STREET NAMES: Coke, Snow, Blow, Powder, Nose Candy, Cola.

Other forms: Crack is a more pure form of cocaine, which is smoked and is commonly referred to as "Rock or Base."

Cocaine is found in the leaves of the coca plant, which grows primarily in South America and Central America. The leaves are processed and produce a coca paste; the paste is in turn processed to form a white hydrochloride powder. It is consumed by sniffing or by intravenous injection. A crystallized form of cocaine base (crack) is inhaled by "smoking" the ignited vapors in small glass pipes.

Most users consume cocaine every few days, on weekends or at parties. Some persons are habituated, in that they like to use the drug on a regular schedule, such as once daily or once every other day. A few persons become so dependent that they smoke cocaine every two to four hours; cocaine users on a binge may take it every few minutes. The immediate effect is a "rush" or "flash" of intense euphoria lasting fifteen to thirty minutes, with lesser euphoria for up to three to four hours. Unless users are tolerant to cocaine, their pupils dilate, their speech is rapid, and excitation occurs. With crack, the euphoria is more intense, often briefer, and usually followed by severe craving and depression.

Complications with chronic use of cocaine may produce severe impairments, including rhinitis, sinusitis, bronchitis, and respiratory ailments; nasal ulcers and/or perforation of the nasal septum; paranoia; mental confusion and forgetfulness; severe depression and lack of energy between doses; addiction; loss of interest and motivation in work; and a distorted sense of time (the user is frequently late or forgets appointments). Further, studies show that chronic use of cocaine may deplete the brain of certain chemicals, including noreprinephinc, dopamine, and serotonin, thus producing changes in brain chemistry. And alcohol and other drugs multiply the impairment caused by cocaine, particularly in teenagers and other inexperienced users.

To the chronic cocaine user, social problems are often devastating. The person may lose the desire to work, experience marital discord or relationship problems, lose friends and family, resort to illegal activities to support the habit, switch to heroin or alcohol abuse, have accidents, or become involved in arguments and fight.

Cocaine is one of the most addictive drugs known. In laboratory studies an addicted rat's craving for cocaine overrides all other natural functions including the desire for food, water, and sex; the rat will seek cocaine until it is exhausted and death occurs. Human cocaine addicts usually take the drug at least four times a day, in an effort to keep the substance constantly in their bloodstream. Those who have sought medical assistance to withdraw from cocaine in treatment facilities have, upon terminating use of the drug, reported symptoms of severe depression, lack of energy, sleep disorders, tremor, muscle aches, nausea, and intense craving for cocaine. With some luck and an intense determination to stop, these persons usually find that initial withdrawal symptoms start to subside after approximately three weeks. Unfortunately, however, relapse is extremely common; many users, for example, switch to alcohol abuse. It is recommended that the cocaine user stay in treatment for several months after withdrawal.

Below is the description used in classification of Cocaine Addiction used in the DSM-IV (3)
304.20 Cocaine Dependence
Cocaine has extremely potent euphoric effects, and individuals exposed to it can develop Dependence after using cocaine for very short periods of time. An early sign of Cocaine Dependence is when the individual finds it increasingly difficult to resist using cocaine whenever it is available. Because of its short half-life, there is a need for frequent dosing to maintain a 'high" Persons with Cocaine Dependence can spend extremely large amounts of money on the drug within a very short period of time. As a result, the person using the substance may become involved in theft, prostitution, or drug dealing or may request salary advances to obtain funds to purchase the drug. Individuals with Cocaine Dependence often find it necessary to discontinue use for several days to rest or to obtain additional funds. Important responsibilities such as work or child-care may be grossly neglected to obtain or use cocaine. Mental or physical complications of chronic use such as paranoid ideation, aggressive behavior, anxiety, depression, and weight loss are common, Regardless of the route of administration, tolerance occurs with repeated use. Withdrawal symptoms, particularly dysphoric mood, can be seen, but are usually transitory and associated with high-dose use.

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