Cocaine

Introduction: The Most Addictive Drug

“Cocaine is the single most addicting drug known to mankind. Mothers have given up their babies to get it.” 

So said Dr. Alan Leshner, and he should know. During his tenure as director of the National Institute on Drug Abuse (NIDA from 1994 to 2001, Dr. Leshner helped deal with the aftermath of the crack cocaine epidemic of the mid-1980s, when more than 12.4 million Americans were using the drug.

Cocaine has ruined many people’s lives because it is so highly addictive and because its effects are short-lived. The euphoria or “rush” of cocaine lasts between 15 and 30 minutes, and once it wears off, addicts will think of nothing but getting their next “hit.” Soon they find themselves drawn into an endless cycle of use and reuse.

The social and psychological effects of cocaine addiction are sometimes as bad as or worse than the physical effects on the body. A cocaine habit is expensive, six times the cost of most other amphetamines, adding up to between $15,000 and $100,000 a year. Addicts will take themselves, their families, and loved ones into debt and bankruptcy to keep up their supplies. Their drug makes them irritable and overly sensitive to criticism, qualities that also take a toll on their interpersonal relationships. Over the long term, as his cocaine habit takes over his life, the addict can become paranoid, isolated, depressed, and aggressive, even.

Cocaine is one of the few drugs that is abused by women as often as by men. One of the main reasons for this is that women are more prone to depression than men are, and the drug temporarily lifts the mood and makes users feel powerful and in control. It also is an appetite suppressant.

A 2009 report from The National Center on Addiction and Substance Abuse (CASA) at Columbia University indicates that 35 percent of people who abuse alcohol or illicit drugs have eating disorders (compared to three percent of the general population). To look at this data another way, half the people with eating disorders also abuse drugs, and 90 percent of those who have eating disorders are female.

Chemically withdrawal from cocaine does not produce as many unpleasant symptoms as does weaning oneself from certain other addictive drugs, such as heroin. However, it is hard to stay away from cocaine once you have developed the habit. As one famous cocaine addict, actor Robert Downey, Jr., once said, “Stopping cocaine is easy. It’s the not starting again that’s hard.”

History of Cocaine Use

Cocaine is made from coca leaves, which (contrary to a common misperception) have nothing to do with cocoa and chocolate. Coca plants are small shrubs that grow in South America. The natives of the Andes mountain area have been chewing coca leaves since 2500 B.C., as a way to combat fatigue from the high altitude. The Incas used it in religious ceremonies. Even today, miners in parts of Peru and Bolivia chew coca leaves in order to stay alert and work longer hours than they could without it.

German scientists isolated cocaine from coca leaves in 1855. At first, it was considered a miracle drug. It was the first local anesthetic, and revolutionized eye surgery, which had been extremely painful before the discovery of cocaine. Sigmund Freud promoted cocaine as a cure for “mental weakness” and as a “restoration for mental capacity” in 1884.

Several patented drugs containing cocaine once appeared on the market, with claims of curing everything from tuberculosis to alcoholism. Manufacturers added cocaine to wine, soda, gum, cigarettes, cigars, and soft drinks – in fact, the original formula for Coca Cola included cocaine.

By 1914, it became clear that people were becoming addicted to many of the medicines and other products that contained cocaine. The Harrison Narcotic Act placed restrictions on the drug’s use and sale of cocaine, and by the 1940s, it was illegal in all but two states. In 1970, the U.S. government classified cocaine as a Schedule I drug, making it illegal to possess or sell the drug.

Over the years, cocaine developed the reputation of being an upscale, expensive drug that was commonly used by artists, musicians, and intellectuals. At the height of the cocaine epidemic in 1985, cocaine had a chic image as the drug of choice in Hollywood and on Wall Street. It was celebrated in books like Bright Lights, Big City and in songs by, among others, Eric Clapton.

Meanwhile, celebrity users were dying from cocaine overdoses. Casualties in the 1980s included Saturday Night Live star John Belushi, basketball player Len Bias, and actor River Phoenix.

How Cocaine is Abused

Cocaine is made by mixing coca leaves with sulfuric acid, kerosene, or gasoline into a mash that is then treated with hydrochloric acid and becomes a white, salty powder. Street cocaine is usually only 15 percent to 60 percent pure, because dealers mix it with other drugs or fillers such as cornstarch, talcum powder, or flour.

People usually snort cocaine into their noses, although some take it orally or intravenously after mixing the powder with water.

Crack cocaine is not a powder, but looks like chunks of clear crystal. Dealers make crack by mixing the coca mash with hydrochloride salt and baking soda and allowing it to dry into “rocks.” Crack is much stronger and more addictive than street cocaine.

Cocaine’s Effects on the Body

Cocaine is a psychomotor stimulant that affects the neurotransmitters in the brain. Abusers often have what look like constant cold symptoms, including wheezing, coughing, and red, runny noses. Snorting cocaine can inflict permanent damage on the lining of the nose, heart, and lungs. Some addicts lose weight, and develop headaches and seizures. Males can become impotent.

Other symptoms include diarrhea, insomnia, and buzzing in the ears. Abusers often use cocaine in combination with PCP, morphine, and heroin, thus increasing their chances of dying from overdoses.

Cocaine can trigger chaotic heart rhythms; accelerate heartbeat and breathing; and increase blood pressure and body temperature. Other physical symptoms may include chest pain, nausea, blurred vision, fever, muscle spasms, convulsions and coma. Cocaine abusers build up a tolerance to the drug, resulting in the use of increasingly large amounts of the drug.

Mixing cocaine with alcohol is also dangerous because the two drugs combine in the body to form cocaethylene, which is more dangerous than either drug alone. Cocaine mixed with alcohol is the most common two-drug combination that results in drug-related death.

If they large enough amounts of the drug, cocaine abusers can experience cocaine “intoxication.” When in this state, they will be disoriented, and can experience tremors; vertigo, muscle twitches, paranoia, or, with repeated doses, undergo toxic reactions closely resembling amphetamine poisoning.

Cocaine makes people feel euphoric, energetic, talkative, and mentally alert, especially to the sensations of sight, sound, and touch. It can also temporarily decrease the need for food and sleep. However, as these effects wear off, cocaine users “crash,” and feel irritable and depressed, which makes them want to use more of the drug.

Cocaine Treatment

Treatment for cocaine abuse depends upon a number of factors, including the age and gender of the user, how long the person was abusing cocaine, how much was used, why it was used, whether the person was using cocaine in combination with other drugs, and whether there are any co-occurring psychiatric issues. Cocaine abusers often need to enter a residential treatment center to overcome their dependence upon the drug.

Choosing a treatment center that is a good fit for the individual is very important. Teenagers often do better in programs designed specifically for them. At therapeutic boarding schools, they can continue to take classes and earn credits toward their high school diplomas or college degrees while undergoing treatment. Many women can better face their unique issues such as prior sexual abuse, depression, eating disorders, and feelings of powerlessness at gender-specific rehab centers that treat only female clients.

Rehab & Recovery

The first step in cocaine rehabilitation is chemical withdrawal from the drug. This can take a few days or as long as a week, and should only be done under medical supervision. At this time there are no drugs for cocaine withdrawal symptoms, but most people do not experience any severe ones, and many experience none at all.

Once withdrawal is complete, cocaine users usually have to remain in treatment and counseling in order to learn the skills they will need to live a drug-free life. Cocaine abusers may become suicidal and depressed after withdrawal, as they may have spent most of their waking hours pursuing and using cocaine, and now they have nothing to do.

For this reason, many benefit from residential treatment that lasts a few months or longer. During their stays in residential treatment centers for cocaine abuse, clients undergo individual and group counseling, attend classes and lectures, learn relaxation techniques, and begin a healthy new life of good nutrition and regular physical exercise.

Cocaine abusers often have underlying psychological problems or “comorbidities” that must be treated separately from their addictions. Typical comorbidities include Attention Deficit Hyperactivity Disorder, anti-social personality, and eating disorders. A trained, professional drug abuse counselor can help recovering clients address these issues in therapy.

Those in recovery from cocaine dependencies are very susceptible to drug cravings, sometimes for a year or more after they withdraw from their drug. For this reason, they may benefit from attending 12-Step programs such as Narc-Anonymous or Cocaine Anonymous, or support groups that have a non-spiritual approach. Recovering individuals often continue in family and group therapy once they return home to help them overcome cravings and relapses.

One extensive study of 1,605 patients who were treated for cocaine dependence indicated that longer treatment leads to better outcomes. For example, relapse rates for those who were heavy users and stayed in residential treatment for three months or more were half the rate of those in short-term care.

Cocaine abuse is a difficult habit to break, but many, many people are able to overcome this problem and resume their pursuit of a healthier lifestyle.

References

Connolly, Sean. Cocaine. Chicago: Heinemann Library, 2001.

Holmes, Ann. Psychological Effects of Cocaine and Crack. Philadelphia: Chelsea House, 1999.

“Treatment of Cocaine,” DATOS – at http://www.datos.org/adults/adults-coctrt.html.

Weil, Dr. Andrew. From Chocolate to Morphine. New York: Howard Mifflin, 1998.