Cocaine

Cocaine is a powerfully addictive stimulant that directly affects the brain. Cocaine is not a new drug. In fact, it is one of the oldest known drugs. The pure chemical, cocaine hydrochloride, has been an abused substance for more than 100 years, and coca leaves, the source of cocaine, have been ingested for thousands of years.

Pure cocaine was first extracted from the leaf of the Erythroxylon coca bush, which grows primarily in Peru and Bolivia, in the mid-19th century. In the early 1900s, it became the main stimulant drug used in most of the tonics/elixirs that were developed to treat a wide variety of illnesses.

Cocaine abuse has a long history and is rooted into the drug culture in the U.S. It is an intense euphoric drug with strong addictive potential. With the increase in purity, the advent of the free-base form of the cocaine ("crack"), and its easy availability on the street, cocaine continues to burden both the law enforcement and health care systems in America.

The powdered, hydrochloride salt form of cocaine can be snorted or dissolved in water and injected. Crack is cocaine that has not been neutralized by an acid to make the hydrochloride salt. This form of cocaine comes in a rock crystal that can be heated and its vapors smoked. The term “crack” refers to the crackling sound heard when it is heated.

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STREET NAMES

Blow, nose candy, snowball, tornado, wicky stick, Perico (Spanish), Charlie, coke, snow, snow white, toot, girl, c-dust, flake and big-c.

SHORT-TERM EFFECTS

Cocaine’s effects appear almost immediately after a single dose, and disappear within a few minutes or hours. Taken in small amounts (up to 100 mg), cocaine usually makes the user feel euphoric, energetic, talkative, and mentally alert, especially to the sensations of sight, sound, and touch. It can also temporarily decrease the need for food and sleep. Some users find that the drug helps them perform simple physical and intellectual tasks more quickly, while others experience the opposite effect.

The duration of cocaine’s immediate euphoric effects depends upon the route of administration. The faster the absorption, the more intense the high. Also, the faster the absorption, the shorter the duration of action. The high from snorting is relatively slow in onset, and may last 15 to 30 minutes, while that from smoking may last 5 to 10 minutes.

The short-term physiological effects of cocaine include constricted blood vessels; dilated pupils; and increased temperature, heart rate, and blood pressure. Large amounts (several hundred milligrams or more) intensify the user’s high, but may also lead to bizarre, erratic, and violent behavior. These users may experience tremors, vertigo, muscle twitches, paranoia, or, with repeated doses, a toxic reaction closely resembling amphetamine poisoning. Some users of cocaine report feelings of restlessness, irritability, and anxiety. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest.

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LONG-TERM EFFECTS

Cocaine is a powerfully addictive drug. Thus, an individual may have difficulty predicting or controlling the extent to which he or she will continue to want or use the drug. Cocaine’s stimulant and addictive effects are thought to be primarily a result of its ability to inhibit the reabsorption of dopamine by nerve cells. Dopamine is released as part of the brain’s reward system, and is either directly or indirectly involved in the addictive properties of every major drug of abuse.

An appreciable tolerance to cocaine’s high may develop, with many addicts reporting that they seek but fail to achieve as much pleasure as they did from their first experience. Some users will frequently increase their doses to intensify and prolong the euphoric effects. While tolerance to the high can occur, users can also become more sensitive (sensitization) to cocaine’s anesthetic and convulsant effects, without increasing the dose taken. This increased sensitivity may explain some deaths occurring after apparently low doses of cocaine.

Use of cocaine in a binge, during which the drug is taken repeatedly and at increasingly high doses, leads to a state of increasing irritability, restlessness, and paranoia. This may result in a full-blown paranoid psychosis, in which the individual loses touch with reality and experiences auditory hallucinations.

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TRAFFICKING TRENDS

The amount of cocaine available in domestic drug markets appears to meet user demand in most markets, without observable shortfall. However, recent ONDCP analysis of data from February through September 2005 shows that the purity of available cocaine could be diminishing at the retail level--reflecting decreases in potential worldwide cocaine production and significant increases in cocaine interdiction.

Mexican DTOs and criminal groups control most wholesale cocaine distribution in the United States, and their control is increasing. According to federal, state, and local law enforcement reporting, Mexican DTOs and criminal groups are the predominant wholesale cocaine distributors in the Great Lakes, Pacific, Southeast, Southwest, and West Central Regions, and although Colombian and Dominican criminal groups control most wholesale distribution in the Northeast and Florida/Caribbean Regions, wholesale distribution by Mexican DTOs and criminal groups is increasing. For example, the Drug Enforcement Administration (DEA) New York Field Division reported in 2005 that in some areas of New York City, Mexican criminal groups have supplanted Colombian criminal groups as the primary source of multikilogram-quantities of cocaine. Similarly, the Central Florida High Intensity Drug Trafficking Area (HIDTA) recently reported that in some areas of central Florida, Mexican DTOs and criminal groups have supplanted Colombian and Dominican criminal groups as the predominant wholesale cocaine distributors and are establishing new distribution networks.

Control over wholesale cocaine distribution by Mexican DTOs and criminal groups has been increasing for several years and is likely to continue to increase in the near term. Cocaine transportation data indicate that most cocaine available in U.S. drug markets is smuggled into the country via the U.S.-Mexico border. As Mexican DTOs and criminal groups control an increasing percentage of the cocaine smuggled into the country, their influence over wholesale distribution will rise even in areas previously controlled by other groups, including areas of the Northeast and Florida/Caribbean Regions.

Cocaine is distributed in nearly every large and midsize city; however, analysis of cocaine seizure data indicates that several specific cities serve as national-level cocaine distribution centers through which most domestic cocaine flows. Midlevel and retail-level distribution of the drug in these and most other cities is controlled primarily by organized gangs; however, in smaller cities and rural communities retail distribution typically is controlled by local independent dealers.

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USE/USER POPULATION

2005 rates of cocaine use were relatively high, and overall, use appears to be stable. According to the National Survey on Drug Use and Health (NSDUH), the rate of past year use for cocaine (powder and crack combined) among individuals aged 12 and older (2.4%) has remained stable since 2002; it is much lower than that for marijuana (10.6%), but is higher than that for methamphetamine (0.6%) or heroin (0.2%). Among adults, NSDUH data show that rates of past year use for cocaine (powder and crack combined) among young adults (aged 18 to 25) are stable but remain the highest among all age groups. Monitoring the Future (MTF) and NSDUH also indicate stable rates of adolescent cocaine use. The number of treatment admissions to publicly funded treatment facilities for cocaine has decreased since the mid-1990s despite increased access to drug treatment. Cocaine is the only major drug of abuse for which treatment admissions have decreased.

Among students surveyed as part of the 2005 Monitoring the Future study, 3.7% of eighth graders, 5.2% of tenth graders, and 8.0% of twelfth graders reported lifetime use of cocaine. In 2004, these percentages were 3.4%, 5.4%, and 8.1%, respectively.

According to the National Survey on Drug Use and Health (NSDUH, 2004), 34.15 million Americans ages 12 and older (14.7% of this age group) had used cocaine once in their lifetime and 2.0 million were current users of cocaine in 2004. The new initiates of cocaine abuse were about 1 million in 2004. According to the Monitoring the Future Study (MTF, 2005), the percentages of eighth, tenth and twelfth graders reported using cocaine once in their life time were 3.7, 5.2 and 8.0, respectively, while the corresponding numbers for the current cocaine users (used in the past month) were 1.0, 1.5 and 2.3, respectively. Cocaine abuse occurs in both genders and among all ethnic groups of the U.S.

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