Cocaine


Important safety warning

Recent studies have found that a substantial portion of cocaine sold in the US may be adulterated with levamisole. Levamisole is an anti-parasitic drug approved for veterinary use, which has serious side-effects in people. Click here to learn more.

What is cocaine?

Cocaine hydrochloride (coke, snow, blow) is a central nervous system stimulant that interferes with the reabsorption of dopamine, a neurotransmitter associated with pleasure and movement. It is a white powder manufactured from the leaves of the coca plant found in South America. It may also be found in crack cocaine, a preparation of cocaine that chemically converts the drug into crystals, which are smoked.

How is cocaine used?

Cocaine is snorted, smoked, or injected. When it is snorted the effects begin after a few minutes and last between 15 and 30 minutes depending on the size of the dose and the tolerance of the user. When smoked, either in the form of crack or free-base, the effects come on intensely and immediately, but wear off quickly. When cocaine is injected the effects are immediate and intense. The immediacy and intensity of smoking and injecting cocaine make those methods more dangerous because of the high potential for addiction and overdose.

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Why do people take cocaine?

Cocaine prompts the release of dopamine, a neurotransmitter responsible for pleasure and movement, and inhibits the reabsorption of it, overstimulating the brain. Users report feelings of euphoria, hyper-stimulation, confidence, and alertness. Cocaine's pleasurable effects begin to wear off quickly. Once they do, withdrawal symptoms can include irritability, anxiety, restlessness, physical pain, insomnia, depression, paranoia, or aggression as the drug's effects wear off.

Are there short-term dangers of taking cocaine?

Cocaine has a number of short-term effects, including the unpleasant withdrawal symptoms mentioned above. Cocaine users frequently report that coming down from the drug is difficult, leading them to take more to prolong the high and avoid withdrawal. This is one of the reasons cocaine is so rapidly addictive. Many users report depression immediately after taking the drug and for days after.

Because cocaine gives the user a sense of power and confidence, users frequently think of themselves as functioning far better than they are. It is dangerous to drive a car on cocaine, especially when combined with alcohol. Because of the stimulant effects of cocaine, users drink more than they are accustomed to without feeling the depressant effects of alcohol. Cocaine, however, wears off much more rapidly, leaving the user more intoxicated than he thought he was. This situation increases the chance of suffering the worst of alcohol's debilitating effects, including slowed respiration, vomiting, and loss of consciousness. Alcohol and cocaine also combine in the human liver manufacturing a third substance, cocaethylene, which, while intensifying cocaine's euphoric effects, also increases the strain on the heart and the risk of sudden death.

At high doses, users of cocaine can become:

  • erratic
  • delusional
  • paranoid
  • violent
  • psychotic

As with other stimulants, cocaine raises blood pressure, heart rate, and respiration. This increases the chances of respiratory arrest or stroke. High or frequent doses have caused seizures, strokes or heart attacks in some people. In rare cases sudden death (from cardiac arrest or seizures following respiratory arrest) occurs on the first use of cocaine or unexpectedly thereafter. It is impossible to determine who might have such an immediately fatal reaction to cocaine.

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Are there long-term consequences to taking cocaine?

Most users don't imagine when they first try cocaine that they will become addicted to it, but this is always a possibility. It is very difficult to predict who will become addicted to cocaine. Other long-term risks include:

  • Cardiovascular problems, including irregular heartbeat, heart attack, and heart failure
  • Sleeplessness or sexual dysfunction
  • Diminished sense of smell or perforated nasal septum
  • Nausea, and headaches
  • Neurological incidents, including strokes, seizures, fungal brain infections, and hemorrhaging in tissue surrounding the brain
  • Pulmonary effects, such as fluid in the lungs, aggravation of asthma and other lung disorders, and respiratory failure
  • Psychiatric complications, including psychosis, paranoia, depression, anxiety disorders, and delusions
  • Increased risk of traumatic injury from accidents and aggressive, violent, or criminal behavior
  • For intravenous (IV) cocaine users, there is increased risk of hepatitis, HIV infection, and endocarditis.

How do I recognize a problem with cocaine?

Some danger signs are:

  • More frequent use
  • Needing more and more to get the same effect
  • Spending time thinking about using the drug
  • If you find it's hard to be happy without it
  • Spending more money than you have on it
  • Missing class or failing to finish assignments because of cocaine
  • Making new friends who do it and neglecting old friends who don't
  • Erratic or unpredictable behavior.

If you find that you can't stop using cocaine, then remember, there's help available.

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Is cocaine addictive?

Yes, cocaine is a powerfully addictive drug because of its interaction with the brain's dopamine levels. People develop tolerance to cocaine and greater quantities of the drug are needed to produce euphoric effects. In lab experiments, animals will continue to take cocaine until they kill themselves.

Did Freud use cocaine?

Yes, and he was an early advocate of what he thought were its medically beneficial properties. However, when his friend and patient, Ernst von Fleischl-Marxow died from cocaine addiction, Freud was disgraced and backed off of his original claims for cocaine's medicinal uses. He was forced to base his career on a different invention: psychoanalysis.

Is cocaine illegal?

Yes, cocaine is illegal and its possession, use, and sale carry heavy prison sentences and fines and disciplinary consequences at Brown. See the Brown University Policy on Drugs on the Student Rights and Responsibilities web site.

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How do I help a friend who's having trouble with drugs?

If you are concerned about a friend's drug or alcohol use, this page contains information about different ways to help them.

Resources at Brown and in Providence

If you or a friend are having trouble with drugs or alcohol, or just have questions, there is help available.

Links you can use

Dance Safe 
Dance Safe is a harm-reduction web site centered on drugs found in nightclubs and raves. The site offers drug information, a risk assessment, ecstasy testing kits and e-news.

National Institute on Drug Abuse 
NIDA drug pages have research reports, statistics and information on addiction.

The Good Drugs Guide
This British harm-reduction web site provides extensive information on cocaine, including the basics, dangers, mixing with other drugs and links.

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