Cocaine is one of the most addictive and powerful stimulants that exists today. Cocaine is made from naturally-occurring coca leaves found in South America, used for millennia by local inhabitants who chew the leaves to ingest organic stimulants. The isolated chemical compound that forms cocaine was used in a wide variety of medicinal solutions around the turn of the 20th Century, including in Coca-Cola. However, it didn’t take long for consumers and doctors alike to recognize the compound’s dangerously addictive nature and to notice that prolonged consumption would change a person’s brain chemistry. Nevertheless, cocaine continues to be one of the most widely-abused drugs in the country and in the world.
Crack is a variant of cocaine that has been treated with baking soda and chemically prepared to form crystals or “rocks.” It produces a stronger, faster-acting high and can be much more dangerous than its original form.
Cocaine and crack are Schedule II drugs in the United States.
Cocaine comes as fine white powder, similar in appearance to salt or sugar. Street cocaine may be cut or tempered with anything from amphetamines like Ritalin to sugar. The most common method by far for ingesting cocaine is to snort it. Some users inject it or smoke it. Snorting, smoking, or injecting cocaine takes several minutes for effects to appear and produces a quick high of 15-45 minutes. It’s common for users to continue to “re-up” over the course of a longer period, such as a night at a club or party, by taking small nasal doses or “bumps” off of spoons, keys, or fingernails. Other users may do long “lines” off of a smooth surface like a mirror, table, or someone’s body.
Similar to other stimulants, cocaine speeds up the brain’s functions, making a user feel more in control, talkative, funny, smart, fast-thinking, and powerful. Some users may feel aggression at higher doses.
Crack rocks vary in size, but are typically off-white or a pale yellow, and may have a strong chemical smell, especially when smoked, which is the primary method used to ingest the drug. Unlike cocaine, smoking crack produces immediate, powerful effects that last 5-10 minutes. A crack high is similar to a cocaine high, marked by bursts of intense energy, increased mental alertness, euphoria, aggression, and rapid speech.
Cocaine is also sometimes mixed with heroin and snorted, smoked, or injected; this is referred to as a speedball. This combination greatly increases a user’s chance of overdose and death.
Overdose occurs whenever a person takes enough of a drug to induce intense negative effects. Overdosing on cocaine and crack is a risk for every user, especially as a person’s tolerance increases, forcing them to use greater quantities to achieve the same highs. Smoking crack is especially risky; its high is so short-lived that many users repeatedly take larger doses in rapid succession before their body can get used to what’s happening.
Cocaine and crack overdose can lead to coma, convulsions, and death. Among the most frequent medical emergencies which result from cocaine overdose include problems in the heart, include heart attacks and tremors, and problems in the brain, include strokes, seizures, and coma. Crack especially can produce such a rapid heartbeat in such a short time that a person may experience irreversibly bodily damage or die. The urban legend that purports that some users die after their first use is far from fantasy; it’s rare, but not legendary, for someone to die suddenly from a stopped heart or brain spasm after their first time taking the drug.
Mixing cocaine with alcohol, opiates, or other stimulants compounds one’s risk of overdose. Some users combine cocaine with depressants like alcohol or heroin to counteract some of its harsher energetic effects, which makes it much harder to notice overdose symptoms and can quickly lead to medical complications.
After synthetic opioids, cocaine and crack rank at the top of overdose-related deaths in the United States in 2018, rating just as deadly as heroin and prescription opioids. A significant number of those fatalities are the result of users combining cocaine with opioids and the upward trend is mainly driven by the growing prevalence of fentanyl and related synthetic opioids. As fentanyl continues to spread throughout the country’s drug traffickers, the synthetic opioid has tainted cocaine, leading to widespread deaths among people who aren’t aware that they’re taking a much stronger drug than they expect.
Once the high wears off, cocaine and crack users find themselves lethargic, depressed, and feeling slow due to the chemical crash in the brain. These conditions make a person experience an intense desire to get high again, leading to a cycle of dependence and addiction. Cocaine and crack are incredibly addictive drugs and, because of the social component which often accompanies their use, it can be easy for a person to fall into a habit of addiction and only begin to realize that they might have a problem once it’s too late for them to stop on their own.
Other side effects can include insomnia, physical jitters and tremors, hoarseness and trouble speaking, bloodshot eyes, dilated pupils, antisocial behavior, lack of interest in work, school, and other personal involvements, and changes in personality. People whose loved ones use cocaine or crack have described feeling like they were living with a stranger. At higher doses, a person may experience increasingly intense mood swings, anger, restlessness, panic, paranoia, and psychosis.
Long-term cocaine use has been linked to Parkinson’s disease and other brain disorders. Research indicates that prolonged cocaine use can have a detrimental effect on a wide variety of brain functions, from memory to fine motor skills to decision making and more.
Chronic cocaine use can also alter your brain chemistry, leading you to make poor decisions, be unable to change behavior based on the negative consequences of addiction, and cause decreased self-awareness and understanding. Mood swings and personality changes may persist even after discontinuing drug use.
Cocaine and crack addiction form intense cravings which can cause even the most determined user to relapse. It is highly recommended that a person go through detox under medical supervision.
Acute withdrawal can begin hours after the last dose or days later, depending on a person’s level of dependency. Acute withdrawal symptoms can include nausea, vomiting, extreme fatigue, anxiety, depression, mood swings, bodily discomfort, inability to sleep, mental agitation, and suicidal ideation.
These symptoms typically last 1-3 weeks, depending on the individual, followed by post-acute withdrawal symptoms which may last for months or longer if untreated. Post-acute withdrawal may include depression, anxiety, intense cravings, lack of motivation, joylessness, feeling “greyed out,” social disinterest, mood swings, aggression, and insomnia.
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