Cocaine, a drug that resembles a white powder, often makes the user feel alert, confident, talkative, and strong. Cocaine use is most prevalent among males between the ages of 18 and 25. On the streets, cocaine may be diluted with cornstarch, talcum powder, sugar, or other drugs. Because cocaine is extremely addictive, the first-time user cannot possibly predict when loss of control will occur. Street names for cocaine are coke, snow, blow, Peruvian marching powder, wicky stick, tornado or C.
Cocaine’s effects appear almost immediately after a single dose, and disappear within a few minutes or hours. Taken in small amounts (up to 100 mg), cocaine usually makes the user feel euphoric, energetic, talkative, and mentally alert, especially to the sensations of sight, sound, and touch. It can also temporarily decrease the need for food and sleep. Some users find that the drug helps them perform simple physical and intellectual tasks more quickly, while others experience the opposite effect.
The duration of cocaine’s immediate euphoric effects depends upon the route of administration. The faster the absorption: the more intense the high and the shorter the duration of action. The high from snorting is relatively slow in onset, and may last 15 to 30 minutes, while that from smoking may last 5 to 10 minutes.
The short-term physiological effects of cocaine include constricted blood vessels; dilated pupils; and increased temperature, heart rate, and blood pressure. Large amounts (several hundred milligrams or more) intensify the user’s high, but may also lead to bizarre, erratic, and violent behavior. These users may experience tremors, vertigo, muscle twitches, paranoia, or, with repeated doses, a toxic reaction closely resembling amphetamine poisoning. Some users of cocaine report feelings of restlessness, irritability, and anxiety. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest.
Cocaine is a powerfully addictive drug. Thus, an individual may have difficulty predicting or controlling the extent to which he or she will continue to want or use the drug. Cocaine’s stimulant and addictive effects are thought to be primarily a result of its ability to inhibit the re-absorption of dopamine by nerve cells. Dopamine is released as part of the brain’s reward system, and is either directly or indirectly involved in the addictive properties of every major drug of abuse.
An appreciable tolerance to cocaine’s high may develop, with many addicts reporting that they seek but fail to achieve as much pleasure as they did from their first experience. Some users will frequently increase their doses to intensify and prolong the euphoric effects. While tolerance to the high can occur, users can also become more sensitive (sensitization) to cocaine’s anesthetic and convulsive effects, without increasing the dose taken. This increased sensitivity may explain some deaths occurring after apparently low doses of cocaine.
Use of cocaine in a binge, during which the drug is taken repeatedly and at increasingly high doses, leads to a state of increasing irritability, restlessness, and paranoia. This may result in a full-blown paranoid psychosis, in which the individual loses touch with reality and experiences auditory hallucinations.
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