Cocaine is an illegal drug extracted from the leaves of the coca plant and processed with a blend of other chemicals to form a white powder known as cocaine hydrochloride. This is the most common form, and it is typically inhaled or injected. Because it is mixed or ‘cut’ with other chemicals, people have no way of knowing whether a dose will be strong or weak.
The added chemicals may include fillers, such as glucose or lactose, that are used purely to boost profits. ‘Freebase’ cocaine, or ‘crack’, is processed differently and can be smoked, but this form is less widely available. Common slang terms for cocaine include ‘coke’, ‘blow’ and ‘stardust’.
How cocaine works#
The brain ‘rewards’ us for life-enhancing behavior, such as eating or having sex, by releasing a flood of pleasurable neurochemicals. One of these is dopamine, and this chemical reinforcement makes us want to repeat the behavior. Cocaine works by tapping into this reward system and triggering the release of dopamine. This makes cocaine extremely addictive, both psychologically and neurochemically.
Effects of cocaine use#
The effects of cocaine depend on the strength of the dose, the blend of chemicals, the person’s physiology and their state of mind at the time. The rush is short-lived, lasting around 15 to 30 minutes after inhalation. Immediate effects can include:
- feelings of euphoria, exhilaration and confidence
- an accelerated heart rate and increased body temperature
- a burst of energy
- dilated pupils
- loss of appetite
- an urge to have sex
In high doses, cocaine can make a person feel extremely agitated, paranoid and aggressive, along with unpleasant physical effects.
Overdose#
Symptoms of an overdose can include dizziness, hallucinations, nausea and vomiting, tremors, headache and heart pain. The consequences of overdose include seizures, brain hemorrhage, kidney failure, heart attack or stroke.
Dependence, tolerance and withdrawal#
As with many drugs, people can build up a tolerance to cocaine, meaning they need larger and larger doses to achieve the same high. Some people experience the opposite effect, a sensitivity in which even tiny amounts are enough to prompt a rush.
Because cocaine interferes with the brain’s chemical reward system, a person withdrawing may be unable to feel pleasurable sensations without the drug to release dopamine. As a result, intense cravings can last for months or even years after giving up, and relapses are common.
Psychological withdrawal symptoms can last for weeks and may include intense cravings, depression, anxiety and angry outbursts. Physical withdrawal symptoms include nausea, tremors, sleeping problems and muscle pain.
Damage caused by long-term use#
- Heart problems are a side effect of long-term use.
- Some people experience mental health problems, such as severe depression.
- A condition known as ‘cocaine psychosis’ includes aggression and disturbing hallucinations, often of insects under the skin.
- If cocaine is regularly inhaled or snorted, it can damage the lining of the nose and the structure separating the nostrils.
- If cocaine is injected, there is a risk of blood poisoning, blood-borne viruses such as HIV or hepatitis from shared equipment, damaged blood vessels and skin abscesses.
Synthetic cocaine#
In recent years, a range of synthetic products claiming to have similar effects to cocaine have become available. The active ingredient can be one of a number of chemicals, such as methylenedioxypyrovalerone (MDPV), but it is difficult to know exactly what they contain. As a result, they can have more unpredictable effects and may be more harmful than cocaine.
Treatment for drug dependence#
Treatment options for drug dependence include detoxification, individual counseling and group therapy. See your doctor for information and referral, or contact an alcohol and other drug service in your area.
Key points#
- The most common form of cocaine is typically inhaled or injected.
- Common slang terms for cocaine include ‘coke’, ‘blow’ and ‘stardust’.
- Treatment options for drug dependence include detoxification, individual counseling and group therapy.
Where to get help#
Sources & further reading
For evidence-based global guidance on this topic, consult authoritative public-health bodies such as the World Health Organization (WHO), CDC, NHS, and ECDC.