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Drug War Facts

"Most cocaine users are episodic recreational users who voluntarily curtail their use. However, cocaine use and the development of addictive behavior in some users has increased in North America, although recent declines are recorded. Availability of highly biologically active forms, such as crack cocaine, has worsened the problem of cocaine dependence."

"Although most cocaine in the US is snorted, smoking crack cocaine has become widely publicized. The hydrochloride salt is converted to a more volatile form, usually by adding NaHCO3, water, and heat. The converted material is combusted and the resultant smoke inhaled. Onset of effect is quicker, and intensity of the high is magnified."

"Tolerance to cocaine occurs, and withdrawal from heavy use is characterized by somnolence, increased appetite, and depression. The tendency to continue taking the drug is strong after a period of withdrawal."

"Effects differ with different modes of use. When injected or smoked, cocaine produces hyperstimulation, alertness, euphoria, and feelings of competence and power. The excitation and high are similar to those produced by injecting amphetamine. These feelings are less intense and disruptive in users who snort cocaine powder.
"An overdose may produce tremors, seizures, and delirium. Death may result from MI, arrhythmias, and heart failure. Patients with extreme clinical toxicity may, on a genetic basis, have decreased (atypical) serum cholinesterase, an enzyme needed for clearance of cocaine. The concurrent use of cocaine and alcohol produces a condensation product, cocaethylene, which has stimulant properties and may contribute to toxicity."

"Some users of cocaine report feelings of restlessness, irritability, and anxiety. A tolerance to the 'high' may develop -- many addicts report that they seek but fail to achieve as much pleasure as they did from their first exposure. Some users will increase their doses to intensify and prolong the euphoric effects. While tolerance to the high can occur, users can also become more sensitive 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."

"Because cocaine is a very short-acting drug, heavy users may inject it or smoke it q 10 to 15 min. This repetition produces toxic effects, such as tachycardia, hypertension, mydriasis, muscle twitching, sleeplessness, and extreme nervousness. Hallucinations, paranoid delusions, and aggressive behavior may develop, which can make the person dangerous. Pupils are maximally dilated, and the drug's sympathomimetic effect increases heart and respiration rates and BP.
"Severe toxic effects occur in the compulsive heavy user. Rarely, repeated snorting causes nasal septal perforation due to local ischemia. Repeatedly smoking volatile crack cocaine in high doses can have serious toxic cardiovascular and behavioral consequences."

"When people mix cocaine and alcohol consumption, they are compounding the danger each drug poses and unknowingly forming a complex chemical experiment within their bodies. NIDA-funded researchers have found that the human liver combines cocaine and alcohol and manufactures a third substance, cocaethylene, that intensifies cocaine's euphoric effects, while potentially increasing the risk of sudden death."

"In 2003, 34.9 million Americans age 12 and over reported lifetime use of cocaine, and 7.9 million reported using crack. About 5.9 million reported annual use of cocaine, and 1.4 million reported using crack. About 2.3 million reported 30-day use of cocaine, and 604,000 reported using crack.
"The percentage of youth ages 12 to 17 reporting lifetime use of cocaine was 2.6 percent in 2003. Among young adults ages 18 to 25, the rate was 15 percent, showing no significant difference from the previous year. However, there was a statistically significant decrease in the rate of lifetime crack use among females in the 12 to 17 age bracket."

"Stopping sustained use requires considerable assistance, and the depression that may result requires close supervision and treatment. Many nonspecific therapies, including support and self-help groups and cocaine hotlines, exist. Extremely expensive inpatient therapy is available."

Research funded by the National Institute on Drug Abuse (NIDA) and the Albert Einstein Medical Center in Philadelphia states: "Although numerous animal experiments and some human data show potent effects of cocaine on the central nervous system, we were unable to detect any difference in Performance, Verbal or Full Scale IQ scores between cocaine-exposed and control children at age 4 years."

Well-controlled studies find minimal or no increased risk of Sudden Infant Death Syndrome (SIDS) among cocaine-exposed infants.

Among the general population there has been no detectable increase in birth defects which may be associated with cocaine use during pregnancy.

The lack of quality prenatal care is associated with undesirable effects often attributed to cocaine exposure: prematurity, low birth weight, and fetal or infant death.