Cocaine is a psychostimulant drug of the tropane family, used for both its psychoactive and its topical anaesthetic properties. It is a naturally occurring alkaloid derived from coca leaf (leaf of the coca bush), which is widely grown (both naturally and commercially) in the mountainous climates of South America.
Mode of Action
Cocaine is a sympathomimetic psychostimulant. It produces its effects by increasing synaptic concentrations of dopamine, norepinephrine and serotonin; in large part via inhibition of monoamine transporters. Its anaesthetic effect is due to its sodium channel blocking properties.
On the illicit market, cocaine is available in various forms. Pure cocaine itself is typically a hydrochloride based salt (cocaine hydrochloride), a fine, white, flaky, crystalline powder. Street cocaine is rarely available in pure form, and may occur as the following:
Regular Powder - A semi-diluted cocaine hydrochloride powder. The powder is often taken by the intranasal route (snorted); dissolved in water and injected; or to a lesser extent smoked, but with limited success, as the hydrochloride powder only vaporizes at the high temp of 197 celsius and is largely destroyed at this temperature. Cocaine hydrochloride has been taken orally in capsule or parachute form, or applied to the genitals (tip of the penis or trans-vaginally) for surface absorbtion. Diluting agents often present in powder cocaine include baking soda, sugars, and local anaesthetics, the latter of which help enhance the products numbing properties and give the illusion of greater purity.
Crack - Crack cocaine is a crude form of cocaine base, most often smoked. It has a higher purity than cocaine powder but less so than freebase - crack is sometimes referred to as "dirty base". Crack is produced via neutralization of cocaine hydrochloride in the presence of sodium bicarbonate (baking soda) and water, when heated. The process is so simple that many users produce their own. The final product is an off white solid, usually with a waxy or soap-like quality (in fact, bar soap has frequently been sold as crack); consisting of a mixture of cocaine base, sodium carbonate, water and other impurities. Its name is rooted in the fact that it makes a distinct crackling sound when heated and smoked.
Cocaine is short acting drug. Effects generally last 15 to 30 minutes (or longer), depending on the route of administration.
Oral - Orally administered cocaine takes effect after 30-40 minutes and peaks after an hour. Oral use provides the longest duration of effects, but only a portion of an oral dose is absorbed systemically.
Intranasal - Snorted cocaine takes effect relatively quickly; about 5 to 10 minutes is common. About 30-60% of a given dose is absorbed by this route; higher doses and higher concentration lead to better absorbtion. Effects peak aft around 15 minutes and last 30-45 minutes.
Inhalation: Smoking cocaine is the fastest way to get the drug to the brain. It offers a high bioavailability as well (~70%). Effects are felt in seconds, and peak subjective effects have been reported after 1-2 minutes of inhalation - the result is intense and shortlived, lasting only 10-15 minutes. Smoked cocaine, espcially freebase, is believed to be cardiotoxic.
Trans-Tissue Absorbtion: Cocaine may be applied to one of a number of body surfaces for absorbtion. It is often taken this way for its local anaesthetic properties. Users have applied cocaine to the genitals (tip of the penis or vaginally), or to the gums, inner cheek or tounge. Some who apply the drug to the genitals do so to enhance or otherwise affect sexual intercourse and orgasm.
Acute effects of cocaine are similar to other psychostimulants.
Increased alertness and wakefulness.
Increased mental clarity.
Euphoria, a sense of well being.
Increased self confidence.
Talkativeness and sociability.
Feelings of empathy or affection toward others.
Cocaine arouses the sympathetic nervous system and excites the hypothalamic pituitary adrenal axis. This leads to a fight or flight like state, characterized by increased heart rate, dilated pupils, tunnel vision, vasodilation in vital areas w/ vasoconstriction in nonvital areas, and increased skeletal muscle tone.
Cocaine toxicity can be life threatening. Acute adverse effects include anxiety and panic attack, stimulant psychosis, palpitations, high blood pressure, increased heart rate, cardiac arrhythmias, cardiac arrest and death.
Adverse effects of chronic use include tolerance, psychological dependence, chemical imbalance, loss of appetite, and potential for precipitation of underlying psychotic disorders. Being known to potentiate the mesolimbic dopamine pathways, similar to other rewarding and reinforcing drugs, heavy cocaine use is often associated with addiction. On the other hand, cocaine does not produce the level of physical dependence associated with other drugs such as narcotics and sedative-hypnotics. Cocaine withdrawal is for the most part psychological in nature, and characterized by depression, cravings for cocaine, insatiable appetite, fatigue, amotivation, and oversleeping.
The limbic system may take some time to restore itself, leading to a protracted state of anhedonia (i.e. an inability to experience pleasure), a form of post acute withdrawal syndrome which is common particularly with psychodependence (i.e. "addiction").