What Is Cocaine?

Cocaine is an intense, euphoria-producing stimulant drug with extremely strong addiction potential that is derived from coca leaves.

It is most commonly distributed as a white crystalline powder. However, it is frequently diluted with other white powders to increase the profits. Substances used to mix in include sugars, cornstarch, talcum powder, and local anesthetics.

How Does Cocaine Work?

Cocaine works by blocking the decrease of dopamine in the body, leading to increased amounts. Increased dopamine levels activate the part of the brain that is referred to as the reward center, the ventral tegmental area (VTA).

The VTA is part of a neural network deep in the brain. When stimulated, it produces feelings of deep pleasure and happiness. Nerve cells in the VTA extend into the nucleus accumbens, a key pleasure center. This center artificially “rewards” the person after Cocaine use with pleasure and euphoria.

How Do People Use Cocaine?

There are two forms of Cocaine: a water-soluble form (powder) or a water-insoluble base (freebase).

“Freebasing” describes a process intended to increase a substance’s potency by altering its form. Cocaine freebase looks like small chunks that are white or brown in color. Today, the freebase form is generally called Crack, and it has been processed with ammonia or baking soda and water and then heated to remove the hydrochloride. When smoked, it has a very rapid onset.

Alternatively, the powder form of Cocaine is injected or snorted. When the powder form is dissolved in water and injected, the drug reaches the bloodstream immediately and has an increased intensity of effect. The powder form can be snorted up the nose or rubbed on the gums.

The slang terms for the different routes are:

  • Chewing (orally/rubbing on gums)
  • Snorting (intranasal)
  • Mainlining (injecting into veins)
  • Smoking (inhalation)

Affects On The Body

Cocaine can have almost immediate effects. Users report that small amounts can cause euphoria, increased energy, and hypersensitive awareness of light and sound. The effects are nearly instantaneous (dependent on the route used) and can last minutes to an hour.

Short-Term Effects

Some short-term effects include:

  • Paranoia
  • Decreased appetite
  • Anger/irritability
  • Extreme sensitivity to touch, light, and sound
  • Dilated pupils
  • Increased temperature

Some people binge on Cocaine, using doses repeatedly until their supply depletes. This can go on over several days, with decreased sleep and extreme energy usage.

After coming down from a binge, users may experience significant physical and mental exhaustion and depression that lasts several days.

Long-Term Effects

Chronic Cocaine use can lead to long-term changes in the brain, an increase in stress hormones, as well as decreased functioning in other parts of the brain.

Animal research suggests the orbitofrontal cortex sustains some level of damage over long periods of Cocaine use. This can contribute to poor decision-making and decreased self-awareness in people who are addicted the the drug.

A wide range of brain functions are damaged with long-term use, including:

  • Ability to focus
  • Impulse control
  • Memory
  • Performance of fine motor tasks
  • Decision making

With ongoing use, the reward pathway becomes dysregulated, resulting in decreased responsiveness to natural reinforcers such as food. In addition, the stress response becomes heightened, leading to irritability and negative moods when not using Cocaine.

This combination of brain-changing effects can evolve into the user focusing on Cocaine instead of relationships, food, or other natural rewards.

Other Health Effects Of Cocaine Use

Cocaine affects the central nervous system, which can cause significant medical complications. Cardiac issues, such as heart rhythm disturbances, heart attacks, seizures, and strokes, have all been reported. Users may have significant chest pain from Cocaine use that mimics a heart attack and may have damaged heart muscle.

Cocaine also reduces blood flow to the gastrointestinal system, which can induce tears and ulcerations in the stomach and GI tract.

The routes of use can also lead to specific adverse effects.


  • Nosebleeds
  • Loss of smell
  • Hoarseness
  • Chronically inflamed runny nose, erosion of upper nasal cavity


  • Asthma
  • Respiratory infections


  • Track marks on the arm, leading to infections
  • Transmission of diseases such as HIV or Hepatitis
  • Allergic reactions to inactive substances mixed in with Cocaine

Can A Person Overdose On Cocaine?

A person can overdose on Cocaine. Large amounts of Cocaine can raise the heart rate and blood pressure to dangerously high levels. In addition, bizarre, violent, psychotic, and erratic behavior has been reported after a large amount of Cocaine is used.

When Cocaine is used repeatedly, a level of tolerance to the euphoria can develop along with a sensitivity to side effects, such as anxiety or seizures. As a result of these combined effects, a user often must take more to reach their desired high and then experiences anxiety, seizures, and other overdose effects.

Sudden death with the first use of Cocaine is also a known possibility. Deaths related to Cocaine use are often due to cardiac arrest or seizures followed by respiratory arrest.

Mixing Cocaine With Other Drugs

When combined with other drugs, the effects can be unpredictable. People often smoke Cocaine in combination with Marijuana or tobacco.

It is often used along with an Opioid. When used with Heroin, it is known as Speedballing. Fentanyl is also a known contaminant of Cocaine, with people purchasing what they think is Cocaine only to overdose and experience respiratory depression when it is found that it was laced with Fentanyl.

When alcohol is combined with Cocaine, the two substances can lead to the production of cocaethylene, which can be damaging to the heart. Cocaethylene has a longer duration of action than either agent alone. This combination is a two-drug combination that often results in drug-related death.

Street Names

Some common street names for Cocaine are:

  • Blow
  • Coke
  • Crack
  • Rock
  • Flake

  • Bazooka
  • Cake
  • Star dust
  • Snow
  • Soda Cot

Help For Cocaine Addiction

Cocaine is a highly addictive substance that sends signals to the user, making them feel that they must continue using it to feel happy. This can make it very difficult to quit using without professional assistance.

Inpatient rehabilitation can provide whole-person care that focuses on the physical and psychological difficulties that addiction causes. If you are ready to start your journey toward recovery and live a healthier, addiction-free life, reach out to a treatment provider today to explore your treatment options.