiding or resisting cues associated with drug use, or managing negative effects of daily life.
Sober living homes are drug-free places to live where people in recovery can help each other to understand and change their behaviors.
12-step groups can be helpful in maintaining sobriety from cocaine use. Many treatment programs, both inpatient and outpatient, use 12-step groups as a part of their services. Practices and beliefs related to the 12 steps that were instituted by AA (Alcoholics Anonymous) are part of basic services to assist clients. Recovery groups help people:
Accept a substance use disorder diagnosis
Accept addiction as an illness
Accept abstinence from drugs is necessary for recovery
Encourage long-term participation in ongoing recovery through groups such as 12-step or SMART recovery
Cocaine Anonymous (CA) is the most well-known 12-step program for people recovering from cocaine or stimulant abuse. All of the members of CA are in recovery themselves. It is a fellowship of people who understand what it is like to abuse stimulants that helps everyone maintain sobriety. CA uses the 12 steps conceived by Alcoholics Anonymous.
There are currently no FDA approved drugs for treating cocaine abuse. There is research that shows methadone treatment can help reduce cocaine use.
Also, researchers are looking at the drug disulfiram, commonly used to treat alcohol dependence, for the treatment of cocaine dependence. Whether the people in the study used alcohol or not, those who took disulfiram significantly decreased the amount and frequency of their cocaine use.