Classification:        Stimulant
     Slang Names:           caine, coke, snow, toot, white lady, nose candy,
                            blow, lines, rails, rock
     Methods of Use:        sniffing/snorting, inhalation, injection
     Dependence Potential:  psychologically and physically addictive

What is Cocaine?

Cocaine is a short-acting, powerful, central nervous system (CNS) stimulant which comes from the South American coca bush. The cocaine (cocaine hydrochloride) most common in this country is a white crystalline powder extracted from the leaves of the coca. The illicit "street" drug is a mixture of this pure substance and adulterants (comprising 5 to 70 percent of the mixture) added to stretch the supply and to increase the seller's profit. Talc, flour, laxatives, sugar, local anesthetics, and other stimulants or powders are just a few of the additives that cocaine is "cut" with.

Users buy powdered cocaine in grams (1/28 ounce) or in fractions of a gram called "quarters" or "eighths." Often, cocaine is snorted through the nose using plastic straws or rolled-up dollar bills. Razor blades are used to crush any large rocks or particles of cocaine and to form "lines" to make snorting easier. Some users inject cocaine into a muscle or vein, or convert cocaine into a smokable form called freebase.

What is Freebase?

Freebase is a form of cocaine that is smoked. It is the result of a chemical process whereby "street cocaine" (cocaine hydrochloride) is converted to a pure base by removing the hydrochloride salt and many of the "cutting" agents. This process usually involves the use of ether, which is a highly flammable solvent. The end product, freebase, is not water soluble. Therefore, the only way to get it into the system is to smoke it.

What is Crack?

"Crack" is a light brown or beige pellet of ready-to-smoke freebase cocaine. It is formed when powdered cocaine is melted in a glass tube with water. When the liquid cools, it is mixed with baking soda and cold water and cut into small pieces which then harden. In some parts of the country, lumps of crack are called "rock" or "ready rock." In other areas, the drug is sold in 3-inch sticks with ridges that are referred to as "french fries" or "teeth." There are also reports that crack is being pressed into pills. Crack should not be confused with "rock cocaine" which is a cocaine hydrochloride product for intranasal snorting and is sold in California.

Crack is very addictive. Because it is smoked, high doses of cocaine reach the brain almost instantly, causing a dramatic high. This rapid "high" is followed by a profound "low" that leaves the user craving more. As a result, physical and psychological addiction can occur in as little as two weeks.

How Cocaine and Crack Affect the Body

Immediate Effects:

When cocaine is "snorted" the effects begin within a few minutes, peak within 15 to 20 minutes and disappear within a few hours. Low doses produce a short-lived euphoria and feelings of increased energy, alertness, self-esteem and sensory awareness. While artificially depleting the body's energy supply, cocaine also reduces the perceived need for food and sleep and can cause impulsive behavior and mood changes.

Smoking freebase produces a shorter more intense "high" (lasting from 2 to 3 minutes) because inhalation is the most direct and rapid way to get the drug to the brain. Because larger amounts are getting to the brain more quickly, smoking also increases the risks of using the drug. Such risks include: confusion, anxiety, slurred speech, and psychological problems.

When crack is smoked, an intense and rapid euphoria, commonly known as a "flash high," is produced. The cocaine molecules reach the brain in less than ten seconds. The three to five-minute high is followed by an unpleasant crash. The user feels irritable, agitated and has an intense craving for more cocaine. The craving is caused by a high concentration of the drug in the bloodstream. The initial high is never reached again and the subsequent lows keep getting lower. This cycle reinforces the craving.

Injecting cocaine produces an effect within 30 seconds, which peaks in 5 minutes and lasts about 30 minutes. Users who inject run the risk of getting hepatitis, AIDS and other infections from using unclean needles.

Long-term Effects

Heart- Cocaine and crack constrict the heart's blood vessels, making it work harder and faster to move blood through the body. In some users, this stress may trigger chest pain or a heart attack. The drug can also interfere with the signals controlling the heart's pumping action. When this happens, the organ beats so irregularly it may stop. Cocaine, in all forms, including crack, has been associated with sudden heart attacks in people under the age of 30, some of whom had used the drug for the first time.

Brain- Cocaine and crack can cause brain seizures, a disturbance in the brain's electrical signals, some of which regulate the heart and muscles controlling breathing. Studies show that over time, the brain appears to become more and more sensitive to cocaine. As a result, the threshold at which seizures occur is lowered. Repeated use of the drug without experiencing problems does not guarantee seizures will not occur. The next dose-used in the same amount and the same way-can produce a seizure that may cause the heart to quit beating or the muscles controlling breathing to stop working. In addition, some users have suffered strokes after using cocaine-the increase in blood pressure caused by cocaine may rupture brain blood vessels.

Changed Behaviors of Cocaine and Crack Users

The obsessive, drug-seeking behavior of cocaine and crack users seems to be due to the drugs' overwhelming influence on what has been called the "reward center" in the brain. Cocaine appears to cause an intense stimulation of the center by allowing a brain chemical called dopamine to remain active longer than normal. This causes changes in brain activity and triggers an intense craving for more of the drug. The user may compulsively use cocaine or crack just to feel normal.

Violent, erratic, or paranoid behavior can sometimes accompany use of these drugs. This "cocaine psychosis," which can occur in all cocaine users, may appear more rapidly in those who smoke crack. Affected users can be anxious, believe they have superhuman powers, or become suspicious and paranoid to the point where they believe that their lives are in danger and react in bizarre or violent ways. Hallucinations are also common. Users may hear or see things that don't exist, or they may experience "coke bugs" - a sensation of imaginary insects crawling over the skin.

Other Effects of Cocaine and Crack Use

	Suicidal tendencies                 Chronic fatigue/exhaustion
	Dramatic mood swings                Chronic sleep problems
	Chronic nose bleeds and runny nose  Chronic headaches
	Chronic sore throat                 Respiratory ailments
	Loss of friends and former values   Vitamin deficiencies
	Loss of interest and motivation     Chronic nausea/vomiting
	Miscarriage/birth defects           Addiction
	Loss of interest and motivation     Death
	Miscarriage/birth defects           Crime/arrests
	Weight loss, resulting from a loss
	of appetite

Cocaine abusers often depend on other drugs, including alcohol, to help them sleep or to combat the jittery feeling that characterizes the cocaine high.

Signs and Symptoms of Cocaine Abusers

Dilated pupils

Dry mouth and nose, bad breath, frequent lip licking

Excessive activity-difficulty in sitting still

Lack of interest in food or sleep

Irritable, anxious, restless

Talkative but conversation lacks continuity

Runny nose, cold or chronic sinus/nasal problems or nosebleeds

Sudden drop in grades or work performance

Frequently in trouble or has accidents

Use or possession of paraphernalia including small spoons, razor blades, mirror, little bottles of white powder, plastic, glass or metal straws, glass pipes and miniature blow torches

Source: Valencia Community College Project Infusion Module, Orlando, FL. Reprinted with permission.