What is Cocaine?

A popular party drug, cocaine is the second most used drug in the UK, after cannabis. For many, the drug is an occasional recreational habit, which has been normalised to a certain extent, though for some, cocaine dependency is dictating their lifestyle.

What is cocaine?

Cocaine, chemically formulated as C17H21NO4, is a stimulant drug, deriving from the two species of coca leaves found predominantly in South America: Erythroxylum and Erythroxylum novogranatense. Cocaine is extremely powerful as a stimulant and possesses highly addictive qualities.

However, cocaine as we know it today in the UK, as a Class A illegal drug, has organic roots. It was, and still is, used by the indigenous people of South America for thousands of years in its raw coca leaf form, with inhabitants chewing it for its stimulant effects, as well as for numbing effects to carry out early surgical procedures.

It was not until the arrival of the Spanish that the leaf was outlawed, until they realised that the indigenous people could scarcely function without it. As they needed labour for their mines, they reinstated growth and use of the leaf, after which they began to accept the coca leaf as tax payments. The history of the coca leaf does not start here, however, with the coca leaf being archaeologically documented as far back as 5000 BC.

Only just over a century ago was cocaine hydrochloride, the powdered form of cocaine, chemically isolated from the leaf, and mainly used in different medications to treat illnesses, and as an anaesthetic due to its nerve-blocking, numbing effects. From the 19th century, it was used to treat toothache, dandruff and other ailments, as well as being used in cigarettes and, of course, in the original recipe for Coca-Cola.

Today, the effects of cocaine as a brain chemical altering drug, combined with its widespread recreational use, have led to it being classified as illegal for individuals or groups to sell, possess, manufacture, import or trade by the Misuse of Drugs Act 1971. It is legal to manufacture cocaine for medical use, as it is still used in anaesthesia and for vasoconstriction.

The Customs and Excise Management Act states that the importation of any drug that is controlled, such as cocaine, is illegal unless a particular licence has been granted by the Home Office. Nevertheless, the estimated street value of cocaine in London alone is over £1 billion per year, and, despite possession of the drug carrying a sentence of up to 7 years imprisonment, and one gram of cocaine costing anywhere up to £90, the addictive substance is highly sought after and used.

Some colloquial names for cocaine include ‘coke’, ‘Charlie’, ‘ching’, ‘blow’, ‘snow’, ‘bump’, ‘chang’, ‘bernice’, ‘white’, ‘dust’, ‘sugar’, ‘crack’, ‘china white’ and ‘rock’. Cocaine can be snorted, which is the most common form of ingestion, inhaled as a vapour, injected, applied to the mouth and dissolved.

Can cocaine be addictive?

There is a debate to understand whether cocaine itself is addictive or whether the body becomes dependent on the effects of the drug. Addiction is described as a neuropsychological disorder, where one has the extreme impulse to use a drug or participate in a particular behaviour, in spite of the risks that may present. Addiction is cited as a change in brain structure, which then leads to dependence, altering the release of neurotransmitters in the brain.

As the individual engages more and more with the substance or behaviour, the brain becomes unable to release substances such as serotonin and dopamine by itself, thus it becomes dependent upon the substance or behaviour.

Cocaine is known to be addictive, as it exhibits neurological effects that alter the brain’s structure. People who are addicted to cocaine require the drug to feel ‘normal’, becoming dependent on the mental and physical effects of the drug, such as high energy levels, increased self-confidence and appetite suppression. The effects of cocaine are fast-acting, with an onset of as quick as 5 minutes, and can last up to an hour. Some people binge on cocaine for prolonged effects, due to how quickly the euphoria wears off.

Use of cocaine is common, and the perceived positive effects it has can also be viewed as a way for people who have responsibilities to ‘let loose’, or for people who are shy and quiet to come out of their shells. Tolerance to the substance builds quickly, leading to the user taking more cocaine, more frequently, to get the same result.

Furthermore, cocaine is often mixed with other addictive substances, sometimes intentionally by the user, or by the person selling it. This can cause greater levels of addictions generally.

What is cocaine used for?

Cocaine is still used medically as a local anaesthetic solution. It is used topically in the mouth, nose and throat to create numbness. It is very unlikely in these doses to cause any addiction or dependence. Cocaine Hydrochloride solution is effective in restricting blood vessels in nasal, laryngeal and oesophageal procedures, to reduce blood loss.

Aside from this, cocaine is used recreationally, to create the effect of euphoria, amongst other stimulating effects.

How is cocaine abused?

Cocaine is abused in the following ways:

• Taking too much, or taking it too frequently. As mentioned, frequent and excessive use of cocaine can lead to the alteration of the brain’s structure and chemistry, which triggers tolerance and dependence.
• Taking cocaine with other substances. Cocaine abuse is often paired with alcohol dependency. Cocaine already puts the heart at significant risk, so combining this with the ingestion of alcohol can be dangerous and, at times, life-threatening. Alcohol combined with cocaine produces cocaethylene, which can lead to toxicity.
• Taking cocaine with heroin. This is particularly dangerous, as it becomes easy to overdose on heroin, due to the effects of the drug being offset by the effects of cocaine.
• Inhaling cocaine. Crack cocaine, also just referred to as ‘crack’ or ‘rock’, is a form of the drug that can be smoked or inhaled, and is sometimes mixed with ammonia. It can be very easy to overdose on this type of cocaine. People use this form of cocaine for a very quick high.

How does cocaine affect the body?

Cocaine triggers the release of dopamine, travelling between the cells of the brain. Usually, once dopamine has been released and used as intended, it is returned to the cell from which it originated, and used again. Whilst using cocaine, the dopamine does not recycle in this way, causing the brain to become over-stimulated, creating a ‘high’. From the time of taking cocaine, it affects the body in various ways, even if you have not taken a lot.

The ‘positive’ effects, and the reason people take cocaine, are as follows:

• Euphoria.
• Confidence.
• High self-esteem.
• Awareness.
• Alertness.
• Wakefulness.
• Increased energy.

Sometimes these effects can manifest into negative effects, such as having too much energy, and being restless.

What are the different forms of cocaine?

There are many different types of cocaine, all formulated to have similar but unique effects, and all ingested in different ways:

• Pure Cocaine
  Cocaine in its purest form is not infiltrated with other substances. This is a very rare form of cocaine, usually only seen in South America, as cocaine is usually bulked up with other substances for street selling
• Crack Cocaine
  This form of cocaine comes in rock form, and is usually smoked, but can sometimes be liquidised and injected. It is known to be particularly potent.
• Synthetic Cocaine
  Synthetic cocaine is manufactured, sometimes for medicinal purposes, but mostly for recreational use. The chemical structure is similar to that of amphetamine. Sometimes, synthetic cocaine is sold under the guise of being authentic cocaine, as a way for drug dealers to make more money.
• Cocaine Hydrochloride
  This form of cocaine is usually bolstered with talcum powder, sugar and starch, and is actually cocaine in its salt form.
• Fish Scale Cocaine
  This type of cocaine is high quality, and appears flaky and shiny, like fish scales. The effects of fish scale cocaine are considered to be more slow forming, but can be more dangerous than other forms of cocaine.
• Black Cocaine
  Black cocaine is a blend of cocaine and other substances. The intention behind the formulation of black cocaine is for cocaine to be hidden, thus making it undetectable to sniffer dogs, and to trick drug tests.

Any other form of cocaine that is not white, so yellow, brown or grey in colour, should not be taken to be cocaine. Cocaine that is non-white is thought to be highly impure, or another substance entirely.

What are the risks of cocaine?

The negative effects of taking cocaine, particularly too much cocaine or too frequently, include:

• Insomnia.
• Frequent nosebleeds.
• Prolonged runny nose.
• Mood swings.
• Depression.
• Poor attention span.
• Poor decision-making.
• Irritability.
• Participating in other risky behaviours.
• Heart palpitations.
• Increased heart rate.
• High blood pressure.
• Sweating.
• Suppressed appetite
• Passing out.
• Dilated pupils.

More severe risks of taking cocaine include:

• Cardiovascular incidences. These include heart attacks, strokes, high blood pressure and irregular heart rhythms, and blood clots, due to the vasoconstriction of the vessels in the brain and the body.
• Neurological incidences. This includes headaches, strokes and seizures.
• Some people can suddenly go into a coma.
• Sudden death.
• Allergic reaction.

Short-term and long-term effects of cocaine

The short-term effects of taking cocaine include:

• A brief ‘high’ or feeling of euphoria.
• A burst of energy.
• Being very talkative.
• Being alert.
• Sensitivity to sensory stimulants such as light and sound.
• Constricted blood vessels.
• Increased body temperature.
• Increased heart rate.

Long-term effects of taking cocaine include:

• Damage to the cardiovascular system, due to the vasoconstriction of the blood vessels. Taking cocaine can lead to permanent hypertension, muscle death (myocardial infarction) due to restricted oxygen flow to the tissue, chest pain and deep vein thrombosis. Heart attack is the leading cause of death for cocaine abusers.
• Nose and mouth damage. Snorting cocaine can cause the tissue in the nasal cavities to die, which then leaves the septal cartilage vulnerable and exposed, causing it to become damaged and die as well, which can cause the nose to collapse. This can also occur with the upper plate of the mouth.
• Damage to the gastrointestinal system. Again, due to vasoconstriction, cocaine can cause nausea, constipation and stomach pain, which, as time progresses, can become permanent. Furthermore, it can actually cause the tissue in the stomach to die. Prolonged cocaine use can overwhelm the liver with toxins, particularly if cocaine is used with alcohol. People who use cocaine long term are also at risk of kidney damage.
• Respiratory damage. Snorting cocaine can induce damage to the sinus cavities, though inhaling crack cocaine has the most damaging effect on the respiratory system. Due to vasoconstriction in the lungs, oxygen supply to the bloodstream becomes limited, and vessels become damaged. This can cause what is known as ‘crack lung’, which displays the following symptoms:
  – Chronic cough
  – Wheezing
  – Chest pain
  – Vulnerability to conditions such as tuberculosis, asthma, pneumonia.
• Brain damage. Limiting the supply of oxygen to the brain so frequently can cause the brain to shrink and can cause permanent damage to the prefrontal and temporal lobe, affecting memory, speech, decision-making and attention, and mood swings, and can cause bodily movement disorders. It also increases the risk of dementia.

What are the signs that someone is dependent on cocaine?

You may notice the following symptoms in someone who has developed or is developing dependence on cocaine:

• They are taking a large quantity of cocaine, perhaps increasing the amount over time.
• They cannot function normally without it.
• They are high on energy.
• They prioritise cocaine over their friends and their family.
• They are being physically affected by cocaine but still can’t stop taking it.
• They display impulsive behaviour.
• They are participating in other risky behaviours.
• They are found to be lying about who they are with, what they are doing and where they are.
• They steal or borrow money to buy cocaine.
• They do not know when the fun should stop – They often want to. keep the party going.
• They are developing an addiction to porn, or paying for sex.
• They are restless.
• They are depressed and irritable when they haven’t taken cocaine.
• They make bad decisions.
• They become confused.
• They experience psychosis.
• They do not sleep much.
• They do not eat much.

The following symptoms may occur in someone with a cocaine addiction, and should be treated immediately as life-threatening, and therefore treated as a medical emergency:

• Heart attack.
• Stroke.
• Excessive sweating.
• Seizure.

What are the treatments for cocaine addiction?

There is no ‘cure’ for addiction, in that the outcome for anyone trying to become drug independent will be different from person to person. Drug treatment for cocaine usually entails talking therapy, such as Cognitive Behavioural Therapy, which aims to help you gain control over your actions, and detox therapy, which will help you to manage withdrawal symptoms.

You may be able to stay at home whilst having treatment, but in extreme cases, you will be admitted to a drug rehab centre. Sometimes, people battling with cocaine addiction are offered incentives for abstaining from the drug.

Who can help?

The first place to seek help for cocaine addiction is with your GP, who can refer you to your local drug treatment service. You can also refer yourself to this service.

There are a number of charities and organisations that can help if you, or someone that you know, are addicted to cocaine:

• Narcotics Anonymous provides a UK-wide service that can help you to get off and stay off drugs such as cocaine. Their helpline runs from 10am to midnight.
• Frank offers free, 24-hour advice for anyone with a drug addiction, or concerned friends and family.
• Release provides support and advice, including legal advice for people battling with drug addictions.