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National Institute on Drug Abuse -  NIDA NOTES
Volume 10, Number 5
September/October 1995

Facts About Cocaine Abuse and Treatment


Cocaine is a drug extracted from the leaves of the coca plant. It is a potent natural brain stimulant and one of the most powerfully addictive drugs of abuse.


Illicit cocaine is distributed on the street in two main forms: cocaine hydrochloride, a white crystalline powder that can be snorted or dissolved in water and injected; and "crack," cocaine hydrochloride that has been processed with ammonia or sodium bicarbonate into a freebase cocaine called chips, chunks, or "rocks" that can be smoked.

Extent of Use:

In 1994, according to the National Household Survey on Drug Abuse, an estimated 1.4 million Americans were current cocaine users; that is, they had used cocaine at least once in the past month. Of that number, an estimated one-half million were current crack users. As in the past, the rate of current cocaine use was highest among young adults in 1994-approximately 60 percent of current cocaine users were ages 18 through 34.

Methods of Use:

Cocaine may be used occasionally, daily, or in a variety of compulsive, repeated-use patterns known as "binging." Major routes of administering cocaine are snorting, injecting, and smoking. When snorted, cocaine powder is inhaled through the nostrils and absorbed into the bloodstream. Cocaine powder can also be dissolved in water and injected directly into the bloodstream. Crack cocaine is usually smoked in a pipe, and the cocaine vapor or smoke is inhaled into the lungs where it is absorbed into the bloodstream. Regardless of the route of administration, cocaine is addictive. Crack cocaine and injected cocaine reach the brain quickly and bring an intense and immediate high. Cocaine taken intranasally produces a high more slowly.

Effects of Use:

Acute physical effects include constricted peripheral blood vessels, dilated pupils, elevated temperature, and increased heart rate and blood pressure. Some cocaine users report feelings of restlessness, irritability, and anxiety. Prolonged cocaine use and smoking crack cocaine can also trigger paranoid behavior. Cocaine may also harm the health and development of infants born to women who use cocaine while they are pregnant. When addicted individuals stop using cocaine, they often suffer from depression and anhedonia, the inability to experience pleasure from normally pleasurable activities. This condition may lead to renewed cocaine use.

Data from the Drug Abuse Warning Network show that the number of cocaine-related emergency room visits more than quintupled from 1984 through 1993.


Although NIDA's Medications Development Division has made considerable progress in the search for cocaine treatment medications, as yet no medications are approved for treating cocaine abuse and dependence. However, data from treatment programs using a variety of psychological and behavioral therapeutic approaches indicate that outpatient cocaine treatment can be successful. NIDA is supporting the development of new behavioral interventions that are showing increased effectiveness in decreasing drug use by patients undergoing treatment for cocaine abuse.

From NIDA NOTES, September/October, 1995
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