Crack and Cocaine
Cocaine is a powerfully addictive drug of abuse. Once having tried cocaine, an individual
predict or control the extent to which he or she will continue to use the drug.
The major routes of administration of cocaine are sniffing or snorting, injecting, and
(including free-base and crack cocaine). Snorting is the process of inhaling cocaine
the nose where it is absorbed into the bloodstream through the nasal tissues. Injecting is
the act of
using a needle to release the drug directly into the bloodstream. Smoking involves
vapor or smoke into the lungs where absorption into the bloodstream is as rapid as by
"Crack" is the street name given to cocaine that has been processed from cocaine
a free base for smoking. Rather than requiring the more volatile method of processing
ether, crack cocaine is processed with ammonia or sodium bicarbonate (baking soda) and
heated to remove the hydrochloride, thus producing a form of cocaine that can be smoked.
term "crack" refers to the crackling sound heard when the mixture is smoked
from the sodium bicarbonate.
There is great risk whether cocaine is ingested by inhalation (snorting), injection, or
appears that compulsive cocaine use may develop even more rapidly if the substance is
rather than snorted. Smoking allows extremely high doses of cocaine to reach the brain
quickly and brings an intense and immediate high. The injecting drug user is at risk for
or acquiring HIV infection/AIDS if needles or other injection equipment are shared.
Cocaine is a strong central nervous system stimulant that interferes with the reabsorption
dopamine, a chemical messenger associated with pleasure and movement. Dopamine is released
part of the brain's reward system and is involved in the high that characterizes cocaine
Physical effects of cocaine use include constricted peripheral blood vessels, dilated
increased temperature, heart rate, and blood pressure. The duration of cocaine's immediate
euphoric effects, which include hyper-stimulation, reduced fatigue, and mental clarity,
the route of administration. The faster the absorption, the more intense the high. On the
hand, the faster the absorption, the shorter the duration of action. The high from
snorting may last
15 to 30 minutes, while that from smoking may last 5 to 10 minutes. Increased use can
period of stimulation.
Some users of cocaine report feelings of restlessness, irritability, and anxiety. An
tolerance to the high may be developed, and many addicts report that they seek but fail to
as much pleasure as they did from their first exposure. Scientific evidence suggests that
powerful neuropsychologic reinforcing property of cocaine is responsible for an
continued use, despite harmful physical and social consequences. In rare instances, sudden
can occur on the first use of cocaine or unexpectedly thereafter. However, there is no way
determine who is prone to sudden death.
High doses of cocaine and/or prolonged use can trigger paranoia. Smoking crack cocaine can
produce a particularly aggressive paranoid behavior in users. When addicted individuals
stop using cocaine, they often become depressed. This also may lead to further cocaine use
depression. Prolonged cocaine snorting can result in ulceration of the mucous membrane of
nose and can damage the nasal septum enough to cause it to collapse. Cocaine-related
often a result of cardiac arrest or seizures followed by respiratory arrest.
Added Danger: Cocaethylene
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.
researchers have found that the human liver combines cocaine and alcohol and manufactures
third substance, cocaethylene, that intensifies cocaine's euphoric effects, while possibly
the risk of sudden death.
The widespread abuse of cocaine has stimulated extensive efforts to develop treatment
for this type of drug abuse.
NIDA's top research priority is to find a medication to block or greatly reduce the
cocaine, to be used as one part of a comprehensive treatment program. NIDA-funded
are also looking at medications that help alleviate the severe craving that people in
cocaine addiction often experience. Several medications are currently being investigated
to test their safety and efficacy in treating cocaine addiction.
In addition to treatment medications, behavioral interventions, particularly cognitive
therapy, can be effective in decreasing drug use by patients in treatment for cocaine
Providing the optimal combination of treatment services for each individual is critical to
Extent of Use
Monitoring the Future Study (MTF)*
The MTF assesses the extent of drug use among adolescents and young adults across the
The proportion of high school seniors who have used cocaine at least once in their
increased from a low of 5.9 percent in 1994 to 9.8 percent in 1999. However, this is lower
peak of 17.3 percent in 1985. Current (past month) use of cocaine by seniors decreased
high of 6.7 percent in 1985 to 2.6 percent in 1999. Also in 1999, 7.7 percent of
tried cocaine at least once, up from a low of 3.3 percent in 1992. The percentage of
who had ever tried cocaine has increased from a low of 2.3 percent in 1991 to 4.7 percent
Of college students 1 to 4 years beyond high school, in 1995, 3.6 percent had used cocaine
the past year, and 0.7 percent had used cocaine in the past month.
Cocaine Use by Students, 1999:
Monitoring the Future Study
|Used in the Past Year
|Used in the Past Month
Community Epidemiology Work Group (CEWG)**
Although demographic data continue to show most cocaine users as older, inner-city crack
isolated field reports indicate new groups of users: teenagers smoking crack with
marijuana in some
cities; Hispanic crack users in Texas; and in the Atlanta area, middle-class suburban
cocaine hydrochloride and female crack users in their thirties with no prior drug history.
National Household Survey on Drug Abuse (NHSDA)***
In 1998, about 1.7 million Americans were current (at least once per month) cocaine users.
about 0.8 percent of the population age 12 and older; about 437,000 of these used crack.
of current cocaine use in 1998 was highest among Americans ages 18 to 25 (2.0 percent).
of use for this age group was significantly higher in 1998 than in 1997, when it was 1.2
* MTF is an annual survey on drug use and related attitudes of America's adolescents that
in 1975. The survey is conducted by the University of Michigan's Institute for Social
and is funded by NIDA. Copies of the latest survey are available from the National
Clearinghouse for Alcohol and Drug Information at 1-800-729-6686
** CEWG is a NIDA-sponsored network of researchers from 20 major U.S. metropolitan areas
and selected foreign countries who meet semiannually to discuss the current epidemiology
*** NHSDA is an annual survey conducted by the Substance Abuse and Mental Health Services
Administration. Copies of the latest survey are available from the National Clearinghouse
Alcohol and Drug Information at 1-800-729-6686.