Fortunately, scientists have figured out how cocaine works, which will help them discover treatments for cocaine addiction. Right now, there are talk therapies that can help, but someday there may be medications as well.
- Associated Drug of Abuse:Publication from NIDA:No
There’s still a lot that scientists don’t know about the effects of cocaine on the brain. Maybe someday you’ll make the next big discovery. Until then, join me—Sara Bellum—in the other magazines in my series, as we explore how drugs affect the brain and nervous system.
Mind Over Matter is produced by the National Institute on Drug Abuse, National Institutes of Health. These materials are in the public domain and may be reproduced without permission. Citation of the source is appreciated. NIH Publication No. 03-3857. Printed 1997. Reprinted 1998, 2000, 2003.Publication from NIDA:No
All materials appearing in the Research Reports series are in the public domain and may be reproduced without permission from NIDA. Citation of the source is appreciated.Publication from NIDA:Yes
Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. It produces short-term euphoria, energy, and talkativeness in addition to potentially dangerous physical effects like raising heart rate and blood pressure.
How Is Cocaine Used?
The powdered form of cocaine is either inhaled through the nose (snorted), where it is absorbed through the nasal tissue, or dissolved in water and injected into the bloodstream.
Crack is a form of cocaine that has been processed to make a rock crystal (also called “freebase cocaine”) that can be smoked. The crystal is heated to produce vapors that are absorbed into the blood-stream through the lungs. (The term “crack” refers to the crackling sound produced by the rock as it is heated.)
The intensity and duration of cocaine’s pleasurable effects depend on the way it is administered. Injecting or smoking cocaine delivers the drug rapidly into the bloodstream and brain, producing a quicker and stronger but shorter-lasting high than snorting. The high from snorting cocaine may last 15 to 30 minutes; the high from smoking may last 5 to 10 minutes.
In order to sustain their high, people who use cocaine often use the drug in a binge pattern—taking the drug repeatedly within a relatively short period of time, at increasingly higher doses. This practice can easily lead to addiction, a chronic relapsing disease caused by changes in the brain and characterized by uncontrollable drug-seeking no matter the consequences.
How Does Cocaine Affect the Brain?
Cocaine is a strong central nervous system stimulant that increases levels of the neurotransmitter dopamine in brain circuits regulating pleasure and movement.
Normally, dopamine is released by neurons in these circuits in response to potential rewards (like the smell of good food) and then recycled back into the cell that released it, thus shutting off the signal between neurons. Cocaine prevents the dopamine from being recycled, causing excessive amounts to build up in the synapse, or junction between neurons. This amplifies the dopamine signal and ultimately disrupts normal brain communication. It is this flood of dopamine that causes cocaine’s characteristic high.
With repeated use, cocaine can cause long-term changes in the brain’s reward system as well as other brain systems, which may lead to addiction. With repeated use, tolerance to cocaine also often develops; many cocaine abusers report that they seek but fail to achieve as much pleasure as they did from their first exposure. Some users will increase their dose in an attempt to intensify and prolong their high, but this can also increase the risk of adverse psychological or physiological effects.
What Are the Other Health Effects of Cocaine?
Cocaine affects the body in a variety of ways. It constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure. It can also cause headaches and gastrointestinal complications such as abdominal pain and nausea. Because cocaine tends to decrease appetite, chronic users can become malnourished as well.
Most seriously, people who use cocaine can suffer heart attacks or strokes, which may cause sudden death. Cocaine-related deaths are often a result of the heart stopping (cardiac arrest) followed by an arrest of breathing.
People who use cocaine also put themselves at risk for contracting HIV, even if they do not share needles or other drug paraphernalia. This is because cocaine intoxication impairs judgment and can lead to risky sexual behavior.
Some effects of cocaine depend on the method of taking it. Regular snorting of cocaine, for example, can lead to loss of the sense of smell, nosebleeds, problems with swallowing, hoarseness, and a chronically runny nose. Ingesting cocaine by the mouth can cause severe bowel gangrene as a result of reduced blood flow. Injecting cocaine can bring about severe allergic reactions and increased risk for contracting HIV, hepatitis C, and other blood-borne diseases.
Binge-patterned cocaine use may lead to irritability, restlessness, and anxiety. Cocaine abusers can also experience severe paranoia—a temporary state of full-blown paranoid psychosis—in which they lose touch with reality and experience auditory hallucinations.
Cocaine is more dangerous when combined with other drugs or alcohol (poly-drug use). For example, the combination of cocaine and heroin (known as a “speedball”) carries a particularly high risk of fatal overdose.
For additional information on cocaine, please refer to the following sources on NIDA’s Web site:Publication from NIDA:Yes
- English DrugPub ID:mi103Publication from NIDA:Yes
Cocaine is made from the leaf of the coca plant. It often comes in the form of a white powder that some people inhale through their nose. Another form of cocaine, known as crack, can be smoked.Spanish DrugPub ID:mi100sEnglish DrugPub ID:mi103Publication from NIDA:No
Hi, my name’s Sara Bellum. Welcome to my magazine series exploring the brain’s response to drugs. In this issue, we’ll investigate the fascinating facts about the drug cocaine, which is considered a stimulant.
Have you eaten any chocolate or drunk any soda lately? If you have, there’s a good chance you gave your body a dose of a stimulant—caffeine, which is also in coffee.
Eating or drinking a large amount of caffeine can make you feel jittery, nervous, or energetic. That’s because caffeine—like any stimulant—changes the way your brain works.
But caffeine is just a mild example of a stimulant. Many other stimulant drugs are much stronger—and some are illegal and very dangerous.
Cocaine is made from the leaf of the coca plant. It often comes in the form of a white powder that some people inhale through their nose. Another form of cocaine, known as crack, can be smoked.Publication from NIDA:No
Cocaine changes the way the brain works by changing the way nerve cells communicate. Nerve cells, called neurons, send messages to each other by releasing special chemicals called neurotransmitters. Neurotransmitters are able to work by attaching to key sites on neurons called receptors.
One of the neurotransmitters affected by cocaine is called dopamine. Dopamine is released by neurons in the limbic system—the part of the brain that controls feelings of pleasure.
Normally, once dopamine has attached to a nerve cell’s receptor and caused a change in the cell, it’s pumped back to the neuron that released it. But cocaine blocks the pump, called the dopamine transporter. Dopamine then builds up in the gap (synapse) between neurons.
The result: dopamine keeps affecting a nerve cell after it should have stopped. That’s why someone who uses cocaine feels an extra sense of pleasure for a short time.Publication from NIDA:No
Although cocaine may make someone feel pleasure for a while, later it can take away a person’s ability to feel pleasure from natural rewards, like a piece of chocolate or a good time with friends. Research suggests that long-term cocaine use may reduce the amount of dopamine or number of dopamine receptors in the brain. When this happens, nerve cells need more dopamine to function normally—or more drug to be able to feel pleasure.
If a long-term user of cocaine stops taking the drug, the person feels tired and sad, and experiences strong craving for the drug. These feelings can last for a long time, until the brain (and the person) recovers from addiction.Publication from NIDA:No
Cocaine causes the body’s blood vessels to become narrow, constricting the flow of blood. This is a problem. It forces the heart to work harder to pump blood through the body. (If you’ve ever tried squeezing into a tight pair of pants, then you know how hard it is for the heart to pump blood through narrowed blood vessels.)
When the heart works harder, it beats faster. It may work so hard that it temporarily loses its natural rhythm. This is called fibrillation, and it can be very dangerous because it stops the flow of blood through the body.
Many of cocaine’s effects on the heart are actually caused by cocaine’s impact on the brain—the body’s control center.Publication from NIDA:No
- November 06, 2014
Q: What do cocaine and bacteria have in common?
A: They both contaminate our cash.
While most of the dollar bills you come into contact with would test positive for cocaine, that doesn’t mean that they were used to snort cocaine. In fact, less than 1 percent of people age 12 or older even use the drug.
It happens because cocaine is a very fine powder that easily transfers from bill to bill. One bill with cocaine on it can contaminate an entire cash drawer or ATM. It’s a little like someone with a cold—if he or she sneezes on you, the chances are good that you’ll catch what the individual has.
But don’t worry. Your stash of cash has only a tiny amount of cocaine on it—not enough to get you high or cause you to fail a drug test.
And What About Bacteria?
Well, germaphobes beware—researchers from New York University found hundreds of different bacteria on dollar bills. In all, they identified over 3,000 different types of bacteria that caused pneumonia, food poisoning, and staph infections.
Want To Know What’s in Your Pocket?
Where’s George? allows users to enter and track dollar bills. It shows how far money can travel while it is in circulation.
So, the bottom line here is that money is dirty. And while cocaine is not likely to get on your skin from handling money, germs will. So, we suggest washing your hands frequently.
Sources for Infographic:
Biello, D. (2009 Aug 16). Cocaine contaminates majority of U.S. currency. Scientific American. Retrieved November 3, 2014, from http://www.scientificamerican.com/article/cocaine-contaminates-majority-of-american-currency/.
Carlton, J. (2014). The Dirty Money Project. Mapping NYC’s MetaGenome: A Research Project at New York University.
Oyler, J., Darwin, W.D., & Cone, E.J. (1996 Jul/Aug). Cocaine contamination of United States paper currency. Journal of Analytical Toxicology, 20(4):213–216. Retrieved November 3, 2014, from http://www.ncbi.nlm.nih.gov/pubmed/8835657.
Substance Abuse and Mental Health Services Administration. (2014 Sept). Results From the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863: Rockville, MD: SAMHSA. Retrieved November 3, 2014, from http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.htm.Categories:Drug Facts for TeensTags:CocaineComments posted to the Drugs & Health Blog are from the general public and may contain inaccurate information. They do not represent the views of NIDA or any other federal government entity.
Also known as: “coke,” “Coca,” “C,” “snow,” “flake,” “blow,” “bump,” “candy,” “Charlie,” “rock,” and “toot”
Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. Cocaine comes in two forms:
- Powder cocaine is a white powder (which scientists call a hydrochloride salt). Street dealers often 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 that causes you not to feel pain in a specific area of the body) and with other stimulants like amphetamines.
- Crack is a form of cocaine that has been processed to make a rock crystal that people smoke. The term “crack” refers to the cracking sound the rocks make when they are heated. To make crack, the powder cocaine is mixed with ammonia or baking soda and water and then heated to produce the crystal.
Powder cocaine can be snorted up the nose or mixed with water and injected with a needle. Sometimes, powder cocaine is rubbed onto gums or other tissues in the body. Crack is smoked in a small glass pipe. The crystal is heated to produce vapors that are absorbed into the blood through the lungs.
In order to keep the “high” going, people may take the drug repeatedly within a short period of time, at increasingly higher doses.
Stimulants like cocaine 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. These neurotransmitters attach to molecules on neurons called receptors. (Learn more about how neurotransmitters work.)
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 playing a video game. It is then recycled back into the cell that released it, thus shutting off the signal. Cocaine prevents the dopamine from being recycled, causing a buildup of the neurotransmitter in the brain. It is this flood of dopamine that causes cocaine’s high. The drug can cause a feeling of intense pleasure and increased energy.
With repeated use, stimulants can disrupt how the brain’s dopamine system works, reducing a person’s ability to feel any pleasure at all. People may try to make up for it by taking more and more of the drug to feel the same pleasure.
After the "high" of the cocaine wears off, many people experience a "crash" and feel tired or sad for days. They also experience a strong craving to take cocaine again to try to feel better.
Learn more about how the brain works and what happens when a person uses drugs.
The surge of dopamine in the brain affects the body in a variety of ways:
- Constricted blood vessels and dilated pupils
- Higher body temperature
- Higher blood pressure and faster heartbeat
- Feeling sick to the stomach
- Decreased appetite and, over time, a loss of weight
- Inability to sleep
- Increased risk of heart attack or stroke due to high blood pressure
- Increased risk of HIV because of impaired judgment leading to risky sexual behavior
- Strange, unpredictable behavior, panic attacks, or paranoid psychosis (losing touch with reality)
How cocaine is used leads to different physical problems. For example, regularly snorting cocaine can lead to a hoarse voice, 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. Injecting cocaine can increase a person’s risk of getting HIV, hepatitis C (a liver disease), and other diseases transmitted by blood contact.
Yes, repeated use can lead to addiction, a devastating brain disease where people can’t stop using drugs even when they really want to and even after it causes terrible consequences to their health and other parts of their lives. Using cocaine over and over can cause tolerance to the drug. This means that it takes more of the drug for the user to get the same high felt when first using it.
Because a cocaine high usually doesn't last very long, people take it again and again to try to keep feeling good. Once addicted, people who are trying to quit taking cocaine might:
- Act nervous and restless
- Feel very sad and tired
- Have bad dreams
- Not trust people and things around them
- Feel a strong need to take cocaine
The right treatment, however, can help an addicted person control their cravings and stop using cocaine.
Yes. In 2011, more than 4,600 people died from a cocaine overdose. Males are nearly three times more likely to die from a cocaine overdose than females.1
Cocaine can be deadly when taken in large doses or when mixed with other drugs or alcohol. Cocaine-related deaths are often a result of the heart stopping (cardiac arrest) followed by stopped breathing. Abusing cocaine with alcohol or other drugs increases these dangers, including the risk of overdose. For example, combining cocaine and heroin (known as a “speedball”) puts a person at higher risk of death from an overdose.
In rare instances, sudden death can occur on the first use of cocaine or soon after.
1Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2011 on CDC WONDER Online Database, released 2014. Available at http://wonder.cdc.gov.
For the most recent statistics on cocaine use among teens, see the results below from NIDA’s Monitoring the Future study.
Swipe left or right to scroll.
Monitoring the Future Study: Trends in Prevalence of Various Drugs for 8th Graders, 10th Graders, and 12th Graders; 2014 (in percent)* Drug Time Period 8th Graders 10th Graders 12th Graders Cocaine Lifetime 1.80 2.60 4.60 Past Year 1.00 1.50 2.60 Past Month 0.50 0.60 1.00 Crack Cocaine Lifetime 1.20 [1.00] 1.80 Past Year 0.70 [0.50] 1.10 Past Month 0.30 0.30 0.70
* Data in brackets indicate statistically significant change from the previous year.
For more statistics on teen drug use, see NIDA’s Monitoring the Future study.
If you or a friend are in crisis and need to speak with someone now, please call:
- National Suicide Prevention Lifeline at 1-800-273-TALK (they don't just talk about suicide—they cover a lot of issues and will help put you in touch with someone close by).
If you need information on treatment and where you can find it, you can call:
- Substance Abuse Treatment Facility Locator at 1-800-662-HELP or visit www.findtreatment.samhsa.gov.
For more information on how to help a friend or loved one, visit our Have a Drug Problem, Need Help? page.
- Commonly Abused Drugs Chart
- DrugFacts: Cocaine
- Mind Over Matter Teaching Guide and Series: Cocaine.
- NIDA Notes Articles: Cocaine
- NIDA Notes Articles: Stimulants
- Research Report Series: Cocaine
Statistics and Trends
Monitoring the Future (University of Michigan):
Substance Abuse and Mental Health Services Administration: