Cocaine (benzoylmethylecgonine) is a potent stimulant drug that is extracted from the leaves of the coca plant. The coca plant is native to Central and South America.  According to the National Institute on Drug Abuse (NIDA), cocaine is generally used in two different forms: 
  • A water-soluble form that is a hydrochloride salt: This form is often snorted or injected. When it is snorted, it is used as a powder. When injected, it is diluted in water or some other liquid. 
  • A base or freebase form that is made by processing the cocaine extracted from coca leaves with baking soda or ammonia and water: It is then heated to remove the hydrochloride portion of the drug, and this produces a substance that can be smoked as crack or as a freebase form.  

Cocaine remains classified as a Schedule II controlled substance by the United States Drug Enforcement Administration, indicating that it does have some medicinal uses but is very tightly controlled, and its distribution is very limited. Cocaine is considered to be a drug that is extremely prone to abuse and can result in the development of significant physical and/or psychological dependence. One of the major risks of using cocaine is the development of a formal substance use disorder.

Other Substances in Cocaine

Cocaine purchased illegally is most often not pure. NIDA reports that a number of other substances are included in cocaine in order to “cut” or dilute it, and extend the profits received from sales. These substances can include: 

    • Mannitol, which is a diuretic 
    • Cornstarch  
    • Baking soda 
    • Sugar 
    • Powdered milk 
    • Talcum powder 
    • Boric acid 
    • Amphetamines or methamphetamine 
    • Lidocaine, benzocaine, or procaine (anesthetics)
    • Other substances including levamisole, which is a drug given to rid one of parasitic worms

Some of the additives in cocaine can obviously be dangerous. For example, the use of numbing agents such as lidocaine, can result in a toxic condition that can lead to seizures. There are rare cases where cocaine has been cut with extremely dangerous substances, such as poisons; however, these are very rare.

Effects of Cocaine Use

Cocaine is a particularly dangerous drug of abuse. Immediate effects of cocaine use include: 

  • A sense of euphoria 
  • Increased energy and even hyperactivity 
  • Decreased need for sleep 
  • A reduction in appetite 
  • Pressured speech 
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    NIDA reports some of the long-term risks of cocaine use to be: 

    • Loss of the sense of smell from snorting cocaine 
    • Frequent issues with nosebleeds or runny nose from snorting cocaine 
    • Severe decay of the intestines due to decreased blood flow (particularly in individuals who snort or swallow cocaine) 
    • Increased risk to contract hepatitis C, HIV, or other diseases as a result of injecting cocaine 
    • Increased probability to engage in a number of dangers and risky behaviors because of cocaine’s effect on judgment 
    • Because chronic use of cocaine results in significantly decreased appetite, a number of issues with nutritional deficiencies  
    • Increased risk of developing cardiovascular diseases, including high blood pressure, arteriosclerosis, heart disease including heart attack, and stroke 
    • Significant issues with dental health, such as accelerated tooth decay 
    • Increased risk for a number of neurological conditions, including Parkinson’s disease, Parkinsonism (some of the symptoms of Parkinson’s disease but not having enough symptoms to actually qualify for the disease), and dementia.  
    • Significant changes in the ability to concentrate, learn new information, and conceptualize abstract concepts 
    • A number of potential mental health issues, including the development of paranoid delusions (the belief that others are out to deceive or harm a person despite evidence to the contrary), the development of hallucinations (seeing or hearing things that are not really there), the development of issues with anxiety, and/or the development of clinical depression 
    • The development of a serious substance use disorder, bringing issues with relationships, career, finances, the law, and other aspects of life