What is Cocaine?
Cocaine belongs to a group of drugs known as stimulants. Stimulants speed up the activity of the central nervous system – the messages going to and from the brain. Amphetamines (or speed) and nicotine are also stimulants.
Cocaine most commonly comes in the form of a white odourless powder called cocaine hydrochloride. It has a bitter, numbing taste. The powder is extracted from the leaves of the coca bush, found mainly in Peru and Bolivia. The extract is then processed with various chemicals.
How is it used?
Cocaine is inhaled (snorted) through the nose or injected. It is also smoked through a process known as freebasing – where the cocaine is converted to an alkaloid form (cocaine hydrochloride cannot be smoked due to the drug being destroyed at high temperatures).
‘Crack’ is a very pure form of freebase cocaine sold in the form of small crystals or rocks. It is smoked in pipes or in cigarettes, mixed with tobacco or marijuana. Crack has rarely been seen in Australia.
Like other illegally manufactured drugs, such as speed, there are no controls on factors such as the strength and hygiene of cocaine. Cocaine can be mixed or cut with other substances such as sugar, baking soda and talcum powder to increase profits. This increases the risk of experiencing harmful or unpleasant effects.
Cocaine was used as a local anaesthetic for eye, ear and throat surgery. Recently cocaine has been replaced with synthetic anaesthetics (e.g. lidocaine), but it continues to have limited use in certain surgical procedures.
C, coke, flake, nose candy, snow, dust, white, white lady, toot, crack, rock, freebase.
Cocaine use in Australia
- No deaths from cocaine use were recorded in 1997. 1
- In 1998, 4.3% of Australians reported having used cocaine at some stage in their life and 1.4% of the population had used it in the past 12 months. 1
- In 1998, the average age for first-time use of cocaine was 22.3 years. 1
- The use of cocaine was rare among secondary students. Only 4% of all students reported ever having used cocaine, and only 1-2% of students had used cocaine in the month prior to being surveyed. 2
1 1998 National Drug Strategy Household Survey, First results, August 1999, Australian Institute of Health and Welfare Canberra.
The effects of any drug (including cocaine) vary from person to person. It depends on many factors including an individual’s size, weight and health, how much and how the drug is taken, whether the person is used to taking it and whether other drugs are taken. It also depends on the environment in which the drug is used – for example, whether the person is alone, with others, or at a party.
Many people have experienced the following effects shortly after taking cocaine:
- physiological arousal, including increased body temperature and heart rate
- feelings of well-being
- decreased hunger
- poor concentration and judgement
- indifference to pain and fatigue
- feelings of great physical strength and mental capacity
- enlarged pupils
- sexual arousal
- unpredictable and/or violent behaviour.
When inhaled, the effects of cocaine peak after 15 to 30 minutes and then diminish.
In greater quatities
Using large quantities of cocaine repeatedly over a period of hours can lead to:
- extreme agitation
- nausea and vomiting
- unpredictable violent/aggressive behaviour
- loss of concentration
- loss of coordination
- loss of interest in sex
- loss of ambition and motivation
- heart pain
- heart attack
- may suffer from paranoid psychosis
- increased body temperature
- rapid irregular shallow breathing.
Overdose and death
The dosage and method of use that can cause cocaine overdose will vary from person to person. The effects of overdose are very intense and, generally, short in nature. Although uncommon, there have been deaths recorded from cocaine overdose due to:
- heart attack
- brain haemorrhage
- kidney failure
- repeated convulsions.
Chronic cocaine users tend to take cocaine in high-quantities ‘binges’ interrupted by ‘crashes’.
A binge is where the drug is repetitively taken over several hours or days. The user may attempt to end the binge by taking a depressant drug such as alcohol, benzodiazepines or heroin. The binge is followed by the ‘crash’ – a period characterised by intense depression, lethargy and hunger.
The unpleasant effects of cocaine increase with more frequent, long-term use. This often results in cocaine users discontinuing their use for a period of time. Most of the following symptoms will dissipate once cocaine use ceases:
- weight loss
- depression/inability to experience pleasure (anhedonia).
Dangers in method of use
There are a number of dangers relating to the method of using cocaine:
- Repeated snorting damages the nasal lining and can also damage the structure separating the nostrils.
- Cocaine is often mixed with substances that are poisonous when injected. This may cause collapsed veins, abscesses and damage to the heart, liver and brain. Also, because users don’t know the exact purity and strength of the drug, the chances of overdose and death are also increased.
- If injected into the skin, either by intent or accident, cocaine causes severe vasoconstriction, which may prevent blood flowing to the tissue, potentially resulting in severe tissue damage. This can occur after just one injection of cocaine.
- There is an increased risk of blood-borne viruses and infections such as HIV , hepatitis B and hepatitis C.
- Smoking cocaine can cause breathing difficulties, a chronic cough, chest pain and lung damage.
Long-term injection can result in:
- blood vessels becoming blocked from substances mixed with cocaine, which can lead to major damage to bodily organs
- inflamed blood vessels and abscesses.
- HIV and hepatitis: sharing needles, syringes and other injecting equipment can greatly increase the risk of contracting blood borne viruses such as hepatitis B, hepatitis C and HIV (Human Immunodeficiency Virus – the virus that causes AIDS).
Cocaine and other drugs
Cocaine users often mix other drugs to enhance desirable effects or to help them cope with the undesirable effects of cocaine. These substances may include alcohol , cannabis , heroin and benzodiazepines. The consequences of mixing cocaine with other substances are often unpredictable. Mixing cocaine with alcohol produces a substance in the blood called cocaethylene, which can be more toxic to the body than the cocaine itself. Injecting cocaine and heroin at the same time can affect the area of the brain that controls breathing, increasing the chances of coma and death. Generally, health risks increase when mixing cocaine with other drugs, especially when large quantities are taken.
Tolerance and dependence
Initial tolerance to cocaine develops rapidly with continual heavy use. After this initial level is reached, cocaine users don’t appear to develop tolerance for increasing amounts. Regular users may in fact develop a ‘reverse tolerance’ where they experience the effects of the drug more intensely. Tolerance to cocaine may not be obvious due to the tendency for users to mix cocaine with other drugs such as heroin and alcohol.
Physical dependence to a drug occurs when a person’s body gets used to functioning with the drug present in the system. Physical dependence to cocaine has not yet been established.
Psychological dependence occurs when using a drug becomes more important than other activities in a person’s life. Because of its powerful euphoric effects, cocaine users may develop a strong psychological dependence on it. Even after long periods of abstinence, strong cravings can persist.
Withdrawal symptoms occur when a person dependent on a drug ceases using it or significantly cuts down the amount they are using. Cocaine withdrawal generally occurs in three phases:
1. ‘The crash’, which describes symptoms experienced immediately after use ceases – usually in the first two to four days. Symptoms include:
- intense craving for the drug
- extreme fatigue.
2. The withdrawal phase may last up to ten weeks and is characterised by:
- lack of energy
- intense craving
- angry outbursts.
3. The extinction phase may last indefinitely and includes symptoms of episodic cravings for cocaine, usually in response to conditioned cues. These cravings may surface months or years after cocaine use has ceased.
Other withdrawal symptoms that may be experienced include:
- lack of motivation
- inability to feel any pleasure
- muscle pain
- long, but disturbed sleep.
In Australia, there are a number of drug treatment options. Some aim solely for the user to achieve a drug-free lifestyle. Others recognise abstinence as one option, however, due to individual circumstances, may not be possible in certain situations. The overall aim of these programs is to reduce the harm/risks related to a person’s drug use.
Treatment is more effective if tailored to suit a person’s specific situation and usually involves a combination of methods. The different options include individual counselling, group therapy, medication and supervised/home withdrawal.
Pregnancy and breastfeeding
Research indicates that effects of cocaine use during pregnancy may cause:
- bleeding, miscarriage
- premature labour
Cocaine increases the heart rate in both the mother and baby and the supply of blood and oxygen to the baby is reduced. This means the baby is more likely to be small and grow slowly both before and after birth. If cocaine is used close to birth, the baby may be born intoxicated showing symptoms of hyperactivity and agitation. Withdrawal symptoms can occur in the babies of mothers who use cocaine regularly. These include sleepiness and lack of responsiveness.
To date, research is inconclusive as to whether children of mothers who use cocaine experience any long-term mental or physical effects. Some studies suggest that malformations of the genito-urinary tract, heart, limbs and/or face occur in the babies of cocaine-using mothers.
It is likely that cocaine will reach the baby through breast milk. The effect this has will depend on factors such as the amount and strength of cocaine used, and the time between using cocaine and feeding the baby. Symptoms may include the baby being irritable, unsettled and difficult to feed.
Cocaine and the law
Cocaine is illegal. Federal and state laws provide penalties for possessing, using, making or selling cocaine. Drug laws in Australia distinguish between those who use drugs and those who supply or traffic drugs.
At present in Victoria, penalties range from a $2,000 fine and/or one year imprisonment for cultivation (if the court is satisfied that the offence is not related to trafficking), $3,000 and/or one year’s imprisonment for possession/use (not relating to trafficking) to fines of up to $250,000 and/or 25 years imprisonment for commercial trafficking.
In Victoria, the police and courts have recently introduced a number of new schemes in relation to drug offences. Some of these aim to divert people from the criminal justice system; others involve referring people with a drug problem into treatment programs.
Cocaine and driving
It is illegal for anyone to drive under the influence of any drug (including cocaine). Breaking this law carries penalties including disqualification from driving, heavy fines and/or imprisonment. Due to the nature of its psychological and physical effects, it is dangerous to drive a vehicle after taking cocaine. If cocaine is combined with other drugs, such as alcohol, the risk of accident is further increased.
Cocaine users can become preoccupied with purchasing, preparing, using and recovering from the effects of use, neglecting other areas of their life. All areas of a person’s life, including family, work, and personal relationships, can be affected by drug use. For example, arguments over drug use can cause family and relationship problems that may lead to break-up. Some effects of cocaine, such as anxiety, paranoia and irrational behaviour, may further exacerbate these problems.
Reducing the risks
Australian drug policy is based on harm minimisation. This is about reducing drug-related harm to both the community and individual drug users.
Harm minimisation strategies range from encouraging ‘non-use’ through to providing the means for drug users to use drugs with less risks.
What to do in a crisis
If someone overdoses or has an adverse reaction while using cocaine it is very important that they receive professional help as soon as possible. Quick responses can save lives.
- Call an ambulance. Dial 000. Don’t delay because you think you or your friend might get into trouble. Ambulance officers are not obliged to involve the police.
- Stay with the person until the ambulance arrives. Find out if anyone at the scene knows mouth-to-mouth resuscitation or cardiopulmonary resuscitation (CPR).
- Ensure adequate air by keeping crowds back and opening windows. Loosen tight clothing.
- If the person is unconscious, don’t leave them on their back â€” they could choke. Turn them on their side and into the recovery position. Gently tilt their head back so their tongue does not block the airway.
- If breathing has stopped, give mouth-to-mouth resuscitation. If there is no pulse, apply CPR.
- Provide the ambulance officers with as much information as you can – how much cocaine was taken, how long ago, and any pre-existing medical conditions.
- Arrange with friends before cocaine is taken about what to do in a crisis.