Crack and Cocaine
In either its powder or rock (“crack”) forms, cocaine is a powerful and highly addictive drug, the use of which in even limited amounts can quickly lead to dependence.
Powder cocaine is most commonly ingested by snorting it through one’s nose, though it can also be free-based (smoked) or injected. Crack cocaine is usually smoked, or the rocks are heated and the fumes inhaled. Crack got its name because of the cracking sound that is emitted when it is heated prior to ingesting.
Producing powder cocaine involves a relatively complex (and potentially volatile) process, while crack can be manufactured more simply and cheaply by processing it with ammonia or sodium bicarbonate. As a result, during the 1980s crack cocaine emerged as a popular (and very dangerous) street drug among low-income drug abusers throughout the nation.
Prevalence of Use
According to the 2007 version of the National Survey on Drug Use and Health (NSDUH), nearly 36 million Americans aged 12 and older – or more than 14 percent of the national population –have tried cocaine at least once in their lifetimes, more than 5.5 million have used the drug in the past year, and more than two million have ingested it in the previous 30 days.
Among the students who were surveyed for the 2007 Monitoring the Future study, 3.1 percent of eighth graders, 5.3 percent of tenth graders, and 7.8 percent of high school seniors reported using cocaine at least once in their lives.
Hazards & Dangers
Cocaine exerts a dramatic effect on the central nervous system and impairs the brain’s ability to reabsorb dopamine, the hormone that is associated with pleasure. Following the dopamine flood that results from cocaine ingestion, users can experience an emotional crash, followed by the need to use increasingly larger amounts in order to achieve the same high that resulted from their initial exposure to the drug.
Because the effects of cocaine are both dramatic and short-lasting (snorting lasts less than 30 minutes; smoking can last less than 10 minutes) users often engage in repeated ingestion, which can exacerbate the drug’s negative effects. In addition to damaging the body’s ability to experience pleasure, chronic cocaine use can lead to hypertension, increased heart rate, constricted blood vessels, and pupil dilation. Cocaine overdose can be fatal – and because the drug affects different people in different ways, even one-time users risk death.
Depending upon the quantity and quality of the cocaine that is ingested (and the chronicity with which one uses the drug) additional effects can include aggression, paranoia, agitation, and depression. Long-term use can cause the collapse of the nasal septum, and can lead to seizure, respiratory distress, and cardiac arrest.
Using the drug with alcohol can intensify cocaine’s effects, but can also result in sudden death due to the manner in which cocaine and alcohol are synthesized in the liver.
For individuals who inject the drug, the risk of HIV infection is increased, especially among those who share needles, syringes, or other paraphernalia.
Treatment
The epidemic of cocaine abuse and addiction during the final decades of the 20th century resulted in a concerted effort to develop effective treatment programs. The National Institute of Drug Abuse (NIDA) has made the development of anti-cocaine medications a top priority, and NIDA-funded research teams are currently investigating pharmacological means of alleviating the cravings of former cocaine addicts who are in treatment or recovery.
In the absence of these greatly sought-after medications, the most effective traditional cocaine treatment programs involves cognitive behavioral therapy, personal and group counseling sessions, and participation in ongoing recovery-support groups.