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Cocaine
is a powerfully addictive drug of abuse.
Once having tried cocaine, an individual
cannot predict or control the extent to
which he or she will continue to use the
drug.
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The
major routes of administration of cocaine
are sniffing or snorting, injecting, and
smoking (including free-base and crack
cocaine). Snorting is the process of
inhaling cocaine powder through the nose
where it is absorbed into the bloodstream
through the nasal tissues. Injecting is the
act of using a needle to release the drug
directly into the bloodstream. Smoking
involves inhaling cocaine vapor or smoke
into the lungs where absorption into the
bloodstream is as rapid as by injection. |
"Crack"
is the street name given to cocaine that has been
processed from cocaine hydrochloride to a free base
for smoking. Rather than requiring the more volatile
method of processing cocaine using ether, crack
cocaine is processed with ammonia or sodium
bicarbonate (baking soda) and water and heated to
remove the hydrochloride, thus producing a form of
cocaine that can be smoked. The term
"crack" refers to the crackling sound
heard when the mixture is smoked (heated),
presumably from the sodium bicarbonate.
There
is great risk whether cocaine is ingested by
inhalation (snorting), injection, or smoking. It
appears that compulsive cocaine use may develop even
more rapidly if the substance is smoked rather than
snorted. Smoking allows extremely high doses of
cocaine to reach the brain very quickly and brings
an intense and immediate high. The injecting drug
user is at risk for transmitting or acquiring HIV
infection/ AIDS if needles or other injection
equipment are shared.
Health
Hazards
Cocaine
is a strong central nervous system stimulant that
interferes with the reabsorption process of
dopamine, a chemical messenger associated with
pleasure and movement. Dopamine is released as part
of the brains reward system and is involved in the
high that characterizes cocaine consumption.
Physical
effects of cocaine use include constricted
peripheral blood vessels, dilated pupils, and
increased temperature, heart rate, and blood
pressure. The duration of cocaines immediate
euphoric effects, which include hyperstimulation,
reduced fatigue, and mental clarity, depends on the
route of administration. The faster the absorption,
the more intense the high. On the other hand, the
faster the absorption, the shorter the duration of
action. The high from snorting may last 15 to 30
minutes, while that from smoking may last 5 to 10
minutes. Increased use can reduce the period of
stimulation.
Some
users of cocaine report feelings of restlessness,
irritability, and anxiety. An appreciable tolerance
to the high may be developed, and many addicts
report that they seek but fail to achieve as much
pleasure as they did from their first exposure.
Scientific evidence suggests that the powerful
neuropsychologic reinforcing property of cocaine is
responsible for an individuals continued use,
despite harmful physical and social consequences. In
rare instances, sudden death can occur on the first
use of cocaine or unexpectedly thereafter. However,
there is no way to determine who is prone to sudden
death.
High
doses of cocaine and/or prolonged use can trigger
paranoia. Smoking crack cocaine can produce a
particularly aggressive paranoid behavior in users.
When addicted individuals stop using cocaine, they
often become depressed. This also may lead to
further cocaine use to alleviate depression.
Prolonged cocaine snorting can result in ulceration
of the mucous membrane of the nose and can damage
the nasal septum enough to cause it to collapse.
Cocaine-related deaths are often a result of cardiac
arrest or seizures followed by respiratory arrest.
Added
Danger: Cocaethylene
When
people mix cocaine and alcohol consumption, they are
compounding the danger each drug poses and
unknowingly performing a complex chemical experiment
within their bodies. NIDA-funded researchers have
found that the human liver combines cocaine and
alcohol and manufactures a third substance,
cocaethylene, that intensifies cocaines euphoric
effects, while possibly increasing the risk of
sudden death.
Extent
of Use
Monitoring
the Future Study (MTF)
The
MTF assesses the extent of drug use among
adolescents and young adults across the country.
- The
proportion of high-school seniors who have used
cocaine at least once in their lifetimes has
increased from a low of 5.9 percent in 1994 to
8.7 percent in 1997. However, this is lower than
its peak of 17.3 percent in 1985. Current (past
month) use of cocaine by seniors decreased from
a high of 6.7 percent in 1985 to 2.3 percent in
1997. Also in 1997, 7.1 percent of 10th-graders
had tried cocaine at least once, up from a low
of 3.3 percent in 1992. The percentage of
8th-graders who had ever tried cocaine has
increased from a low of 2.3 percent in 1991 to
4.4 percent in 1997.
- Of
college students 1 to 4 years beyond high
school, in 1995, 3.6 percent had used cocaine
within the past year, and 0.7 percent had used
cocaine in the past month.
Cocaine
Use by Students, 1997:
Monitoring the Future Study
| |
8th-Graders |
10th-Graders |
12th-Graders |
| Ever
Used |
4.4% |
7.1% |
8.7% |
| Used
in Past Year |
2.8 |
4.7 |
5.5 |
| Used
in Past Month |
1.1 |
2.0 |
2.3 |
| Daily
Use |
0.1 |
0.1 |
0.2 |
Community
Epidemiology Work Group (CEWG)
Although
demographic data continue to show most cocaine users
as older, inner-city crack addicts, isolated field
reports indicate new groups of users: teenagers
smoking crack with marijuana in some cities;
Hispanic crack users in Texas; and in the Atlanta
area, middle-class suburban users of cocaine
hydrochloride and female crack users in their
thirties with no prior drug history.
National
Household Survey on Drug Abuse (NHSDA)
In
1996, about 1.7 million Americans were current (at
least once per month) cocaine users. This is about
0.8 percent of the population age 12 and older.
About 668,000 of these used crack. The rate of
current cocaine use in 1996 was highest among
Americans ages 18 to 25 (2.0 percent). The rate of
use for this age group was significantly higher in
1996 than in 1995, when it was 1.3 percent.
Information on
this page courtesy of National Institute on Drug
Abuse.
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