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Alcohol, Tobacco, and Other Drugs

What is cocaine?

Cocaine is a white powder manufactured from the leaves of the coca plant found in South America. It is a central nervous system stimulant that interferes with the reabsorption of the neurotramsmitter dopamine (which is associated with pleasure and movement). The build-up of dopamine causes the euphoric effects commonly reported by cocaine users, including hyperstimulation, reduced fatigue, and mental clarity.

Cocaine can be snorted, smoked, or when dissolved in water, injected directly into the veins. Crack cocaine is a crystallized version of cocaine that is smoked. Dealers "cut" cocaine with many products; some of which, such as caffeine or Sudafed, mimic the effects of cocaine. It is impossible to know what other drugs are added. The duration of effects of cocaine depends on the delivery method and purity of the dose. The more quickly the cocaine enters the bloodstream, the less time the euphoric effects last. As a result, individuals may take cocaine more frequently and in larger amounts which results in high potential for overdose and addiction.

Street names for cocaine include: coke, snow, flake, and blow.

Adults 18 to 25 years old have the highest rate of current cocaine use, compared to other age groups. Source: NIDA Research Report: Cocaine Abuse and Addiction.

What are the short-term consequences of using cocaine?

As a result of the euphoric effects of cocaine, users may believe that their level of functioning is better than it is. Therefore, users place themselves in danger if they attempt to drive a car or operate machinery. Alcohol consumption further increases this danger, and cocaine users often drink more alcohol than normal because of the stimulant effects of cocaine. When the cocaine's effects wear off, the user finds himself or herself more intoxicated than realized. Consumption of both alcohol and cocaine poses the additional risk of the formation of cocaethylene in the liver, which increases the strain on the heart and can lead to sudden death.

The unpleasant withdrawal symptoms of cocaine occur as cocaine's pleasurable effects quickly wear off. These symptoms may include irritability, anxiety, restlessness, physical pain, insomnia, depression, paranoia, or aggression.

Cocaine is a stimulant. It raises the blood pressure, heart rate, and respiration. Respiratory arrest or stroke can occur. High or frequent doses can cause seizures, stroke, or heart attack. In some cases, sudden death from cardiac arrest or seizures can occur even the first time an individual uses cocaine.

At high doses, an individual using cocaine can become irritable, erratic, delusional, paranoid, violent, and/or psychotic.

What are the long-term consequences of using cocaine?

Individuals can easily become physically and psychologically addicted to cocaine. Regular users soon build up a tolerance to the effects of the drug and need to take more of the drug to feel its effects.

In addition, users of cocaine may experience:

  1. Cardiovascular problems, including irregular heartbeat, heart attack, and heart failure
  2. Sleeplessness or sexual dysfunction
  3. Diminished sense of smell, nosebleeds, a chronically runny nose, and/or a perforated nasal septum
  4. Problems with swallowing and hoarseness
  5. Nausea and headaches
  6. Neurological incidents, including strokes, seizures, fungal brain infections, and hemorrhaging in the tissue surrounding the brain
  7. Pulmonary effects, such as fluid in the lungs, aggravation of asthma, and other lung disorders, and respiratory failure
  8. Psychiatric complications, including psychosis, paranoia, depression, anxiety disorders, and delusions
  9. Increased risk of traumatic injury from accidents and aggressive, violent, or criminal behavior
  10. For intravenous users, there is increased risk of sudden death and of contracting hepatitis B or C and HIV

Remember, cocaine is addictive!

How do I know if I have a problem with cocaine?

Each person is different, but some warning signs are:

  1. More frequent use
  2. Needing larger doses to get the same effect
  3. Spending time thinking about using or getting the drug
  4. Spending more money than you can afford on it
  5. Missing class or failing to finish assignments because of cocaine
  6. If you find that it's hard to be happy without it
  7. Erratic or unpredictable behavior

Treatment medications along with behavioral interventions are often used to treat an individual with cocaine addiction.

Where can I get help?

Join Together, a project of the Boston University School of Public Health, maintains a searchable database on treatment facilities so that you can find one convenient to you. Visit and click on "Find Help."