Cocaine is a powerful stimulant. Stimulants are a class of drugs that can elevate mood, increase feelings of well-being, and increase energy and alertness, but they also have dangerous effects like raising heart rate and blood pressure.
Cocaine comes in two forms:
- Powder cocaine: Powder cocaine is a white powder (which scientists call a hydrochloride salt) made from the leaf of the coca plant. Street dealers generally mix cocaine with other substances like cornstarch, talcum powder, or sugar. They also mix cocaine with active drugs like procaine, a chemical that produces local anesthesia—a local anesthetic makes it so you don’t feel pain in a certain (local) area of the body— and with other stimulants like amphetamines.
- Crack: Crack comes in the form of small white rocks that are smokeable. It gets its name from the cracking sound the rocks make when they are heated. Crack is often processed with ammonia or baking soda and water, and heated to remove the chemical hydrochloride.
Cocaine is generally sold on the street as a fine, white powder, known as “coke,” “Coca,” “C,“ “snow,” “flake,“ “blow,” “bump,“ “candy,” “Charlie,” “rock,” and “toot.” A “speedball” is cocaine or crack combined with heroin, or crack and heroin smoked together.
Powder cocaine can be snorted up the nose or mixed with water and injected with a needle. Sometimes, powder cocaine is rubbed onto tissues, like the gums. Crack cocaine is smoked in a small glass pipe.
According to the 2012 Monitoring the Future study, a NIDA-funded survey of teens in grades 8, 10, and 12, the following percentages of 8th, 10th, and 12th graders had abused cocaine at least once in the past year:
- Powder cocaine: 1.0% of 8th graders, 1.8% of 10th graders, and 2.4% of 12th graders
- Crack cocaine: 0.6% of 8th graders, 0.8% of 10th graders, and 1.2% of 12th graders
Stimulants change the way the brain works by changing the way nerve cells communicate. Nerve cells, called neurons, send messages to each other by releasing chemicals called neurotransmitters. Neurotransmitters work by attaching to key sites on neurons called receptors.
Learn more about how neurotransmitters work in the section “How Does Your Brain Communicate?”
There are many neurotransmitters, but dopamine is the main one that makes people feel good when they do something they enjoy, like eating a piece of chocolate cake or riding a roller coaster. Stimulants cause a buildup of dopamine in the brain, which can make people who abuse stimulants feel intense pleasure and increased energy. They can also make people feel anxious and paranoid. And with repeated use, stimulants can disrupt the functioning of the brain’s dopamine system, dampening users’ ability to feel any pleasure at all. People may try to compensate by taking more and more of the drug to experience the same pleasure.
Cocaine increases the amount of dopamine in brain circuits that control movement and pleasure, making neurons (nerve cells) fire more. So for one thing, it can make you feel happy and excited, and you may talk, move, and think quickly. Cocaine also speeds up the rest of your body. Your heart beats faster, your body feels too hot, you might shake and twitch, and you don't sleep or eat much.
Your positive mood can also change. You can become angry, nervous, and afraid that someone's out to get you.
After the "high" of the cocaine wears off, you can "crash" and feel tired and sad for days. You also get a strong craving to take cocaine again to try to feel better.
Other effects include:
- Feelings of sickness: Cocaine can cause stomach pain and headaches. It can make you shake, throw up, or pass out.
- Decrease in appetite: Cocaine can make you not want to eat. Over time, you might lose a lot of weight and get sick.
- Risk for heart attack and stroke: Cocaine raises your blood pressure and makes your heart beat faster. This can hurt your heart and give you a heart attack or a stroke. A stroke is a brain injury from a blood clot. These cocaine effects can cause death.
- Risk for getting HIV/AIDS and hepatitis: People who inject cocaine can get HIV/AIDS and hepatitis if they share used needles. Hepatitis is a liver disease. People also get HIV by having unsafe sex. They may forget to use condoms because they're high on cocaine.
Repeatedly using cocaine can cause tolerance to the drug. This tolerance can cause people to take greater amounts or to use cocaine more often to get the same high. Such use of cocaine can lead to strange, unpredictable behavior. Some people who abuse cocaine experience panic attacks or episodes of full-blown paranoid psychosis, in which they lose touch with reality and hear sounds that aren’t there.
Different ways of using cocaine can produce different bad effects. For example, regularly snorting cocaine can lead to hoarseness, loss of the sense of smell, nosebleeds, and a constant runny nose. Cocaine taken by mouth can reduce blood flow in your intestines, leading to bowel problems.
Yes, it is easy to lose control over cocaine use and become addicted. People addicted to cocaine might take bigger doses or take it more often to get high. A cocaine high usually doesn't last very long, so people take it again and again to try to keep feeling good. When they stop using cocaine, people who are addicted feel strong cravings for the drug, so staying off it can be hard.
People who are trying to quit taking cocaine might:
- Act nervous and restless.
- Feel very sad and tired.
- Have bad dreams.
- Be suspicious of people and things around them.
- Feel a strong need to take cocaine.
Despite these challenges, treatment can help an addicted person control their cravings and stop using cocaine.
Yes. Like most drugs, cocaine can be deadly when taken in large doses or when mixed with other substances. Cocaine overdoses can lead to heart problems, strokes, increased body temperature, and convulsions, which if not treated immediately can result in death. Abusing cocaine along with alcohol increases these dangers, including the risk of overdose.
In rare instances, sudden death can occur on the first use of cocaine or unexpectedly soon after.
People who snort cocaine through their nose can get nosebleeds. They can even lose their sense of smell. Their nose may be runny all the time, like they always have a cold.
People who inject cocaine will have marks where the needle went in, usually on their arms.
Possibly. Scientists have found that if a woman takes cocaine during her pregnancy, her child may have subtle but significant problems later in life, including problems with attention and information processing—abilities that are important for success in school.
When someone has a drug problem, it's not always easy to know what to do. If someone you know is abusing cocaine, encourage him or her to talk to a parent, school guidance counselor, doctor or other trusted adult. There are also anonymous resources, such as the National Suicide Prevention Lifeline (1-800-273-TALK) and the Treatment Referral Helpline (1-800-662-HELP).
The National Suicide Prevention Lifeline (1-800-273-TALK) is a crisis hotline that can help with a lot of issues, not just suicide. For example, anyone who feels sad, hopeless, or suicidal; family and friends who are concerned about a loved one; or anyone interested in mental health treatment referrals can call this Lifeline. Callers are connected with a professional nearby who will talk with them about what they’re feeling or about concerns for family and friends.
In addition, the Treatment Referral Helpline (1-800-662-HELP)—offered by the Substance Abuse and Mental Health Services Administration—refers callers to treatment facilities, support groups, and other local organizations that can provide help for their specific need. You can also locate treatment centers in your state by going to www.samhsa.gov/treatment.