Cocaine Abuse

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Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Cocaine Abuse Overview
• How and Why People Abuse Cocaine
• Cocaine Abuse Causes
• Cocaine Abuse Symptoms
• Other Symptoms of Cocaine Abuse
• Signs of Cocaine Addiction
• When to Seek Medical Care
• Diagnosis of Cocaine Abuse
• Cocaine Abuse Treatment
• Self-Care at Home
• Follow-up
• Prevention of Cocaine Abuse
• Prognosis of Cocaine Abuse
• Synonyms and Keywords
• Authors and Editors

Cocaine is presently the most abused major stimulant drug in America. It has recently become the drug most frequently involved in emergency department visits. It is not a new drug of abuse but is often considered the "caviar" of recreational drugs. Thus, this distinction is reflected in its descriptions; cocaine has been called the champagne of drugs, gold dust, Cadillac of drugs, status stimulant, yuppie drug, and others. Street names for cocaine also reflect its appearance or method of use (such as flake, snow, toot, blow, nose candy, her, she, lady flake, liquid lady [a mixture of cocaine and alcohol], speedball [cocaine and heroin], crack, rock). It can also express its method of preparation, such as freebase. It is more popularly known simply as coke.

There are several noteworthy statistics regarding the use of cocaine in the United States:

• As of 2008, about 15% of Americans used cocaine at some time in their life, 6% by their senior year of high school.
• As of 2008, 1.9 million Americans had used cocaine in the past month, which includes more than 300,000 people who used crack cocaine.

Other important facts about cocaine use include the drop in cocaine use in teens as of 2009; a peak in adolescent cocaine use during the 1990s and the fact that men tend to use the drug more often than women. Adults 18-25 years of age have by far the highest rate of cocaine use.

A common myth is that cocaine is not addictive because it lacks the physical withdrawal symptoms seen in alcohol or heroin addiction. But cocaine does have powerful psychological addictive properties. As more than one user has reflected, "If it is not addictive, then why can't I stop?" The trend in drug abuse in the United States is presently multiple or polydrug abuse, and cocaine is no exception. Cocaine is often used with alcohol, sedatives such as diazepam (Valium), lorazepam (Ativan), or heroin, as an upper/downer combination. The other drug is also used to moderate the side effects of the primary addiction.

The use of cocaine in teens seems to have certain patterns. For example, while college students tend to abuse alcohol more than teens the same age who do not go on to college, noncollege students seem to abuse cocaine, as well as marijuana and tobacco, more than their peers who attend college. A common polydrug abuse problem, seen especially in adolescents, is cocaine, alcohol, and marijuana.

Drug abuse, chemical dependency, and addictive behavior spare no one and are spread throughout society. They are not limited by age, profession, race, religion, or physical attributes.

• History: Cocaine is a naturally occurring alkaloid usually extracted from the leaves of the coca shrub, which was originally found in the Andes Mountains of Peru and Bolivia. With its appreciation as a lucrative cash crop, it is now cultivated in Colombia, Argentina, Brazil, Mexico, the West Indies, Ecuador, and Java. Coca leaves were mixed with lime and chewed by the Peruvian Indians as early as the sixth century to allay the effects of cold, hunger, and fatigue. It is still used as such as a gift from the Sun God. In this sense, coca is an important sociocultural tradition for Peruvian and Bolivian Indians and should not be confused with the cocaine snorting, smoking, and injecting of the Western abuser. Coca was later introduced to Europe, where the alkaloid cocaine was isolated. Its medicinal effects on depression, alcohol and morphine addiction, fatigue, and as a local anesthetic were discovered. However, these discoveries were not without cost to those who experimented with it. The result was addiction and dependency on the drug.
• A brain tonic: In 1886, an elixir containing cocaine from the coca leaf and caffeine from the African kola nut was marketed in Atlanta. It was sold as a brain tonic recommended as a medication for headaches, alcoholism, morphine addiction, abdominal pain, and menstrual cramps. This elixir, appropriately named Coca-Cola, rapidly became one of the most popular elixirs in the country. But because of the adverse effects of cocaine, appreciated even then, the Coca-Cola Company agreed to use decocainized coca leaves in 1903. Cocaine came under strict control in the United States in 1914 with the Harrison Narcotic Act. It is listed as a narcotic and dangerous. Though its use is dangerous, it is not a narcotic, but its use is subject to the same penalties as those for opium, morphine, and heroin.
• Limited medical use: Cocaine has little medical use. Because of its anesthetic effect, it was used for eye surgery. But because of its profound ability to vasoconstrict blood vessels (that is, make veins and arteries narrow, thus stopping bleeding), it can lead to scarring and delayed healing of the cornea. Medications that are chemically similar to cocaine are available for use in the nose for surgery, stopping nosebleeds, and as a local anesthetic for cuts in children (for example, Novocaine).

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