Cocaine

Street names: Blow, Coke, Crack

Revised February 2019

What is cocaine?

Photo of little baggies containing cocaine powder.©Shutterstock/Africa Studio

Also known as: Blow, Bump, C, Candy, Charlie, Coke, Crack, Flake, Rock, Snow, and Toot

Cocaine is an 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 stimulant drugs like amphetamines, or synthetic opioids, including fentanyl, which has caused deaths.
  • 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. 

How Cocaine Is Used

There are a few different ways that cocaine can enter the body: through the nose by snorting, and directly into the blood stream by injecting or rubbing it into gums above the teeth. The crystal of crack cocaine is heated in a glass pipe to produce vapors that are absorbed into the blood through the lungs.

What happens to your brain when you use cocaine?

All drugs 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.) Drugs affect this signaling process.

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. Normally, dopamine gets recycled back into the cell that released it, thus shutting off the signal. Stimulants like cocaine prevent the dopamine from being recycled, causing a buildup of the neurotransmitter in the brain. It is this flood of dopamine that reinforces taking cocaine, “training” the brain to repeat the behavior.  The drug can cause a feeling of intense pleasure and increased energy.

With repeated use, stimulants like cocaine can disrupt how the brain’s dopamine system works, reducing a person’s ability to feel pleasure from normal, everyday activities. People will often develop tolerance, which means they must take more of the drug to get the desired effect. If a person becomes addicted, they might take the drug just to feel “normal.”

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. And, check out how the brain responds to natural rewards and to drugs.

What happens to your body when you use cocaine?

Short-Term Effects

Cocaine is a stimulant so it gives the body a feeling of stimulation and alertness, which can be both pleasurable and harmful. Cocaine’s short-term effects appear quickly and disappear within a few minutes to an hour. How long and intense the effects are depends on the method of use. Here are some of the ways cocaine affects the body:

  • extreme happiness and energy
  • mental alertness
  • sensitivity to sight, sound, and touch
  • irritability
  • paranoia (feeling that people are out to get you)
  • constricted blood vessels and dilated pupils
  • higher body temperature
  • higher blood pressure and faster heartbeat, leading to higher risk of heart attack or stroke
  • feeling sick to the stomach
  • restlessness
  • decreased appetite and, over time, a loss of weight
  • inability to sleep

Long-Term Effects

The long-term effects of cocaine depend, in part, on the method of use and include the following:

  • snorting: loss of sense of smell, nosebleeds, nasal damage, and trouble swallowing
  • smoking: cough, asthma, and lung damage
  • consuming by mouth: damage to intestines (between the stomach and anus) caused by reduced blood flow
  • needle injection: higher risk for HIV and hepatitis (a liver disease) through shared needles (read more about the link between viral infections and drug use)
  • all methods: poor nutrition and weight loss

Can you overdose or die if you use cocaine?

Len Bias preparing to throw ball

Victim of Cocaine Overdose

One of the most famous victims of cocaine overdose is Len Bias, a senior at the University of Maryland, who had been drafted as the No. 2 pick by the Boston Celtics on June 17, 1986. Just 2 days later, he died from a cocaine overdose.

Yes. In, 2017, nearly 14,000 people died from a cocaine overdose. That's more than twice as many people who died in 2015 from a cocaine overdose. Males are much more likely to die in this way than are females.

Cocaine can be deadly when taken in large doses or when mixed with other drugs or alcohol. Cocaine-related deaths often happen because the heart stops (cardiac arrest), then breathing stops. Using cocaine and drinking alcohol or using 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. Among the deaths that occurred from cocaine use, most also included misuse of an opioid of some form, either a prescription pain reliever, heroin, or man-made opioids like fentanyl. Learn more about drug overdoses in youth.

Type of Opioid Involved in Cocaine-Related Overdose DeathsNational Drug Overdose Deaths Involving Cocaine, by Opioid Involvement–Number Among All Ages, 1999-2017. The figure above is a bar and line graph showing the total number of U.S. overdose deaths involving cocaine from 1999 to 2017. Drug overdose deaths involving cocaine rose from 3,822 in 1999 to 13,942 in 2017. The bars are overlaid by lines showing the number of deaths involving cocaine and any opioid, cocaine without any opioid, and cocaine and other synthetic narcotics. The number of deaths in combination with any opioid has been increasing steadily since 2014 and is mainly driven by deaths involving cocaine in combination with other synthetic narcotics (Source: CDC WONDER).

1 Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2017 on CDC WONDER Online Database, released 2018. Available at http://wonder.cdc.gov.

Is cocaine addictive?

Yes, repeated cocaine use can lead to addiction. Addiction is a devastating brain disease in which 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.

Because a cocaine high usually doesn't last very long, people take this drug again and again to try to keep feeling good. Once addicted, people who are trying to quit taking cocaine might experience withdrawal symptoms, including:

  • depression
  • feeling very tired
  • increased appetite
  • bad dreams and trouble sleeping
  • slowed thinking
  • restlessness

The right treatment, however, can help a person who is addicted control cravings and stop using cocaine.

How many teens use cocaine?

It is mostly adults who use cocaine, but there are a few teens who report that they have tried it. Repeated cocaine use can produce addiction and other adverse health consequences. According to results from the 2016 National Survey on Drug Use and Health, about 865,000 Americans met the criteria for dependence or abuse of cocaine (in any form) during the past 12 months.2

Below is a chart showing the percentage of teens who use cocaine.  

Swipe left or right to scroll.

Monitoring the Future Study: Trends in Prevalence of Various Drugs for 8th Graders, 10th Graders, and 12th Graders; 2018 (in percent)*
Drug Time Period 8th Graders 10th Graders 12th Graders
Cocaine Lifetime 1.40 2.60 3.90
Past Year 0.80 1.50 2.30
Past Month 0.30 0.60 1.10
Crack Cocaine Lifetime 0.90 1.00 1.50
Past Year 0.40 0.60 0.90
Past Month 0.20 0.30 0.50

For more statistics on teen drug use, see NIDA’s Monitoring the Future study.

2 Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm.

What should I do if someone I know needs help?

If you, or a friend, are in crisis and need to speak with someone now: 

  • Call the 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 want to help a friend, you can:

If a friend is using drugs, you might have to step away from the friendship for a while. It is important to protect your own mental health and not put yourself in situations where drugs are being used.

For more information on how to help a friend or loved one, visit our Have a Drug Problem, Need Help? page.

Blog Posts

Chat Day Transcripts

Infographics

See below for text description

Drug and Alcohol Use in College-Age Adults in 2015

Published: November 03, 2016
The 2015 Monitoring the Future College Students and Adults survey shows trends in the use of alcohol, marijuana, nicotine, cocaine, and other drugs in college students and non-college peers.
See below for text description

Drug and Alcohol Use in College-Age Adults in 2014

Published: December 21, 2015
The 2014 Monitoring the Future College Students and Adults survey shows trends in alcohol, marijuana, nicotine, and stimulant use in college students and non-college peers.
See text description below

Monitoring the Future 2015 Survey Results

Published: December 16, 2015
NIH’s 2015 Monitoring the Future survey shows long term decline in illicit drug use, prescription opioid abuse, cigarette and alcohol use among the nation’s youth.
Dirty Money and Cocaine

Dirty Money and Cocaine

Published: December 18, 2014
Dirty money: find out just how much of your cash may be soiled with cocaine and bacteria.
Content on this site is available for your use and may be reproduced in its entirety without permission from NIDA. Citation of the source is appreciated, using the following language: Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. HHS Syndication Storefront: Select NIDA content is available for you to use on your own site.  Through HHS Syndication Storefront, you may promote this high-quality content on your website and it will take on the look and feel of your site.  This syndicated content will also update content in real-time, leaving you free from having to perform manual updates.