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Thomas Christiansen
Thomas Christiansen

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Annie Tye
Annie Tye, PHD

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Updated on 12/28/22

Cocaine is an illicit drug that causes profound chemical and structural changes in the brain, leading to a self-reinforcing addiction that can be difficult to overcome. Learning about what cocaine is, how it is used and the common short- and long-term side effects that are associated with its use is key in understanding how the drug impacts people and causes addiction.

What is Cocaine?

Many people have heard of cocaine but may not be aware of what is cocaine made from. Cocaine is extracted from a South American plant (Erythroxylon coca), generally by soaking leaves in gasoline. The purified product, cocaine hydrochloride, is a white powder that can be pressed into brick form. Further chemical processing can convert powdered cocaine into a water-insoluble, crystalline product.

What type of drug is cocaine? Cocaine is a central nervous system stimulant. Although its use decreased somewhat since its peak in the 1970s and 1980s, it is still a popular drug that can have profoundly negative effects on people who take it. Additionally, cocaine may be combined with other drugs. For example, a recent spike in deaths was observed due to cocaine being diluted with the synthetic opioid fentanyl.

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What is Cocaine Used For?

Despite having been used as an anesthetic in the 20th century, cocaine has no valid medical use today. It is used as an illicit recreational drug and is highly addictive. People who use cocaine face serious legal, social and medical ramifications. Cocaine is a short-acting stimulant that affects the central nervous system by increasing dopamine levels in the brain. Under normal conditions, dopamine signaling in the brain indicates that a rewarding behavior has occurred — for example, drinking water when one is thirsty. Cocaine hijacks this reward circuit, which is how the substance exerts its addictive properties.

Frequent cocaine users cite increased energy levels or appetite/weight loss as reasons for use. However, the negative consequences of chronic cocaine use significantly outweigh any perceived benefit. Cocaine use offers no short- or long-term benefits.

Administration

There are several methods of administration for cocaine use, all of which are dangerous and can cause potentially irreparable physiological changes:

Snorting cocaine: Cocaine powder is commonly snorted through the nose, although it can also be dissolved in a liquid to be ingested orally or injected intravenously. 

Smoking cocaine: Cocaine can also be processed into a crystalline form, commonly known as crack, which is smoked alone or mixed with marijuana or tobacco.

What is Cocaine Cut With?

Cocaine is “cut”, or diluted, with other white powders, rendering the final product anywhere from 5% to 70% cocaine. Many cutting agents that are used to cut cocaine are relatively innocuous (laxatives, baking soda, talcum powder, cornstarch or flour), but cocaine is also routinely cut with other stimulants (caffeine, amphetamine) or with synthetic opioids (fentanyl), which increase the dangers associated with using cocaine. Cocaine may also be cut with levamisole, a deworming agent used by veterinarians.

Dealers routinely cut cocaine to increase profits, and cocaine that travels through many hands may be cut with several different compounds. It may be impossible for people to identify cutting agents and someone who uses cocaine may end up ingesting a lethal cocktail of unknown identity.

What Does Cocaine Look Like?

Pure cocaine looks like a fine, white powder. Drug traffickers will frequently press the powder into brick form, so it is common for hard-packed “rocks” of powdered cocaine to be purchased on the street. Before use, the crystalline rocks are crushed into powder. Prior to inhalation, powdered cocaine is shaped into lines (or rails) and straws or dollar bills are used to ingest the powder. Crack cocaine is a light brown, hard pellet that is not water-soluble.

Street Names for Cocaine

There is nearly an endless list of cocaine street names. Some common code names for cocaine include:

  • Coke
  • Snow
  • Flake
  • Blow
  • White
  • Powder
  • Rock
  • Dust
  • C.
  • Nose candy
  • Toot
  • White lady
  • Freebase
  • Crack

Cocaine Side Effects

Side effects of cocaine use are both physical and psychological. Different routes of administration may result in somewhat varied physical effects, but any cocaine use leads to potentially dangerous physical or psychological effects.

  • Physical Side Effects

    Snorting cocaine affects the central nervous system within a few minutes of use, causing the user to feel heightened energy levels, alertness and the perception of increased self-esteem. The effects of cocaine on the body are short-lasting, peaking around 15 to 20 minutes after use. Smoking cocaine has a more rapid onset of effects, but the duration of effects is shorter.

    Physical effects of cocaine include chronic nosebleeds, degradation of the nasal cavities, chronic sore throat and respiratory ailments, sleep disturbances, loss of appetite and headaches.

    Cocaine effects on the brain can occur after even short-term exposure, leading to physical changes in the brain and chronic use can cause substantial re-wiring of several pathways in the brain, further reinforcing the addictive nature of cocaine. Single overdoses or chronic cocaine use are associated with seizures.

    Cocaine also affects the cardiovascular system. Cocaine effects on the heart include heart attacks, which can result from a single overdose. Chronic users are at an increased risk for heart attack due to constant constriction of blood vessels (elevated blood pressure), requiring the heart to work harder to move blood through the body.

    Pregnant women who use cocaine are at risk for miscarriages or birth defects.

  • Psychological

    Cocaine use is associated with feelings of euphoria and increased self-esteem. However, cocaine use can also lead to profoundly negative psychological states, including feelings of paranoia, irritability, extreme anxiety and hypersensitivity. Large amounts of cocaine, or chronic use, can lead to erratic or violent behavior and hallucinations. Mood swings, changes in interests and motivation, and even suicidal tendencies are common psychological effects of cocaine use.

How Long Does Cocaine Stay in Your System?

Cocaine and its metabolites are generally not measurable by most tests for more than 48 hours after use, although heavy users may deliver positive tests for up to a week or more after the last use of cocaine. Hair follicle tests are an exception and can deliver positive results for several months. How long cocaine lasts in your system is somewhat dependent on the method of use, frequency of use and the individual’s metabolism.

Cocaine Detection Times

  • Blood

    Cocaine can stay in your blood for 12 hours and as metabolites for up to 48 hours.

  • Urine

    Cocaine can stay in your urine for two to three days, or up to two weeks with heavy cocaine use.

  • Hair

    Cocaine can stay in your hair for months.

  • Breastmilk

    Cocaine can stay in breastmilk for 24 to 36 hours. Cocaine use while breastfeeding can have profoundly negative effects on a baby. It is imperative that a mother seeks help if she is nursing and struggling with cocaine use.

  • Saliva

    Cocaine can stay in saliva for one to two days.

Is Cocaine Addictive?

Cocaine is addictive, with dependence potentially occurring after just a few uses. Addiction can develop within just a couple of weeks of routine use. The substantial effects that cocaine has on the brain lead to altered neural networks, causing people to seek cocaine at the expense of normal daily activities. Other signs of cocaine addiction include:

  • Signs of Cocaine Addiction

    Physical Signs:

    Dilated pupils

    Trembling or twitching

    Bloody nose

    Headaches

    Stomach aches

    Rapid pulse

    Elevated body temperature

    Behavioral Signs:

    High energy levels

    Short attention span

    Rapid speech

    Anxiety

    Mood swings

    Insomnia

    Paranoia

    Euphoria

    Elevated self-confidence

Cocaine addiction also poses the risk of overdose. Cocaine overdose can lead to a plethora of health side effects including heart disease, stroke and brain damage. Some symptoms of cocaine overdose are elevated heart rate, tremors, chest pains and difficulty breathing.

Cocaine addiction is physical and psychological. Withdrawal symptoms can be profoundly debilitating and often include intense cravings, insomnia, anxiety, irritability, depression or dysphoria and hypersensitivity. Some individuals who suffer from cocaine use disorder may forego food, water and safe shelter to get more cocaine. Once addiction takes hold, many people find quitting to be extremely difficult and require reliable medical and social support to stay sober. There are many quality sources of help and support for people who suffer from cocaine use disorder, and recovery is well within the realm of possibility for all users.

Related Topic: Cocaine Overdose

If you struggle with cocaine addiction, contact The Recovery Village Palm Beach at Baptist Health to speak with a representative about how addiction treatment can help you. By using a personalized treatment plan, The Recovery Village Palm Beach at Baptist Health works with you to determine which treatment is most beneficial to you. Take the first step toward a healthier future by calling today.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.