Updated February 03, 2006 11:55 AM

Street names: blow, C, coke, crack, flake, freebase, rock, snow

What is cocaine?
Cocaine is a stimulant drug. Stimulants make people feel more alert and energetic. Cocaine can also make people feel euphoric, or "high."

Pure cocaine was first isolated from the leaves of the coca bush in 1860. Researchers soon discovered that cocaine numbs whatever tissues it touches, leading to its use as a local anesthetic. Today, we mostly use synthetic anesthetics, rather than cocaine.

In the 1880s, psychiatrist Sigmund Freud wrote scientific papers that praised cocaine as a treatment for many ailments, including depression and alcohol and opioid addiction. After this, cocaine became widely and legally available in patent medicines and soft drinks.

As cocaine use increased, people began to discover its dangers. In 1911, Canada passed laws restricting the importation, manufacture, sale and possession of cocaine. The use of cocaine declined until the 1970s, when it became known for its high cost, and for the rich and glamorous people who used it. Cheaper "crack" cocaine became available in the 1980s.

Where does cocaine come from?
Cocaine is contained in small amounts in the leaves of several species of the erythroxylum (coca) bush, which grow on the slopes of the Andes Mountains in South America. For at least 4,500 years, people in Peru and Bolivia have chewed coca leaves to lessen hunger and fatigue. Today, most of the world's supply of coca is grown and refined into cocaine in Colombia. Criminal networks control the lucrative cocaine trade.

What does cocaine look like and how is it used?
Cocaine hydrochloride-the form in which cocaine is snorted or injected-is a white crystalline powder. It is sometimes "cut," or mixed, with things that look like it, such as cornstarch or talcum powder, or with other drugs, such as local anesthetics or amphetamines.

Powder cocaine can be chemically changed to create forms of cocaine that can be smoked. These forms, known as "freebase" and "crack," look like crystals or rocks.

Cocaine is often used with other drugs, especially alcohol and marijuana. Cocaine and heroin, mixed and dissolved for injection, is called a "speedball."

Who uses cocaine?
A 2001 survey of Ontario students in grades 7 to OAC reported that

4.3 per cent had used cocaine at least once.
Two per cent had used crack cocaine at least once in the past year.
A 2000 survey of Ontario adults reported that

6.4 per cent had used cocaine at least once.
1.2 per cent had used it in the past year.

How does cocaine make you feel?
How cocaine makes you feel depends on:

• how much you use
  
• how often and how long you use
  
• how you use it (by injection, orally, etc.)
  
• your mood, expectation and environment
  
• your age
  
• whether you have certain medical or psychiatric conditions
  
• whether you've taken any alcohol or other drugs (illicit, prescription, over-the-counter or herbal).

Cocaine makes people feel energetic, talkative, alert and euphoric. They feel more aware of their senses: sound, touch, sight and sexuality seem heightened. Hunger and the need for sleep are reduced. Although cocaine is a stimulant, some people find it calming, and feel increased self-control, confidence and ease with others. Other people may feel nervous and agitated, and can't relax.

Taking high doses of cocaine for a long time can lead to:

• panic attacks
  
• psychotic symptoms, such as paranoia (feeling overly suspicious, jealous, or persecuted), hallucinations (seeing, hearing, smelling, etc., things that aren't real) and delusions (false beliefs)
  
• erratic, bizarre and sometimes violent behaviour.
  

With regular use, people may become tolerant to the euphoric effects of cocaine. This means they need to take more and more of the drug to get the same desired effect. At the same time, people who use the drug regularly may also become more sensitive to its negative effects, such as anxiety, psychosis hallucinations, loss of contact with reality) and seizures.

Cocaine also makes the heartbeat and breathing faster, and raises blood pressure and body temperature.

How long does the feeling last?
Not long. Cocaine is both fast- and short-acting.

Intranasal use, or "snorting," takes effect within a few minutes, and lasts 60 to 90 minutes.
Injecting produces a "rush" that is felt within minutes, and lasts 20 to 60 minutes.
Smoking causes a high within seconds, which lasts only five to 10 minutes.
When the cocaine high fades, the person may begin to feel anxious and depressed, and have intense craving for more of the drug. Some people stay high by "binging," or continually using the drug, for hours or days.

Is cocaine dangerous?
Yes.

While many people use cocaine on occasion without harm, the drug can be very dangerous, whether it's used once or often.

Cocaine causes the blood vessels to thicken and constrict, reducing the flow of oxygen to the heart. At the same time, cocaine causes the heart muscle to work harder, leading to heart attack or stroke, even in healthy people.
Cocaine raises blood pressure, which can explode weakened blood vessels in the brain.
A person can overdose on even a small amount of cocaine. Overdose can cause seizures and heart failure. It can cause breathing to become weak or stop altogether. There is no antidote to cocaine overdose.
Snorting cocaine can cause sinus infections and loss of smell. It can damage tissues in the nose and cause holes in the bony separation between the nostrils inside the nose.
Smoking cocaine can damage the lungs and cause "crack lung." Symptoms include severe chest pains, breathing problems and high temperatures. Crack lung can be fatal.
Injection can cause infections from used needles or impurities in the drug. Sharing needles can also cause hepatitis or HIV infection.
Cocaine use in pregnancy may increase risk of miscarriage and premature delivery. It also increases the chance that the baby will be born underweight. Because women who use cocaine during pregnancy often also use alcohol, nicotine and other drugs, we do not fully know the extent of the effects of cocaine use on the baby.
Cocaine use while breastfeeding transmits cocaine to the nursing child. This exposes the baby to all the effects and risks of cocaine use.
Cocaine use is linked with risk-taking and violent behaviours. It is also linked to poor concentration and judgment, increasing risk of injury and sexually transmitted disease.
Chronic use can cause severe psychiatric symptoms, including psychosis, anxiety, depression and paranoia.

Is cocaine addictive?
It can be.

Not everyone who uses cocaine becomes addicted, but if they do, it can be one of the hardest drug habits to break.

People who become addicted to cocaine lose control over their use of the drug. They feel a strong need for cocaine, even when they know it causes them medical, psychological and social problems. Getting and taking cocaine can become the most important thing in their lives.

Smoking crack, with its rapid, intense and short-lived effects, is most addictive. However, any method of taking cocaine can lead to addiction. The amount of drug used, and how often people use the drug, has an effect on whether people get addicted.

Cocaine causes people to "crash" when they stop using it. When they crash, their mood swings rapidly from feeling high to distress. This brings powerful cravings for more of the drug. Binging to stay high leads quickly to addiction.

Symptoms of cocaine withdrawal can include exhaustion, extended and restless sleep or sleeplessness, hunger, irritability, depression, suicidal thoughts and intense cravings for more of the drug. The memory of cocaine euphoria is powerful, and brings a strong risk of relapse to drug use.

What are the long-term effects of taking cocaine?
Cocaine increases the same chemicals in the brain that make people feel good when they eat, drink or have sex. Regular cocaine use can cause lasting changes in the brain. This may explain the craving and psychiatric symptoms that last even after drug use stops.

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©2003 Centre for Addiction and Mental Health. A PAHO/WHO Collaborating Centre.
Fully affiliated with the University of Toronto.

DISCLAIMER: Information on this site is not to be used for diagnosis, treatment or referral services and CAMH does not provide diagnostic, treatment or referral services through the Internet. Individuals should contact their personal physician, and/or their local addiction or mental health agency for further information.

ID#P13470 published April 11, 2006 10:48 AM