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Cocaine is among the most powerful addictive stimulants directly affecting the brain. Its chemical structure is that of a crystalline tropane alkaloid. It functions as a central nervous system stimulant and an appetite suppressant.

Cocaine is known to cause euphoric happiness and a sense of increased energy, although precise reactions vary from person to person.

Short-term effects of cocaine use are noticeable immediately and include increased energy levels, heart rate, blood pressure, and temperature; decreased appetite; dilated pupils; mental alertness. With time, people who get addicted to the drug develop tolerance to these short-term effects, in which case certain other effect become noticeable. These include several major medical complications and health problems, such as heart disease, heart attacks, respiratory failure, strokes, seizures, and gastrointestinal problems. There are also several adverse mental effects, such as paranoia, irritability, restlessness, audio-visual hallucinations, and mood disturbances.

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Some claim that Cocaine does not cause addiction, but this is untrue. Once you’ve started to use cocaine, you will have difficulties predicting or controlling the extent of its continued use.

Pathophysiology of Effects

The primary effect of cocaine is the blockage of electrical impulse initialization or conduction in the nerve cells. This alteration in synaptic transmissions seriously damages the metabolism of noradrenalin, dopamine, serotonin, and acetylcholine. This can cause a number of physical responses, such as rise in arterial pressure, tachycardia, ventricular arrhythmias and seizures. Effects can last from 20 minutes to several hours, depending upon the dosage of cocaine that has been taken.

Origin

Cocaine is made from Erythroxylon coca, a plant that contains several alkaloid chemicals, including cocaine itself. Coca has been used for thousands of years by the South American indigenous peoples, traditionally by chewing.  It is also proven that these cultures have used it in combination with saliva to get an anesthetic effect in order to diminish fatigue or perform trepanation. No one really knows when it was used for the first time as an addictive drug. Some claim that people became aware of its potential after Sigmund Freud's book about a “wonder drug” that could cure depression and alcohol dependence. The book was published in 1884.
The fact remains that cocaine as a pure chemical has been an abused substance for more than a century. Cocaine use in the United States and all around the world has reached epidemic proportions especially in the second half of the twentieth century. According to previous research, thirty million people in North America were cocaine users by the late 1980s, and 6 million of them were cocaine addicts!

Variants

The most common form of cocaine is “pure cocaine” or cocaine hydrochloride. It is the purest form, and looks like white, pearly powder. In most cases it is mixed with various additives such as baking soda, sugars such as lactose, inositol, and mannitol to get extra numbing effect on mucous membranes. With these additives, it can assume a pinkish hue. This “powder cocaine” has is very famous among mostly middle and upper class people, especially celebrities, musicians and entertainers.

Cocaine can be used in many other forms and some of the most common include the following.

1) Cocaine sulfate – This form is produced from macerating coca leaves along with water mixed with sulfuric acid. After the cocaine is extracted, the water evaporates. This form of cocaine is commonly smoked as or along with a tobacco. Other street names of this form of cocaine are pasta, basa, pitillo, basuco, paco or paste.
2) Freebase – This form is made from cocaine hydrochloride dissolved in water and then filtered. This procedure is very dangerous because its vapors are extremely inflammable. Resulting freebase, unlike cocaine hydrochloride, is extremely insoluble in water. Impossible to drink, snort, or inject, freebase is however suitable for smoking because it vaporizes at a low temperature. After it enters the lungs, it quickly goes into the bloodstream and directly to the brain. The effect is much more intense then that of the same amount of drug sniffed would be. The feeling of euphoria lasts 5-10 minutes, but users commonly don’t wait that long before the next inhalation, which is what makes it so dangerous. 
3) Crack cocaine – “Crack” is a street name for the form of freebase cocaine that looks like small lumps or shavings. The name comes from the crackling sound that can usually be heard when the substance is smoked. Why is this form so common among addicts, especially poor, urban, and homeless? One of the reasons is the fact that it is often sold in small, low-priced packages, and no matter how small the package is, it offers a strong cocaine experience. The prices vary from 5$ to 10$ per package.

There are several street names for crack such are bones, candy, cheese, devil's dick, devil’s dandruff, devil's candy, devil drug, dope, girl, juice, matter, smoke, white bitch, work, but most commonly, it is simply called “rock”.

Forms of Administration

1) Chewing - The simplest and probably the oldest form of cocaine administration is the chewing of coca plant leaves. A very small amount of drug enters the bloodstream via this method, so the effects are comparatively mild.
2) Insufflation (sniffing) – This is the most common modern form of cocaine administration. It is significantly different from inhalation because approximately 80% of sniffed cocaine is absorbed through the mucous membranes of the sinuses, which makes this method highly dangerous. A user is in high risk for developing rhinitis and necrosis of the nasal membranes, including a tumor called granuloma. Before sniffing, the user must first divide the cocaine into fine particles, commonly done with a razor blade or credit card.
3) Injection – This form of cocaine administration certainly provides the highest drug levels in the bloodstream, and more importantly, for the shortest amount of time. After it has been injected into the veins it gets to the brain almost instantly. The sense of euphoria is very strong, sometimes causing vomiting or even a complete loss of touch with reality. This is the most dangerous form of administration because the most common complication is sudden death. This can result from toxic effects of the drug or from emboli from the insoluble substances that can often be found in the “impure” cocaine.
There is also a special form of injective mixture is called “speedball”, produced by mixing heroin and cocaine.
4) Smoking – It has been done for many years now, and the most commonly used tool for smoking cocaine is small glass pipe (a “crack pipe”). The mouth-side of the pipe is open, and the other side has a metal plate attached. This end is where cocaine is melted and boiled into vapor using flame from a cigarette lighter or handheld torch.

Addiction and Treatment

Although cocaine has certain positive reinforcement effects, such as behavioral changes – euphoria and increased muscle strength – it is highly addictive, potentially even life-threatening in case of a fatal overdose. Even pregnant women are using it although it has been proven that prenatal exposure to cocaine is related to aggressive behavior at the age of five and below. Most long-term users develop the characteristic symptoms, such as physiological damage, lethargy and depression.

Cocaine withdrawal requires hospitalization for detoxification, and the management of acute neurovascular complications that can occur during the process. This must be a professionally controlled program, because when cocaine use stops, several symptoms follow almost immediately. The primary symptoms include a very strong depression, or “person crash”. Of course, all this is accompanied by strong cravings that could last for months, fatigue, anxiety, irritability, sleepiness, and sometimes agitation or paranoia. Suicidal thoughts are also very common during the withdrawal period.

A single upside is that cocaine withdrawal is not as dramatic as withdrawal from other similarly addictive drugs (such as heroine, fir example). It has been proven that several medications have a possible benefit in cocaine addiction treatment. Some of these are Disulfiram, Amantadine, Tiagabine, Topiramate, and Baclofen.

Read More: What ecstasy does to your mind and body

Production

According to CIA's Crime and Narcotics Center, Colombia is the world's leading producer of cocaine, but the fact is that the cultivation of coca has become a highly lucrative activity throughout the world. The biggest trade routes are from several South American countries (such as Colombia and Peru), through Mexico, and into the United States – primary Arizona, southern California, southern Florida, and Texas.