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Cocaine is a
powerfully addictive stimulant that directly affects the brain. Cocaine
is not a new drug. In fact, it is one of the oldest known drugs. The
pure chemical, cocaine hydrochloride, has been an abused substance for
more than 100 years, and coca leaves, the source of cocaine, have been
ingested for thousands of years.
Pure cocaine was
first extracted from the leaf of the Erythroxylon coca bush,
which grows primarily in Peru and Bolivia, in the mid-19th century. In
the early 1900s, it became the main stimulant drug used in most of the
tonics/elixirs that were developed to treat a wide variety of illnesses.
Cocaine abuse has
a long history and is rooted into the drug culture in the U.S. It is an
intense euphoric drug with strong addictive potential. With the increase
in purity, the advent of the free-base form of the cocaine ("crack"),
and its easy availability on the street, cocaine continues to burden
both the law enforcement and health care systems in America.
The powdered,
hydrochloride salt form of cocaine can be snorted or dissolved in water
and injected. Crack is cocaine that has not been neutralized by an acid
to make the hydrochloride salt. This form of cocaine comes in a rock
crystal that can be heated and its vapors smoked. The term “crack”
refers to the crackling sound heard when it is heated.
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Blow, nose candy,
snowball, tornado, wicky stick,
Perico (Spanish),
Charlie, coke, snow, snow white, toot, girl, c-dust, flake and big-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.
Also, the faster the absorption, 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.
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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 reabsorption 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 convulsant 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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The
amount of cocaine available in domestic drug markets appears to meet
user demand in most markets, without observable shortfall. However,
recent ONDCP analysis of data from February through September 2005 shows
that the purity of available cocaine could be diminishing at the retail
level--reflecting decreases in potential worldwide cocaine production
and significant increases in cocaine interdiction.
Mexican DTOs and criminal groups control most wholesale cocaine
distribution in the United States, and their control is increasing.
According to federal, state, and local law enforcement reporting,
Mexican DTOs and criminal groups are the predominant wholesale cocaine
distributors in the Great Lakes, Pacific, Southeast, Southwest, and West
Central Regions, and although Colombian and Dominican criminal groups
control most wholesale distribution in the Northeast and
Florida/Caribbean Regions, wholesale distribution by Mexican DTOs and
criminal groups is increasing. For example, the Drug Enforcement
Administration (DEA) New York Field Division reported in 2005 that in
some areas of New York City, Mexican criminal groups have supplanted
Colombian criminal groups as the primary source of multikilogram-quantities
of cocaine. Similarly, the Central Florida High Intensity Drug
Trafficking Area (HIDTA) recently reported that in some areas of central
Florida, Mexican DTOs and criminal groups have supplanted Colombian and
Dominican criminal groups as the predominant wholesale cocaine
distributors and are establishing new distribution networks.
Control over
wholesale cocaine distribution by Mexican DTOs and criminal groups has
been increasing for several years and is likely to continue to increase
in the near term. Cocaine transportation data indicate that most cocaine
available in U.S. drug markets is smuggled into the country via the
U.S.-Mexico border. As Mexican DTOs and criminal groups control an
increasing percentage of the cocaine smuggled into the country, their
influence over wholesale distribution will rise even in areas previously
controlled by other groups, including areas of the Northeast and
Florida/Caribbean Regions.
Cocaine is
distributed in nearly every large and midsize city; however, analysis of
cocaine seizure data indicates that several specific cities serve as
national-level cocaine distribution centers through which most domestic
cocaine flows. Midlevel and retail-level distribution of the drug in
these and most other cities is controlled primarily by organized gangs;
however, in smaller cities and rural communities retail distribution
typically is controlled by local independent dealers.
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2005
rates of cocaine use were relatively high, and overall, use appears to
be stable. According to the National Survey on Drug Use and Health (NSDUH),
the rate of past year use for cocaine (powder and crack combined) among
individuals aged 12 and older (2.4%) has remained stable since 2002; it
is much lower than that for marijuana (10.6%), but is higher than that
for methamphetamine (0.6%) or heroin (0.2%). Among adults, NSDUH data
show that rates of past year use for cocaine (powder and crack combined)
among young adults (aged 18 to 25) are stable but remain the highest
among all age groups. Monitoring the Future (MTF) and NSDUH also
indicate stable rates of adolescent cocaine use. The number of treatment
admissions to publicly funded treatment facilities for cocaine has
decreased since the mid-1990s despite increased access to drug
treatment. Cocaine is the only major drug of abuse for which treatment
admissions have decreased.
Among
students surveyed as part of the 2005 Monitoring the Future study, 3.7%
of eighth graders, 5.2% of tenth graders, and 8.0% of twelfth graders
reported lifetime use of cocaine. In 2004, these percentages were 3.4%,
5.4%, and 8.1%, respectively.
According to the National Survey on Drug Use and Health (NSDUH, 2004),
34.15 million Americans ages 12 and older (14.7% of this age group) had
used cocaine once in their lifetime and 2.0 million were current users
of cocaine in 2004. The new initiates of cocaine abuse were about 1
million in 2004. According to the Monitoring the Future Study (MTF,
2005), the percentages of eighth, tenth and twelfth graders reported
using cocaine once in their life time were 3.7, 5.2 and 8.0,
respectively, while the corresponding numbers for the current cocaine
users (used in the past month) were 1.0, 1.5 and 2.3, respectively.
Cocaine abuse occurs in both genders and among all ethnic groups of the
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