Cocaine Fact Sheet Two 

Cocaine is one of the most powerful Central Nervous System (CNS) stimulants. Like other stimulants such as amphetamines (speed), cocaine produces heightened alertness, intense feelings of euphoria and well-being, and decreased need for food and sleep.

The source of cocaine is the coca plant which grows almost exclusively in the mountainous regions of Bolivia and Peru. The active ingredient extracted from the coca leaf is cocaine hydrochloride.

Botanically classified in the 1700's, cocaine is derived from the Erythroxylon coca plant. Historically, use of cocaine was limited until the 1800's when the chemical cocaine hydrochloride was isolated from the leaves. Interest in the drug became widespread. The first product to contain cocaine as an ingredient was the french wine "Vin Mariani" ; a short time later, "Coca Cola" was introduced. Use of cocaine declined for a period of time when it became classified as a narcotic under the Narcotic Control act in the early 1900's. Its use became popular again in the early 1970's. Today the only accepted medical use is as a surface anesthetic in ear, nose, and throat surgery.

Street cocaine comes in several forms - coca leaf, coca paste, cocaine hydrochloride powder, or freebase cocaine. Coca leaf is considered to be a mild product and its use in North America is not popular. Coca plants do not grow naturally in this climate and leaves are hard to smuggle across the border.

Combining coca leaves with sulphuric acid, kerosene, or gasoline produces a paste called cocaine sulphate. It is not a pure form of the drug but when smoked it gives a quick high and is highly addictive. Paste is not a commonly used form of cocaine.

Hydrochloric acid removes the remaining impurities from the paste, producing a salt known as cocaine hydrochloride. This is generally the most common form sold on the street worldwide. This is a white powder which is either snorted into the nose or dissolved in water and injected. When sold as a powder, cocaine is often "bulked up" with other look-alike substances (cornstarch, sugar, talcum powder), other anesthetics (procaine, benzocaine), or other stimulants (amphetamines).

Freebasing cocaine to produce a smokeable form of the drug involves heating cocaine hydrochloride with various liquids (solvents). There is danger of injury in this method because the solvents are flammable and explosions may occur. "Crack" or "rock" is freebase cocaine made by heating cocaine hydrochloride with baking soda. It forms small white/beige rocks which are smoked. Crack is the most common form of cocaine sold in the Maritimes.

Cocaine works by triggering a rapid release of neurotransmitters - messengers between brain cells. This rapid release causes the "rush". As the brain cells are gradually depleted of essential neurotransmitters, craving for more cocaine occurs.

The amount, the purity, the route of administration, the experience and mindset of the user and the concurrent use of other drugs will determine the action and duration of cocaine's effects.

Oral Chewing leaves

• Onset 5-10 minutes
• Duration of effects 45-90 minutes

Snorting (20-30 mg typical dose)

• Onset 2-3 minutes
• Peak 10-20 minutes
• Fades 30-45 minutes

Intravenous (25-50 mg, typical dose)

• Onset (rush) 15-25 seconds
• Duration of post-rush activity 10-20 minutes

Smoking (250-1000 mg typical dose)

• Onset 7-10 seconds
• Peak 3 minutes
• Duration of sought-after effects 5-10 minutes

Effects of acute intoxication include feelings of euphoria, confidence and power. There is a dramatic increase in energy and alertness accompanied by a decrease in need for sleep and food. The physical effects include increased respiration, heart rate, blood pressure and temperature. Undesirable effects include agitation, paranoia, violent behaviour, compulsive behaviour, nausea and vomiting, chest pain, tremors, seizures, and heart arrhythmias.

The common pattern of addicted use is one of bingeing - short intense periods of use interrupted by periods of non-use or use of other drugs. When on what is termed as a "coke run", the user administers the drug every few minutes to maintain the high. A "run" can last from about 12 hours to several days.

Problems associated with cocaine use include physiological and psychological problems as well as financial, employment, marital/family problems and legal difficulties.

Physical effects of regular or long-term cocaine use include:

• headaches
• chapped nostrils/eroded septum
• depression/hallucinations/paranoia
• seizures
• weakened immune system
• extreme weight loss
• heart problems/hypertension
• respiratory/lung problems
• intestinal ischemia/gangrene
• liver damage

Complications of cocaine use can occur in the frequent and infrequent user. The most common causes of death from cocaine ingestion are:

• central nervous system stimulation which triggers convulsions and results in respiratory and cardiovascular collapse

• cardiac arrhythmias resulting in cardiac arrest

• heart attack

• stroke due to brain hemorrhage

• hyperthermia due to effects on the brain and body regulation of temperature

• Death can result from smoking, snorting, oral and more frequently, intravenous use. A user may also die from an allergic reaction to impurities in the dose or from mixing cocaine with another drug (like heroin).

Cocaine use by a pregnant woman may result in spontaneous abortion or premature birth. Although there are concerns about cocaine use and its effects on fetal growth and development, medical research has not firmly established the effects. Several studies do suggest that maternal cocaine use is associated with growth retardation in offspring, with reductions in both weight and head circumference.

Cocaine is considered by many to be one of the most addictive drugs. Users experience both tolerance and withdrawal. The route of ingestion can affect how quickly a person will develop addiction. The more quickly the cocaine gets to the brain, the higher the risk (of addiction). Once a user becomes addicted, cocaine use is very difficult to stop. Intense craving for the drug can last for months after last use and often leads to a return to use.

Cocaine withdrawal seems to have a three phase pattern called abstinence syndrome. The duration and intensity of withdrawal can vary based on the "binge" characteristics.

Phase I "Crash"

This phase last from 9 hours to 4 days following the end of the drug binge and includes:

• early stage agitation, depression, anorexia and intense craving

• middle stage fatigue, depression, insomnia with increasing desire for sleep

• late stage exhaustion, excessive sleeping, and excessive eating

Phase II "Withdrawal"

This phase lasts from 1 -10 weeks after the cocaine binge stops and includes:

• early stage sleep is more normalized, low anxiety, low drug craving

• middle & late anhedonia (absences of feelings of pleasure), lack of energy,

• stage anxiety, high drug craving especially with conditioned triggers (needles, white powder, etc.)

Phase III "Extinction"

This phase occurs with no return to use and may last for an indefinite time. It includes:

• gradual diminishing of craving and response to triggers or conditioned cues

• return to normal mood swings including experience of pleasure feelings

According to the Canadian Profile: Alcohol, Tobacco, and Other Drugs, 1997, the proportion of Canadians who reported using cocaine in the previous year increased from 0.3% in 1993 to 0.7% in 1994. In 1995 statistics on cocaine use by clients of Drug Dependency Services, Nova Scotia show that over 20% of clients presented with cocaine as their most used drug. The 1996 NS Student Drug Use Survey reports that 3.6% of junior/senior high school students used cocaine at least once in the year prior to the survey. The most recent statistics from the Adolescent Treatment program show that about 36% of clients used cocaine prior to admission to treatment.

Cocaine is governed under the Controlled Drugs and Substances Act. Unlawful possession is a criminal offence with penalties of up to a $1000 fine and/or 6 months imprisonment for first offence and a fine of up to $2000 and/or two years imprisonment for subsequent offenses. A possession charge can carry a penalty of up to 7 years imprisonment when the charge is tried by indictment. Trafficking and possession for the purposes of trafficking are indictable offenses and punishable by up to life imprisonment. Importing and exporting are punishable by 7 years to life imprisonment.

Drug Dependency Services, Central Region, 1999