08/07/2018
What is co***ne?
Co***ne is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. Although health care providers can use it for valid medical purposes, such as local anesthesia for some surgeries, co***ne is an illegal drug. As a street drug, co***ne looks like a fine, white, crystal powder. Street dealers often mix it with things like cornstarch, talcum powder, or flour to increase profits. They may also mix it with other drugs such as the stimulant amphetamine.
Photo of small baggies containing co***ne powder.
Photo ©Africa Studio/Shutterstock
Popular nicknames for co***ne include:
Blow
Coke
Crack
Rock
Snow
How do people use co***ne?
People snort co***ne powder through the nose, or they rub it into their gums. Others dissolve the powder in water and inject it into the bloodstream. Some people inject a combination of co***ne and he**in, called a Speedball.
Another popular method of use is to smoke co***ne that has been processed to make a rock crystal (also called "freebase co***ne"). The crystal is heated to produce vapors that are inhaled into the lungs. This form of co***ne is called Crack, which refers to the crackling sound of the rock as it's heated.
People who use co***ne often take it in binges—taking the drug repeatedly within a short time, at increasingly higher doses—to maintain their high.
Image of the brain's reward circuit.
Image by NIDA
The brain's reward circuit, which controls feelings of pleasure
How does co***ne affect the brain?
Co***ne increases levels of the natural chemical messenger dopamine in brain circuits controlling pleasure and movement.
Normally, the brain releases dopamine in these circuits in response to potential rewards, like the smell of good food. It then recycles back into the cell that released it, shutting off the signal between nerve cells. Co***ne prevents dopamine from recycling, causing excessive amounts to build up between nerve cells. This flood of dopamine ultimately disrupts normal brain communication and causes co***ne’s high.
Short-Term Effects
Short-term health effects of co***ne include:
extreme happiness and energy
mental alertness
hypersensitivity to sight, sound, and touch
irritability
paranoia—extreme and unreasonable distrust of others
Some people find that co***ne helps them perform simple physical and mental tasks more quickly, although others experience the opposite effect. Large amounts of co***ne can lead to bizarre, unpredictable, and violent behavior.
Co***ne's effects appear almost immediately and disappear within a few minutes to an hour. How long the effects last and how intense they are depend on the method of use. Injecting or smoking co***ne produces a quicker and stronger but shorter-lasting high than snorting. The high from snorting co***ne may last 15 to 30 minutes. The high from smoking may last 5 to 10 minutes.
What are the other health effects of co***ne use?
Other health effects of co***ne use include:
constricted blood vessels
dilated pupils
nausea
raised body temperature and blood pressure
faster heartbeat
tremors and muscle twitches
restlessness
Long-Term Effects
Some long-term health effects of co***ne depend on the method of use and include the following:
snorting: loss of sense of smell, nosebleeds, frequent runny nose, and problems with swallowing.
consuming by mouth: severe bowel decay from reduced blood flow.
needle injection: higher risk for contracting HIV, hepatitis C, and other bloodborne diseases. However, even people involved with non-needle co***ne use place themselves at a risk for HIV because co***ne impairs judgment, which can lead to risky sexual behavior with infected partners (see "Co***ne, HIV, and Hepatitis").
Other long-term effects of co***ne use include being malnourished, because co***ne decreases appetite, and movement disorders, including Parkinson’s disease, which may occur after many years of use. In addition, people report irritability and restlessness resulting from co***ne binges, and some also experience severe paranoia, in which they lose touch with reality and have auditory hallucinations—hearing noises that aren't real.
Co***ne, HIV, and Hepatitis
Studies have shown that co***ne use speeds up HIV infection. According to research, co***ne impairs immune cell function and promotes reproduction of the HIV virus. Research also suggests that people who are infected with HIV and use co***ne and are infected with HIV may be at also increased their risk for co-infection with contracting hepatitis C, a virus that affects the liver, even if they do not inject drugs. Read more about the connection between co***ne and these diseases in NIDA's Co***ne Research Report: www.drugabuse.gov/publications/research-reports/co***ne.
Can a person overdose on co***ne?
Yes, a person can overdose on co***ne. An overdose occurs when the person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death. An overdose can be intentional or unintentional.
Death from overdose can occur on the first use of co***ne or unexpectedly thereafter. Many people who use co***ne also drink alcohol at the same time, which is particularly risky and can lead to overdose. Others mix co***ne with he**in, another dangerous—and deadly—combination.
Some of the most frequent and severe health consequences leading to overdose involve the heart and blood vessels, including irregular heart rhythm and heart attacks, and the nerves, including seizures and strokes.
How can a co***ne overdose be treated?
Because co***ne overdose often leads to a heart attack, stroke, or seizure, first responders and emergency room doctors try to treat the overdose by treating these conditions, with the intent of:
restoring blood flow to the heart (heart attack)
restoring oxygen-rich blood supply to the affected part of the brain (stroke)
stopping the seizure
How does co***ne use lead to addiction?
As with other drugs, repeated use of co***ne can cause long-term changes in the brain’s reward circuit and other brain systems, which may lead to addiction. The reward circuit eventually adapts to the excess dopamine brought on by the drug. As a result, people take stronger and more frequent doses to achieve the same high and feel relief from initial withdrawal. Withdrawal symptoms include:
depression
fatigue
increased appetite
unpleasant dreams and insomnia
slowed thinking
How can people get treatment for co***ne addiction?
Behavioral therapy may be used to treat co***ne addiction. Examples include:
cognitive-behavioral therapy
contingency management, or motivational incentives—providing rewards to patients who remain substance free
therapeutic communities—drug-free residences in which people in recovery from substance use disorders help each other to understand and change their behaviors
While no government-approved medicines are currently available to treat co***ne addiction, researchers are testing some treatments, including:
disulfiram (used to treat alcoholism)
modanifil (used to treat narcolepsy—a disorder characterized by uncontrollable episodes of deep sleep)
lorcaserin (used to treat obesity)
Points to Remember
Co***ne is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America.
Street dealers often mix it with things like cornstarch, talcum powder, or flour to increase profits. They may also mix it with other drugs such as the stimulant amphetamine.
People snort co***ne powder through the nose, or rub it into their gums. Others dissolve it in water and inject it or inject a combination of co***ne and he**in, called a Speedball. Another popular method of use is to smoke Crack co***ne.
Co***ne increases levels of the natural chemical messenger dopamine in brain circuits controlling pleasure and movement. This flood of dopamine ultimately disrupts normal brain communication and causes co***ne's high.
Short-term effects include:
constricted blood vessels
nausea
faster heartbeat
extreme happiness and energy
irritability
paranoia
Long-term effects include:
nosebleeds
severe bowel decay
higher risk of contracting HIV, hepatitis C, and other bloodborne diseases
malnourishment
restlessness
severe paranoia with auditory hallucinations
A person can overdose on co***ne, which can lead to death.
Behavioral therapy may be used to treat co***ne addiction.
While no government-approved medicines are currently available to treat co***ne addiction, researchers are testing some treatments.
Photo by ©iStock.com/Rafal Cichawa
