An addictive drug that stimulates the central nervous system and induces feelings of euphoria. Cocaine is most often found in the form of white powder and is typically ingested by inhaling or “snorting,” usually through a straw or other tube, into the nose. It can also be injected into the veins. After conversion back to its base form, cocaine can be smoked, which is known as “free-basing.”
Cocaine use can lead to severe psychological and physical dependence. It can increase the pulse, blood pressure, body temperature and respiratory rate. Paranoid psychosis, hallucinations and other mental health problems can result from cocaine use. Cocaine use also causes bleeding and other damage to nasal passages. Cocaine-related heart and respiratory failure can lead to death.
In pregnancy, cocaine use endangers the unborn child, who may be born prematurely, with low birth weight, a variety of serious birth defects and later learning and behavioral problems. Crack is a form of cocaine base that is smoked and is most highly addictive. Cocaine is sometimes used with other drugs. The cocaine-heroin combination is called a “speedball,” and the cocaine-PCP mixture is known as “space base.” Different users react to the drug in different ways. However, many experience an instant feeling of enormous pleasure known as a “rush.” Initially it may also make the user feel energetic and selfconfident. However, the pleasurable feelings produced by cocaine are followed by depression and fatigue, known as a “crash.” To avoid the “crash,” users take more cocaine, establishing a cycle of use and dependency that is extremely difficult to end and often requires lengthy treatment.
Estimates of Cocaine Usage and Costs
During 2000 there were an estimated 1,707,000 chronic cocaine users and 3,035,000 occasional cocaine users in the United States. According to What America’s Users Spend on Illegal Drugs, users spent $35.3 billion on cocaine in 2000, a decrease from the $69.9 billion spent in 1990. The U.S. Department of Health and Human Services’ Results From the 2002 National Survey of Drug Use and Health: National Findings found that more than 33 million people ages 12 and older (14.4 percent) in 2002 reported that they had used cocaine at least once in their lifetime. More than 8 million Americans (3.6 percent) ages 12 and older had used crack cocaine at least once in their lifetime.
Treatment for cocaine use
Researchers are working to identify and test medications for treating cocaine addiction. One medication is Selegiline, which seems to be the most promising experimental medication, according to the Monitoring the Future Study. Another medication, disulfiram, which has been used to treat alcoholism, has been effective in treating cocaine abuse in clinical trials. Often antidepressants are prescribed to help people cope with the mood changes that come with withdrawal from cocaine use.
Treatments such as cognitive-behavioral coping skills focusing on the learning process have been effective in cocaine addiction but are a short-term approach. Behavioral treatment is useful to help people recognize, avoid and cope with situations when they are most likely to use cocaine.
Legislation and medical use
Cocaine falls under Schedule II of the Controlled Substance Act. A Schedule II Controlled Substance has a high potential for abuse but is currently accepted for medical use in treatment in the United States, which means it is occasionally administered by a doctor for legitimate medical uses, such as for a local anesthetic for some eye, ear and throat surgeries.
Cocaine is produced from the coca leaf in two stages to yield coca paste and then cocaine base. The coca leaf is grown primarily in Peru, Bolivia and, to a lesser extent, Colombia. The conversion to the white crystalline powder form, cocaine HCl, is done primarily in Colombia but occurs elsewhere in the Andean region.
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