Q) How is cocaine used?

A) There are four primary methods of ingesting cocaine. These are:

1. "Snorting" - absorbing cocaine through the mucous membranes of the nose.

2. Injecting - users mix cocaine powder with water and use a syringe to inject the solution intravenously.

3. Freebasing - Cocaine hydrochloride is converted to a "freebase" which can then be smoked.

4. Crack Cocaine - Cocaine hydrochloride is mixed with ammonia or sodium bicarbonate (baking soda) and other ingredients, causing it to solidify into pellets or "rocks". The crack is then smoked in glass pipes.

Q) How widespread is cocaine or crack addiction?

A) In 1997, there were approximately 1.5 million regular users of crack cocaine or powdered cocaine.

Q) Why would anyone become addicted to cocaine?

A) The effects of cocaine are immediate, extremely pleasurable, and brief. Cocaine and crack cocaine both produce intense but short-lived euphoria and can make users feel more energetic. Like caffeine, cocaine produces wakefulness and reduces hunger. Psychological effects include feelings of well-being and a grandiose sense of power and ability mixed with anxiety and restlessness. As the drug wears off, these temporary sensations of mastery are replaced by an intense depression, and the drug abuser will then "crash", becoming lethargic and typically sleeping for several days.

Q) What are the physical effects of crack cocaine addiction?

A)

• Changes in blood pressure, heart rates, and breathing rates
• Nausea
• Vomiting
• Anxiety
• Convulsions
• Insomnia
• Loss of appetite leading to malnutrition and weight loss
• Cold sweats
• Swelling and bleeding of mucous membranes
• Restlessness and anxiety
• Damage to nasal cavities
• Damage to lungs
• Possible heart attacks, strokes, or convulsions

HEALTH EFFECTS

Even though the public is often regaled with highly publicized accounts of deaths from cocaine, many still mistakenly believe the drug, especially when sniffed, to be nonaddictive and not as harmful as other illicit drugs. Cocaine's immediate physical effects include raised breathing rate, raised blood pressure and body temperature, and dilated pupils.

By causing the coronary arteries to constrict, blood pressure rises and the blood supply to the heart diminishes. This can cause heart attacks or convulsions within an hour after use. Chronic users and those with hypertension, epilepsy, and cardiovascular disease are at particular risk. Studies show that even those with no previous heart problems risk cardiac complications from cocaine. Increased use may sensitize the brain to the drug's effects so that less of the substance is needed to induce a seizure. Those who inject the drug are at high risk for AIDS and hepatitis when they share needles. Allergic reactions to cocaine or other substances mixed in with the drug may also occur.

In the 1970s cocaine was expensive and considered a "status" drug. The introduction of inexpensive crack increased the accessibility of this substance, and crack has become the drug of choice for many drug users, especially inner-city disadvantaged youth. Crack's convenience, ease of concealment, wide availability, and low cost have increased its use. The fact that it is smoked rather than snorted or injected (ingestion methods associated with the stigma of being a "junkie") has contributed to its popularity.

Crack is particularly dangerous for several reasons.

Crack is inhaled and rapidly absorbed through the lungs, into the blood, and carried swiftly to the brain. The chances of overdosing and poisoning leading to coma, convulsions, and death are greatly increased over other types of cocaine.. Crack's rapid rush—5 to 7 minutes of intense pleasure— quickly subsides, leading to depression that needs to be relieved by more crack. This cycle enhances the chances of addiction and dependency. Because of the brief high, users are constantly thinking about and devising ways to get more crack. Psychologically, the drug reduces concentration, ambition, and drive, and increases confusion and irritability, wreaking havoc on users' professional and personal lives. Habitual use may lead to cocaine psychosis, causing paranoia, hallucinations, and a condition known as formication, in which insects or snakes are perceived to be crawling under the skin. The paranoia and depression can instigate violent and suicidal behavior. The side effects of adulterants increase cocaine's risks. The drug is often cut with one or more of any number of other substances, such as the cheaper drugs procaine, lidocaine, and benzocaine, and substances that pose no serious risks, such as sugars (mannitol and sucrose), or starches. However, when quinine or amphetamines are added, the potential for serious side effects increases dramatically.

Q) What is the difference between crack and cocaine?

A) Crack is made from cocaine in a process called freebasing, in which cocaine powder is cooked with ammonia or sodium bicarbonate (baking soda) to create rocks, chips, or chunks that can be smoked. The term crack refers to the crackling sound that is heard when the mixture is smoked. Crack is usually smoked in a pipe. Because it's smoked, crack cocaine effects are felt more quickly and they are more intense than those of powder cocaine. However, the effects of smoked crack are shorter lived than the effects of snorted powder cocaine.

Q) Is cocaine addiction serious?

A) Cocaine addiction can occur very quickly and be very difficult to break. Animal studies have shown that animals will work very hard (press a bar over 10,000 times) for a single injection of cocaine, choose cocaine over food and water, and take cocaine even when this behavior is punished. Animals must have their access to cocaine limited in order not to take toxic or even lethal doses. People addicted to cocaine behave similarly. They will go to great lengths to get cocaine and continue to take it even when it hurts their school or job performance and their relationships with loved ones.

Q) Are there any other problems that can occur from crack or cocaine addiction?

A) Crack and other forms of cocaine can cause feelings of anxiety and depression, which may last for weeks. Attempts to stop using the drugs can fail simply because the resulting depression can be overwhelming, causing the addict to use more cocaine in an attempt to overcome his depression.