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Many people who are addicted to cocaine go through a phase called withdrawal when they first do this. Many people start to build a tolerance after their first use of cocaine. Another reason cocaine can lead to substance use disorder is that each time you use it, your body builds a tolerance. That same year, about 24,486 people died from an overdose that involved cocaine. With cocaine use disorder, you may become both physically and mentally dependent on the drug.

For example, cocaine acts by binding to the dopamine transporter, blocking the removal of dopamine from the synapse. The mechanisms of drug euphoria or reward are only somewhat understood but are now believed to involve several dispersed brain structures called “hedonic hotspots” that produce especially intense pleasure when activated simultaneously.4,5 Their activation involves several different chemical messengers including the body’s naturally occurring opioids. Drugs like cocaine powerfully activate reward and reinforcement mechanisms in the brain. Any route of administration can potentially lead to absorption of toxic amounts of cocaine, causing heart attacks, strokes, or seizures—all of which can result in sudden death.2,3

Cocaine FAQs

• While cocaine and crack cocaine highs are brief, the drug may stay in your system for up to three days.
• Therapeutic communities (TCs)—drug-free residences in which people in recovery from substance use disorders help each other to understand and change their behaviors—can be an effective treatment for people who use drugs, including cocaine.46 TCs may require a 6- to 12-month stay and can include onsite vocational rehabilitation and other supportive services.
• The prolonged or compulsive use of cocaine in any of its purified forms can cause severe personality disturbances, inability to sleep, and loss of appetite.
• Food and Drug Administration to treat cocaine use disorder.
• In 1994, the US 9th Circuit Court of Appeals cited findings that in Los Angeles, three out of four banknotes were tainted by cocaine or another illicit drug.

Cocaine overdose may result in hyperthermia as stimulation and increased muscular activity cause greater heat production. When nasal damage is too severe for reconstruction, a nose prosthesis may be used to restore appearance and quality of life. Repair may involve rhinoplasty, which includes creating a new internal lining with nasolabial flaps and restoring support with costal cartilage grafts. Chronic intranasal usage can degrade the cartilage separating the nostrils (the septum nasi), leading eventually to its complete disappearance. Cocaine use should be considered as a potential cause of persistent or unexplained rhinitis, including in adolescent patients.

Detection in the body

If you or someone you know has problems with cocaine use, seek help from a doctor or mental health professional. The vaccine activates your immune system to create antibodies that attach to cocaine and stop it from making its way into your brain. The FDA hasn’t approved any medicine to treat cocaine addiction. Counseling and other types of therapy are the most common treatments for cocaine use disorder.

Insufflation of cocaine also leads to the longest duration of its effects (60–90 minutes). This occurs because cocaine’s absorption is slowed by its constricting effect on the blood vessels of the nose. Crack cocaine is a smokeable form of cocaine made into small “rocks” by processing cocaine with sodium bicarbonate (baking soda) and water. The duration of cocaine’s effects depends on the amount taken and the route of administration.

Coca leaves

Using cocaine during pregnancy can cause problems for both the parent and the developing baby. There are about 750,000 cocaine-exposed pregnancies each year. Some research has suggested that cocaine damages the way immune cells work in your body, which could make HIV worse. Your chances of getting HIV, the virus that causes AIDS, are higher if you use cocaine. They can also add other drugs like amphetamine, fentanyl, heroin, or procaine. To make more money, dealers may “cut” the drug with other substances, like flour, baking soda, cornstarch, or talcum powder.

Cocaine should not be used in individuals with a known allergy or hypersensitivity to the drug or any components of its topical formulation. This effectively destroys some of the cocaine and yields a sharp, acrid, and foul-tasting smoke. Powder cocaine (cocaine hydrochloride) must be heated to a high temperature to be smoked (about 197 °C), and considerable decomposition/burning occurs at these high temperatures. Crude cocaine preparation intermediates are marketed as cheaper alternatives to pure cocaine to local markets while the more expensive end product is exported to United States and European markets.

Pregnancy

• These modifications may result in lasting epigenetic “scars”, which are believed to contribute to the persistent epigenetic changes observed in cocaine addiction.
• It’s hard to stop using crack on your own.
• Cocaine can induce tolerance after a single dose, and repeated use frequently leads to the development of addiction and prolonged craving.
• Cocaine’s effects appear almost immediately after a single dose and typically disappear within a few minutes to an hour.
• Cocaine’s effects start quickly after you take a dose.

WebMD does not provide medical advice, diagnosis or treatment. Scientists don’t know exactly how it works to reduce cocaine use. Research to test new drugs is under way.

Just as cocaine produces a brief high that temporarily enhances the sense of worth, narcissists rely on external admiration to feed an addiction to their self-esteem, resulting in a self-reinforcing feedback cycle. It also disrupts dopamine levels and blood flow, accelerating brain aging and causing long-term neurological harm. Brain imaging studies consistently report that individuals who misuse cocaine exhibit structural and functional abnormalities compared to non-users, supporting the classification of cocaine as a neurotoxic substance. In 2025, the Liberty House Clinic in the United Kingdom noted that chronic cocaine usage in fact had a higher risk of death than alcoholism. Persons with regular or problematic use of cocaine have a significantly higher mortality rate, and are specifically at higher risk of traumatic deaths and deaths attributable to infectious disease.

Where Does Cocaine Come From?

It’s absorbed through the tissues in your nasal passages and moves into your bloodstream. The traditional way to use cocaine is to sniff or snort it into your nostrils. Crack is stronger and more addictive than the powder form of the drug,

Latin America

These mice self-administer cocaine at lower doses and display a greater propensity for relapse after withdrawal ΔFosB also enhances sensitivity to reward by upregulating the AMPA receptor subunit GluR2 and downregulating the expression of dynorphin. Cocaine abuse can trigger addiction-related structural neuroplasticity in the human brain, although the permanence of such changes remains uncertain. According to the Global Burden of Disease Study, cocaine use is responsible for approximately 7,300 deaths annually.

How can I help someone who is addicted to cocaine?

Sometimes, people use cocaine and an opioid drug, such as Cocaine Withdrawal Guide heroin, at the same time. Instead of using baking soda as you would with crack, you add ammonia to “free” the cocaine base from its natural form. Freebase cocaine is also a solid form of the drug.

Recent research has also examined the use of prescription psychostimulants for cocaine dependence, following the Self-Medication Hypothesis. Cocaine haptens are chemically modified derivatives of cocaine that retain key immunogenic features, allowing them to be attached to carrier proteins such as keyhole limpet hemocyanin or bovine serum albumin. It provides a highly reliable, conservative record of cocaine movements and interdiction efforts, revealing that despite large seizures, interdiction captures only a small fraction of trafficking events and has minimal impact on U.S. cocaine prices. One of the major implications of cocaine production is deforestation as large areas of forest are cleared for coca cultivation. The environmental destruction caused by the production of cocaine has been well documented, with reports made the UN and other government bodies.

The faster the drug is absorbed, the more intense the resulting high, but also the shorter its duration. Cocaine’s effects appear almost immediately after a single dose and typically disappear within a few minutes to an hour. The stress circuits of the brain are distinct from the reward pathway, but research indicates that there are important ways that they overlap. This reinforcement sets in motion the addiction cycle.8,9 Another specialized protein called a transporter removes dopamine from the synapse to be recycled for further use.6

NIDA is a biomedical research organization and does not provide personalized medical advice, treatment, counseling, or legal consultation. Once inpatient treatment ends, ongoing support—also called aftercare—can help people avoid recurrence. For example, an unemployed patient would benefit from vocational rehabilitation or career counseling along with addiction treatment. Regardless of the specific type of substance use disorder treatment, it is important that patients receive services that match all of their treatment needs.

Farmers are able to use unregulated and highly toxic pesticides due to the clandestine nature of drug production. Such areas are chosen for coca cultivation due to their remote locations, minimising chances of detection. The UNODC approximated that 97,622 hectares of primary forest were cleared for coca cultivation during 2001–2004 in the Andean region. Due to the illegal nature of coca production, farmers make little effort in soil conservation and sustainability practices as seen in the high mobility and short life of coca plots in Colombia. Many of these hazardous substances, such as solvents and acids, remain in the paste after processing.