Cocaine (commonly known as “coke”, “white”, “sniff” or by a number of other street names) is a strong, highly addictive stimulant derived from the coca plant which originates from the Americas. Normally found in the form of a white powder, it is typically snorted (though can be taken orally, injected or – in the form of crack cocaine – smoked) to produce feelings of euphoria, energy, confidence and perceptions of clarity, which begin almost immediately after consumption and can last for up to two hours. It is sometimes used as an aphrodisiac (though may also result in impotence and/or anorgasmia) and as a performance-enhancing substance in sport and fitness training. Cocaine has certain medicinal properties (mostly relating to its anaesthetic characteristics) through its addictive nature means that its use is highly controlled, and it is a prohibited substance worldwide; in the UK, it is a Class A controlled substance (the most serious classification). Despite its comparatively high cost, it is the second-most-commonly consumed illegal drug in the UK (after cannabis) – according to a 2016 United Nations report, England and Wales have the highest rate of cocaine usage anywhere in the world, with 2.4% of all adults using cocaine annually – and the trade in cocaine is related to a significant amount of crime and social breakdown.
The coca plant has been used as a stimulant and anaesthetic by indigenous South American peoples for well over a thousand years, mostly by chewing the leaves. After the Spanish conquest the authorities recognised the value of the plant and began to tax it, and coca started to make its way to the Old World in negligible quantities. However, it wasn’t until the middle of the 19th century that its key component – the cocaine alkaloid – was isolated; following this discovery, the medical applications of cocaine were quickly realised. Meanwhile, Mariani wine (wine treated with coca leaves) had become very popular recreationally (followed by the original Coca-Cola which contained a significant quantity of cocaine), and from the late 1880s cocaine powder began to be used and abused recreationally throughout the West, available legally at pharmacies.
Cocaine’s addictive properties were soon realised, and fears about the drug’s social impact led to its being outlawed despite its being firmly established as a recreational drug – with a somewhat elite reputation compared with similarly addictive substances. In the West, cocaine use is now common across social strata, ethnicities, geographies and age-brackets; no accurate measure of the true value of the cocaine market globally is available thanks to its highly illicit nature, but most experts estimate it runs well into the hundreds of billions of pounds globally. The trade and consumption of cocaine is a primary factor in several civil and international conflicts and in the imprisonment of many thousands of people each year, as well as in an unknown quantity of abuse-related deaths.
Taken in negligible quantities, cocaine may produce few visible symptoms. However, in small doses upwards a user may begin to display certain symptoms and traits which differ from his/her normal behaviour. Some of the most obvious signs of cocaine abuse may include:
Because of the illicit nature of cocaine, a user may begin to behave more furtively – perhaps making frequent trips to places (such as a bathroom) where the drug can be consumed privately. They might disappear on occasion without explanation (to procure cocaine) and may guard their phone more zealously (to avoid having communication with dealers, or other mention of the drug, brought to light). As cocaine is one of the most expensive drugs available on the market, and users can consume significant quantities in binges, financial problems may result, along with stressed relationships with partners, family and friends.
As cocaine abuse grows more frequent and increases in quantity, perhaps resulting in addiction, a user is likely to display significant behavioural symptoms including markedly increased levels of aggression, emotional volatility, severe agitation if s/he cannot obtain the drug, changes in sexual behaviour, insomnia and a lack of empathy. They may find it very difficult to keep focused on even minor tasks, while realistic assessments of their capabilities regarding future plans might prove impossible. They may also begin to suffer health problems, especially conditions relating to the heart and respiratory system, which if untreated could prove fatal in the long term.
Small quantities of cocaine taken infrequently are unlikely to lead to long-term problems (though even one does could prove fatal for those with pre-existing conditions). However, protracted and/or heavy cocaine abuse and dependency will almost certainly lead to serious health consequences, both physical and mental, which may eventually prove fatal if the user is unable to break the addiction.
Cocaine use places increased strain upon the heart as it increases the heart rate (and disrupts the user’s normal biorhythms). Over the long-term, this can lead to heart muscle damage and inflammation, including cardiomyopathy (the destruction of cells in the structure of the heart) which in turn can lead to heart attacks, arrhythmia and a tearing of primary blood vessels, which can all result in death. Damage to blood vessels can also increase the risk of stroke and/or brain damage. Cocaine is also associated with damage to other organs including the kidneys; this can be greatly exacerbated when cocaine is consumed in conjunction with alcohol, as the two substances interact to produce dangerous toxins within the body.
Less potentially fatal – though still unpleasant – physical effects include damage to the nasal septum and throat from repeated snorting of the drug; skin conditions (especially around the nose) and dental/oral problems (from eating the drug or rubbing it into the gums).
Regular/long-term cocaine abuse can lead to an alteration of the chemistry of the brain, with resultant psychological and behavioural consequences. A user may find him/herself unable to think rationally and to make frequent questionable decisions (which can increase the risk of accidents and damage to other people, as well as the danger of exposure to sexually transmitted infections such as HIV/AIDS). In the most serious cases, psychosis can develop, along with intense paranoia and an inability to relate to loved ones, friends and colleagues. Cocaine has also been linked with the development of attention-deficit hyperactivity disorder (ADHD) and complications resulting from insomnia, as well as generally decreased cognitive performance. Suicidal ideation has been known to result from cocaine addiction, especially when the dependency has had a significant negative impact on the addict’s personal, professional and financial life.
Cocaine is by no means as physically addictive as certain other drugs, and physical withdrawal is consequently less unpleasant. However, it is extremely psychologically addictive thanks to its impact upon brain chemistry. Over the long term, cocaine affects brain transmitters and receptors to the extent that the brain becomes used to the presence of cocaine – in other words, develops a tolerance for it – and accordingly changes its production of chemicals including dopamine and serotonin (responsible for, among other things, feelings of pleasure and happiness). The sudden absence of the drug means that those chemicals are in short supply, leading to dysphoria and depression and hence cravings for more cocaine – which may be intense, leading the addict to feel that they must do anything necessary to obtain the drug. A user withdrawing from cocaine may experience significant psychological symptoms as their brain “rebalances”, including the aforementioned depression (and potentially suicidal agitation), nightmares, seriously affected sleep patterns and profound loneliness.
It is possible to beat cocaine addiction without needing to go into rehabilitation. However, because of the drug’s highly addictive nature and common availability, many users are unable to break the habit without taking themselves away from their normal environments, especially when suffering some of the more extreme cravings which accompany withdrawal. Furthermore, rehab includes a variety of therapies addressing the root causes of an addiction, and support groups, without which an addict may return to their pattern of substance abuse even months or years after giving up cocaine. It’s also important to bear in mind that although the physical symptoms of cocaine withdrawal are relatively minor, the psychological symptoms can be extremely unpleasant and experience them without the assistance of trained personnel can have serious ramifications including self-harm and even thoughts of suicide. It is normally advisable not to go through any form of detoxification without the assistance of a medical professional, and to consult your GP to get a medical assessment of your addiction before considering attempting to break a cocaine addiction without professional help.