Cocaine << koh KAYN >> is a powerful drug made from leaves of the coca shrub of South America. United States laws forbid the importation, manufacture, and use of cocaine for nonmedical purposes. But many people obtain it illegally and use it for its pleasurable effects. Repeated misuse can endanger users’ health and create a dependence on the drug.
Medical use of cocaine in the United States is extremely limited. A few surgeons prescribe cocaine as a local anesthetic (painkiller) during certain kinds of surgery. They prefer cocaine because, in addition to blocking pain sensations, it causes small arteries to tighten, thus reducing bleeding during surgery.
Many people take cocaine illegally in social settings, using it because their friends do. Most users of the drug seek the feeling of intense pleasure, known as a high, that occurs for a short period after taking cocaine.
Illegal cocaine is a white powder that consists of cocaine hydrochloride—the active ingredient—mixed with other compounds. It is most commonly taken by “snorting” a small amount into the nose, where it is absorbed through the nasal lining. Some cocaine users inject the drug into a vein to produce more rapid and powerful effects. Just as rapid and even stronger effects are obtained by smoking a type of cocaine called freebase. Cocaine is also smoked in a potent pellet form called crack. The injecting and the smoking of cocaine account for many drug-related medical emergencies.
Physical and psychological effects.
Cocaine is a stimulant—that is, it increases the activity of the nervous system. Cocaine causes sudden increases in heart rate and blood pressure. It also produces a feeling of euphoria (a sense of well-being). After taking cocaine, people feel alert and powerful, and their thinking seems better and clearer than usual. Occasionally, strong feelings of anxiety and fear occur instead of the expected high.
Cocaine can be extremely addictive. When the drug’s effects wear off, usually after 20 to 40 minutes, people often feel depressed and take another dose to try to regain the euphoria. Frequent users may come to feel that nothing is enjoyable without cocaine.
The long-term use of cocaine may cause some people to suffer depression or psychosis (severe mental breakdown), which makes them unrealistically suspicious or fearful. These symptoms may continue for weeks or months, even after a person has stopped using the drug.
History.
Indigenous (native) Andean peoples of South America have chewed coca leaves for thousands of years. This practice does not produce a high, but it does reduce fatigue and hunger, and it helps the Andeans work more effectively in the high altitude of the mountains.
A German scientist discovered how to extract cocaine from the coca leaves in the mid-1800’s. Many physicians at first considered it a miracle drug. During the late 1800’s, doctors prescribed cocaine for all sorts of physical and mental ailments, including exhaustion, depression, alcoholism, and morphine addiction. Many of the patent medicines of the day contained cocaine.
Overuse caused many people to become dependent on the drug. By the mid-1900’s, medical and nonmedical use of cocaine had become far less common. But during the 1970’s, claims of the drug’s harmlessness and exciting effects renewed the popularity of its illegal use.
As cocaine use increased, the number of cocaine-related problems also increased. The United States government began a “war on drugs,” which sought to reduce the illegal drug trade by requiring prison sentences for drug possession.
In the 1980’s, the federal government and many states passed laws that punished crack cocaine users more harshly than powder cocaine users. At the same time, law enforcement agencies were tasked with making more arrests for drug possession and sales. After the war on drugs began, nonviolent drug offenders crowded courtrooms, jails, and prisons, creating a burden on the criminal justice system. Black Americans were disproportionately affected, because crack cocaine, which brought harsher penalties, was more likely to be used by Black people, while powder cocaine was more likely to be used by white people. In 1980, about 145,000 African American men were in prison. Twenty-five years later, about four times as many were in prison. Social scientists attributed this increase to racial bias in antidrug policies.
Beginning in the 1990’s, illegal use of cocaine became less popular. In 2010, the U.S. Congress passed a law that brought federal sentences for crack cocaine in line with those for powder cocaine.
Cocaine use remains a public health concern. In the early 2010’s, drug overdoses began to kill greater numbers of cocaine users each year. Investigations revealed that much of the illegally sold cocaine in the United States was contaminated with fentanyl, an extremely powerful drug similar to heroin. Manufacturers of illegal drugs purposefully contaminate drugs with fentanyl to increase their potency. Many people die of overdoses because they take illegal drugs without knowing they contain fentanyl.
Today, more than 20,000 people die each year from drug overdoses involving cocaine. Government programs increasingly treat drug misuse as an epidemic of addiction rather than as a crime problem.
See also Addiction; Drug misuse.
