NIDA for Teens: The Science Behind Drug Abuse
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  • 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.

  • The NIDA Blog Team

    The Super Bowl is only a few days away. From the game itself to the halftime show to the commercials (of course!), the event has something for everyone. Most people who tune in, however, won’t realize that behind the scenes, a different competition is going on: the National Football League (NFL) vs. drug use.

    Some NFL players may abuse prescription drugs to cover up the pain that can result from football-related injuries. Or they may take performance-enhancing drugs (PEDs), like anabolic steroids, trying to make themselves stronger and (they hope) play a better game.

    The NFL’s drug policy—which it developed along with the NFL Players’ Association (NFLPA)—takes a stand against PEDs as well as other substances. But the policy doesn’t score with some critics, who think it isn’t strict enough.

    No illegal kicks

    The League bans players from using, possessing, or distributing drugs like cocaine, marijuana, painkillers such as opioids, MDMA (Molly or Ecstasy), and PCP. Amphetamines are also banned unless the player has a genuine, proven need to use them for a medical condition. The policy also covers alcohol use that’s associated with breaking the law: for instance, failing an alcohol breath test.

    In 2014, the NFL and NFLPA agreed on a separate policy for PEDs. It bans players’ use of anabolic steroids, stimulants, human or animal growth hormones, and related PEDs.

    NFL players are tested for drugs at certain points throughout the season, and again at other times if a player fails a drug test, or is arrested in connection with drug use, or shows signs of drug abuse.

    Time to move the goalposts?

    If a player violates the NFL’s drug policy once, he receives 90 days of treatment and the unannounced testing. Second-time violators get two years of treatment and testing, plus a four-game suspension if they don’t stick with the treatment or they test positive. Three-time offenders who don’t stay with treatment or who have a positive test for marijuana get a 10-game suspension, and a year-long ban from the League for using other drugs.

    People who think the NFL drug policy should be tougher point to players like Josh Gordon, the Cleveland Browns’ 24-year-old wide receiver, who has already faced four suspensions (two of them lasting a year each). And in 2014, there were 41 drug-related suspensions in the League—an all-time record—and the current season may break that record.

    A lot of people look up to the players, and critics worry that when so many NFL players are violating drug policy, it sends a bad message. The League may or may not “move the goalposts” for players who use drugs—but either way, the consequences for those players are a reminder that using banned or illegal drugs for any reason is a losing game.

    Comments 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.
  • 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.

  • 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.

  • 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.

  • 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.

  • The NIDA Blog Team

    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.

    Graphic of text saying, "Q: What do cocaine and bacteria have in common? A: They both contaminate our cash.”  Below that, text says, “Nearly 9 out of 10 dollar bills in the United States test positive for cocaine residue. The amount of cocaine found on money is usually minuscule—a nanogram to a milligram.” Beside the text is a graphic of 10, one-dollar bills with 9 of them containing red marks. Below that, text says, “Yet, less than 1% of people age 12 and older are using cocaine.” Beside the text is a graphic of 100 people and only 1 is colored red. Below that is a graphic of a person at an ATM with text beside it that says, “Cocaine is a very fine powder that easily transfers from one bill to another. It only takes one dollar that has any trace of cocaine to contaminate an entire ATM.” Below that, text says, “Researchers have identified more than 3,000 different types of bacteria on dollar bills.” Beside the text is a graphic of a one-dollar bill with a close-up of bacteria. Below that, text says, “Just another good reason to wash your hands!” Beside the text is a graphic of hands washing and a red check-mark.

    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

    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

    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

    Comments 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.
  • 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.

  • 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.

  • Describes the latest research findings on cocaine, exploring the scope of abuse in the U.S., its potential long- and short-term health effects, maternal cocaine use, and treatment approaches.

  • Provides basic facts about cocaine, including how it affects the brain, other health consequences of its use, treatment options, and statistics on cocaine abuse.

  • Explores with young teens how cocaine changes the way nerve cells communicate in the brain and the negative effects the drug can have on the body.

  • The first in a 5-part series, offers an understanding of the brain, how the reward center works, and what happens in the brain when a person uses cocaine, opiates (heroine), or marijuana.

  • Jeremy Waletzky, M.D.

    Every year since 2003, NIDA has honored a young career scientist with the Society for Neuroscience Jacob P. Waletzky Memorial Award for Innovative Research in Drug Addiction and Alcoholism. This award would not be possible without the generosity of the Waletzky family, who, in memory of their son Jacob, wanted to recognize research contributions in this area. We have asked his father, Dr. Jeremy Waletzky, to share some thoughts about their family’s experience with the disease of addiction.

    My son Jacob, age 29, graduated from Yale, and at Columbia University he finished his Master of Fine Arts in writing fiction (stories and novels). Jacob won a literary prize for his work. Ironically, the prize was established to honor the memory of a former student who died from a heroin overdose. I remember telling Jacob, “You better not follow in his footsteps!”

    Jacob had everything going for him. But for more than five years, he was plagued by a speedball (cocaine and heroin) addiction.

    Jacob completed a four-week inpatient program at Hazelden Addiction Center and was drug-free for five months. He was proud of his sobriety.

    That all ended May 20, 2001—the worst day of my life. A call from Jacob's girlfriend: “Dr. Waletzky, I've got some horrible news. Jacob is dead.” I heard myself saying, “Maybe he's just asleep and he’ll wake up.” She said, “No, he's dead. I'm waiting for the medical examiner.”

    I got on the next plane to New York, and when I arrived, Jacob was lying on the floor of his apartment covered by an old blanket. I didn't lift it. I didn't want to see his dead face.

    The night before the memorial service, 30 of Jacob's friends were invited to attend a dinner we hosted. That evening, seven friends claimed him as their best friend. More than 400 people attended his service.

    Jacob's mother and I wanted to do something positive to commemorate his life. I knew that if there had been a treatment that worked, Jacob would have used it. He’d had several treatments that helped some—but he was still dead. I’m a psychiatrist and an expert in using medication for people who are depressed or anxious. I think we might improve treatment for drug abuse with neuroscience: the scientific study of nerves, and especially how nerves affect learning and behavior.

    We decided to establish an award in Jacob's name, in hopes it would make more people aware of addiction research. In 2003, the Society for Neuroscience began to give out the award every year to a young scientist who has already made important discoveries that improve our understanding of drug addiction.

    Dr. Nora Volkow, director of NIDA, has invited the award winner to speak at the Society of Neuroscience each year. When she introduces the winner, Nora shows Jacob’s photograph to the audience on big screens. I always start to cry.

    In a dream one night, Jacob appeared to me and said everything would be all right. As time has passed, I can focus less on the day he died and celebrate his birthday instead. I know that the award has helped me accept his death, because something useful has come from the tragic end to his life.

    Get more information on the Jacob P. Waletzky Award from the Society for Neuroscience website.

    Comments 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.
  • What Is Cocaine?

    A pile of cocaine

    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.
  • How Is Cocaine Used?

    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.

  • How Does Cocaine Affect the Brain?

    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.

  • What Are the Other Effects of Cocaine?

    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
    • Restlessness
    • 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.

  • Can You Get Addicted to Cocaine?

    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.

  • Can You Die If You Use Cocaine?

    Yes. In 2014, more than 5,400 people died from a cocaine overdose. Males are much more likely to die in this way than are females. During the year, 3,900 males overdosed on cocaine, as compared with 1,500 females who died as a result of a cocaine overdose.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 1999-2014 on CDC WONDER Online Database, released 2015. Available at

  • How Many Teens Use Cocaine?

    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; 2015 (in percent)*
    Drug Time Period 8th Graders 10th Graders 12th Graders
    Cocaine Lifetime 1.60 2.70 4.00
    Past Year 0.90 1.80 2.50
    Past Month 0.50 0.80 1.10
    Crack Cocaine Lifetime 1.00 1.10 1.70
    Past Year 0.50 0.70 1.10
    Past Month 0.30 0.30 0.60

    * Data in brackets indicate statistically significant change from the previous year.

    Source: University of Michigan, Monitoring the Future Study

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

  • 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, 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:

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