Cocaine Addiction (or Cocaine Dependence) is physical and psychological dependency on the regular use of cocaine. It can result in severe physiological damage, psychosis, schizophrenia, lethargy, depression, cocaine addiction is potentially fatal if you overdose.
Cocaine is a powerfully addictive stimulant drug. The use of the cocaine in powdered hydrochloride salt form can be snorted or dissolved in water and injected. Crack use is cocaine base that has not been neutralized by an acid to make the hydrochloride salt. This form of cocaine use comes in a rock crystal that is heated to produce vapors, which are smoked. The term “crack” refers to the crackling sound produced by the rock as it is heated.
Short Term Gain Long Term Pain
The effects of cocaine are immediate, extremely pleasurable, and brief. Cocaine produces intense but short-lived euphoria and can make users feel more energetic. Like caffeine, cocaine produces wakefulness and reduces hunger. Psychological effects include feelings of well-being and a grandiose sense of power and ability mixed with anxiety and restlessness. As the drug wears off, these temporary sensations of mastery are replaced by an intense depression. The drug abuser will then “crash”, becoming lethargic and typically sleeping for several days.
Cocaine addiction can occur very quickly and can be very difficult to break. Animal studies have shown that animals will work very hard (press a bar over 10,000 times) for a single injection of cocaine, choose cocaine over food and water, and take cocaine even when this behavior is punished. Animals must have their access to cocaine limited in order to prevent taking toxic or even lethal doses.
Researchers have found that cocaine stimulates the brain’s reward system inducing an even greater feeling of pleasure than natural functions. In turn, its influence on the reward circuit can lead a user to bypass survival activities and repeat drug use. Chronic cocaine use can lead to a cocaine addiction and in some cases damage the brain and other organs. An addict will continue to use cocaine even when faced with adverse consequences. Dependency can develop in less than 2 weeks. Some research indicates that a psychological dependency may develop after a single dose of high-potency cocaine. As the person develops a tolerance to cocaine, higher and higher doses are needed to produce the same level of euphoria.
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What is cocaine?
Cocaine (benzoylmethyl ecgonine) is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name Cocaine comes from “coca” in addition to the alkaloid suffix -ine, forming cocaine. Cocaine is both a stimulant of the central nervous system and an appetite suppressant. Specifically, it is a dopamine reuptake inhibitor, a norepinephrine reuptake inhibitor and a serotonin reuptake inhibitor. Because of the way cocaine affects the mesolimbic reward pathway, cocaine is addictive. Nevertheless, cocaine is used in medicine as a topical anesthetic, even in children, specifically in eye, nose and throat surgery.
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Coca leaf
For over a thousand years South American indigenous peoples have chewed the coca leaf (Erythroxylon coca), a plant that contains vital nutrients as well as numerous alkaloids, including cocaine. The leaf was, and is, chewed almost universally by some indigenous communities—ancient Peruvian mummies have been found with the remains of coca leaves, and pottery from the time period depicts humans, cheeks bulged with the presence of something on which they are chewing. There is also evidence that these cultures used a mixture of coca leaves and saliva as an anesthetic for the performance of trepanation.
Appearance
Cocaine in its purest form is a white, pearly product. Cocaine appearing in powder form is a salt, typically cocaine hydrochloride. Street market cocaine is frequently adulterated or “cut” with various powdery fillers to increase its weight; the substances most commonly used in this process are baking soda; sugars, such as lactose, dextrose, inositol, and mannitol; and local anesthetics, such as lidocaine or benzocaine, which mimic or add to cocaine’s numbing effect on mucous membranes. Cocaine may also be “cut” with other stimulants such as methamphetamine. Adulterated cocaine is often a white, off-white or pinkish powder.
The color of “crack” cocaine depends upon several factors including the origin of the cocaine used, the method of preparation – with ammonia or baking soda – and the presence of impurities, but will generally range from white to a yellowish cream to a light brown. Its texture will also depend on the adulterants, origin and processing of the powdered cocaine, and the method of converting the base. It ranges from a crumbly texture, sometimes extremely oily, to a hard, almost crystalline nature.
Forms of cocaine
Cocaine sulfate is produced by macerating coca leaves along with water that has been acidulated with sulfuric acid, or an aromatic-based solvent, like kerosene or benzene. This is often accomplished by placing the ingredients into a vat and stomping on them, in a manner similar to the traditional method for crushing grapes.
Freebase is the base form of cocaine, as opposed to the salt form of cocaine hydrochloride. Whereas cocaine hydrochloride is extremely soluble in water, cocaine base is insoluble in water and is therefore not suitable for drinking, snorting or injecting. Whereas cocaine hydrochloride is not well-suited for smoking because the temperature at which it vaporizes is very high and close to the temperature at which it burns; cocaine base vaporizes at a much lower temperature, which makes it suitable for inhalation.
Crack cocaine in its creation process, due to the dangers of using ether to produce pure freebase cocaine, cocaine producers began to omit the step of removing the freebase cocaine precipitate from the ammonia mixture. Typically, filtration processes are also omitted. The end result of this process is that the cut, in addition to the ammonium salt (NH4Cl), remains in the freebase cocaine after the mixture is evaporated.
Chewed/eaten coca leaves are typically mixed with an alkaline substance (such as lime) and chewed into a wad that is retained in the mouth between gum and cheek (much in the same as chewing tobacco is chewed) and sucked of its juices.
Insufflation (known colloquially as “snorting,” “sniffing,” or “blowing”) is the most common method of ingestion of recreational powdered cocaine in the Western world. The drug coats and is absorbed through the mucous membranes lining the sinuses. When insufflating cocaine, absorption through the nasal membranes is approximately 30–60%, with higher doses leading to increased absorption efficiency.
Drug injection provides the highest blood levels of drug in the shortest amount of time. Upon injection, cocaine reaches the brain in a matter of seconds, and the exhilarating rush that follows can be so intense that it induces some users to vomit uncontrollably.
Smoking freebase or crack cocaine is most often accomplished using a pipe made from a small glass tube, often taken from “Love roses,” small glass tubes with a paper rose that are promoted as romantic gifts. These are sometimes called “stems”, “horns”, “blasters” and “straight shooters”.
Coca herbal infusion (also referred to as Coca tea) is used in coca-leaf producing countries much as any herbal medicinal infusion would elsewhere in the world. The free and legal commercialization of dried coca leaves under the form of filtration bags to be used as “coca tea” has been actively promoted by the governments of Peru and Bolivia for many years as a drink having medicinal powers.
Oral cocaine has been used medically and informally as an oral anesthetic. Many users rub the powder along the gum line, or onto a cigarette filter which is then smoked (called a “hoolie”), which numbs the gums and teeth – hence the colloquial names of “numbies”, “gummers” or “cocoa puffs” for this type of administration. This is mostly done with the small amounts of cocaine remaining on a surface after insufflation. Another oral method is to wrap up some cocaine in rolling paper and swallow it. This is sometimes called a “snow bomb.”
Cocaine use
Three routes of administration are commonly used for cocaine: snorting, injecting, and smoking. 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 use of 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. All three methods of cocaine abuse can lead to addiction and other severe health problems, including increasing the risk of contracting HIV and infectious diseases.
The intensity and duration of cocaine’s effects, which include increased energy, reduced fatigue, and mental alertness, depend on the route of drug administration. The faster cocaine is absorbed into the bloodstream and delivered to the brain, the more intense the high. Injecting or smoking cocaine produces a quicker, stronger high than snorting. On the other hand, faster absorption usually means shorter duration of action. The high from snorting cocaine may last 15 to 30 minutes, but the high from smoking may last only 5 to 10 minutes. In order to sustain the high, a cocaine abuser has to administer the drug again. For this reason, cocaine is sometimes abused in binges—taken repeatedly within a relatively short period of time, at increasingly high doses.
Symptoms of cocaine addiction
Common physical signs of cocaine addiction include but are not limited to:
- Red, bloodshot eyes
- Runny nose or frequent sniffing
- Weight loss
- Increased susceptibility to illness
- Increased blood pressure
- Constricted blood vessels
- Dilated pupils
- Increased heart rate
- Increased temperature
- Nosebleeds
- Altered motor activities (tremors, hyperactivity)
- Perspiration or chills
- Nausea or vomiting
These signs are not limited…
How does cocaine affect the brain?
Cocaine is a strong central nervous system stimulant that increases levels of dopamine, a brain chemical associated with pleasure and movement, in the brain’s reward circuit. Certain brain cells, or neurons, use dopamine to communicate. Normally, dopamine is released by a neuron in response to a pleasurable signal (e.g., the smell of good food), and then recycled back into the cell that released it, shutting off the signal between neurons. Cocaine acts by preventing the dopamine from being recycled, causing excessive amounts of dopamine to build up, amplifying the message, and ultimately disrupting normal communication. It is this excess of dopamine that is responsible for cocaine’s euphoric effects. With repeated use, cocaine can cause long-term changes in the brain’s reward system and in other brain systems as well, which may eventually lead to addiction. With repeated use, tolerance to the cocaine high also often develops. Many cocaine abusers report that they seek but fail to achieve as much pleasure as they did from their first exposure. Some users will increase their dose in an attempt to intensify and prolong the euphoria, but this can also increase the risk of adverse psychological or physiological effects.
Through the use of sophisticated technology, scientists can actually see the dynamic changes that occur in the brain as an individual takes cocaine. They can observe the different brain changes that occur as a person experiences the “rush,” the “high,” and finally the craving of cocaine. They can also identify parts of the brain that become active when a cocaine addict sees or hears environmental stimuli that trigger the craving for cocaine.
Researchers know that certain kinds of experiences, such as those involved in learning, can physically change brain structure and affect behavior. Now, new research in rats shows that exposure to stimulant drugs such as cocaine can impair the ability of specific brain cells to change as a consequence of experience.
The ability of experiences to alter brain structure is thought to be one of the primary mechanisms by which the past can influence behavior and cognition. However, when these alterations in brain structure are produced by drugs of abuse, they may lead to the development of compulsive patterns of drug-seeking behaviors that are the hallmark of addiction.
Researchers conducted a series of experiments to examine how drugs of abuse and experience might interact to produce changes in brain structure. To accomplish this, they administered amphetamine, cocaine, or saline repeatedly for 20 days to individually housed rats. This pattern of drug administration was previously shown by these investigators to produce both behavioral changes in response to the drugs and structural changes in several brain regions. However, in the current study, the researchers went one step further. After the 20-day drug exposure, the rats were housed in a new environment for 3 to 3.5 months. Half of the drug- and saline-injected animals were placed in standard laboratory cages; the other animals in each group were housed in a complex environment. The environment contained a variety of stimuli: multiple levels with ramps, bridges, a climbing chain, tunnels, and toys that were rearranged once a week to encourage continued exploration of the environment. At the end of 3 or 3.5 months, the rats’ brains were analyzed for changes in dendrite branching and spine density. Specifically, the researchers examined the spiny neurons in the nucleus accumbens and the pyramidal cells in the parietal cortex. These areas were shown in previous studies to be altered by experience and/or drugs of abuse. The nucleus accumbens is involved in motivation and reward, and the parietal cortex is important for sensory-motor function.
Remarkably, animals that had been given amphetamine and then placed in the complex environment did not show the same environmental-induced structural changes in the nucleus accumbens and parietal cortex as did saline-treated animals in the complex environment. The results for those animals treated with cocaine were similar, in that prior treatment with cocaine blocked the environment-induced changes in the medium spiny neurons of the nucleus accumbens (the only region examined).
The findings from this study indicate that at least some of the cognitive and behavioral advantages that accrue with experience may be diminished by prior exposure to psycho stimulant drugs. This impairment of the ability of specific brain circuits to change in response to experiences may help explain some of the behavioral and cognitive deficits seen in people who are addicted to drugs. More research is warranted to determine whether certain experiences, such as exposure to complex or rewarding environments, can alter the ability of drugs to induce structural changes in the brain. If exposure to psycho stimulant drugs can alter the effects of subsequent experience, experience may be able to influence the later effects of drugs. It may even be possible for certain experiences to counteract the effects of psycho stimulant drugs.
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Why would anyone become addicted to cocaine?
The immediate craving of the addict is for more soon after use and due to the short-lived high that usually subsides within an hour, leading to prolonged, multi-dose binge use. When administration stops after binge use, it is followed by a “crash” (also known as a “come down”), the onset of severely dysphoric mood with escalating exhaustion until sleep is achieved, which is sometimes accomplished by taking sleeping medications, or sedatives, a popular one being Seroquel, or by combination use of alcohol and cannabis. Resumption of use may occur upon awakening or may not occur for several days, but the intense euphoria of such use can, as it has in many users, produce intense craving and develop rather quickly into addiction.
The risk of becoming cocaine-dependent within 2 years of first use (recent-onset) is 5-6%; after 10 years, it’s 15-16%. These are the aggregate rates for all types of use considered, i.e., smoking, snorting, injecting. Among recent-onset users, the relative rates are higher for smoking (3.4 times) and much higher for injecting. They also vary, based on other characteristics, such as gender: among recent-onset users, females are 3.3 times more likely to become addicted, compared to males; age: among recent-onset users, those who started using at ages 12 or 13 were 4 times as likely to become addicted, compared to those who started between ages 18 and 20; and race: among recent-onset users, non-Hispanic Blacks are 7 times as likely to become addicted, compared to non-Hispanic Whites. Many habitual abusers develop a transient manic-like condition similar to amphetamine psychosis and schizophrenia, whose symptoms include aggression, severe paranoia, and tactile hallucinations (including the feeling of insects under the skin, or “coke bugs”) during binges.
Cocaine addiction has positive reinforcement effects, which refers to the effect that certain stimuli have on behavior. Good feelings become associated with the drug, causing a frequent user to take the drug as a response to bad news or mild depression. This activation strengthens the response that was just made.
If the drug was taken by a fast acting route such as injection or inhalation, the response will be the act of taking more cocaine, so the response will be reinforced. Powder cocaine, being a club drug, is mostly consumed in the evening and night hours. Because cocaine is a stimulant, a user will often drink large amounts of alcohol during and after usage or smoke cannabis to dull “crash” or “come down” effects and hasten slumber. Benzodiazepines (e.g., Restoril, Rohypnol Xanax, and Klonopin) are also used for this purpose. Other drugs such as heroin and various pharmaceuticals are often used to amplify reinforcement or to minimize such negative effects, further increasing addiction potential and harmfulness.
Cocaine and alcohol
Added Danger using Cocaine with Alcohol
When people consume cocaine and alcohol together, they compound the danger each drug poses and unknowingly perform a complex chemical experiment within their bodies. Researchers have found that the human liver combines cocaine and alcohol to produce a third substance, cocaethylene, which intensifies cocaine’s euphoric effects. Cocaethylene is associated with a greater risk of sudden death than cocaine alone.
Mechanism of cocaine addiction
It is speculated that cocaine’s intense addictive properties stem partially from its DAT-blocking effects (in particular, increasing the dopaminergic transmission from ventral tegmental area neurons). However, a study has shown that mice with no dopamine transporters still exhibit the rewarding effects of cocaine administration. Later work demonstrated that a combined DAT/SERT knockout eliminated the rewarding effects. The rewarding effects of cocaine are influenced by circadian rhythms, possibly by involving a set of genes termed “clock genes”.
However, chronic cocaine addiction is not solely due to cocaine reward. Chronic repeated use is needed to produce cocaine-induced changes in brain reward centers and consequent chronic dysphoria (described above under Effects and Health Issues – Chronic). Dysphoria magnifies craving for cocaine because cocaine reward rapidly, albeit transiently, improves mood. This contributes to continued use and a self-perpetuating, worsening condition, since those addicted usually cannot appreciate that long-term effects are opposite those occurring immediately after use.
What treatment options exist?
Currently, there are no medications for treating cocaine addiction, so this remains one of NIDA’s top research priorities. Researchers are looking for medications that help alleviate the severe craving experienced by people in treatment for cocaine addiction, as well as medications to counteract other triggers of relapse, such as stress. Several compounds are currently being investigated for their safety and efficacy, including a vaccine that would sequester cocaine in the bloodstream and prevent it from reaching the brain. Research so far suggests that addiction medications are most effective when used as a part of a comprehensive treatment program.