Over time, cocaine use may change other brain functions. The 2021 (U.S.) National Survey on Drug Use and Health (NSDUH) concludes 4.8 million people age 12 and older used cocaine in 2020. People use crack cocaine by heating it in a glass pipe or adding it to marijuana or tobacco. More commonly, people use cocaine to boost feelings like being energized, happy and alert. Cocaine is a powerful stimulant drug that\u2019s extracted and processed from coca plant leaves in South America.<\/p>\n

For Treatment Providers<\/h2>\n

Stress can contribute to cocaine recurrence, and cocaine use disorders frequently co-occur with stress-related disorders. This pathway originates in a region of the midbrain called the ventral tegmental area and projects to other brain areas including the nucleus accumbens, where one of the brain\u2019s hedonic hotspots is also located.6 Besides reward and reinforcement, this circuit also regulates emotions and motivation.7 Cocaine is a Schedule II drug, which means that it has high potential for misuse but can be administered by a doctor for medical uses, such as local anesthesia for some eye, ear, and throat surgeries. It is made from the leaves of the coca plant (Erythroxylon coca), which is native to South America.1<\/p>\n

In an emergency? Need treatment?<\/h2>\n

Ask a healthcare provider about programs and services for people affected by another person\u2019s cocaine use. Over time, using cocaine may increase the risk of medical issues, some of which may be life-threatening. One study showed 15% of people who used cocaine became addicted to the drug within 10 years. As people keep on using cocaine, their brains get used to the huge overstimulation and they need stronger, more frequent doses. But that cocaine-driven dopamine release or rush fades quickly, leaving them wanting more of those feelings \u2014 and the drug.<\/p>\n

Cocaine and its major metabolites may be quantified in blood, plasma, or urine to monitor for use, confirm a diagnosis of poisoning, or assist in the forensic investigation of a traffic or other criminal violation or sudden death. 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.<\/p>\n

Who Controls the Cocaine Trade?<\/h2>\n

Cocaine hydrochloride (Numbrino) was approved for medical use in the United States in January 2020. Like coca teas consumed in Peru to adapt to sickness induced by high elevation, it has a long ethnobotanical history and cultural associations. While the packaging claimed it had been “decocainized”, no such process had actually taken place.<\/p>\n

A 2021 study found that cocaine use disorder impairs emotion recognition, especially for happiness and fear, with improvement after long-term abstinence. A 2020 study found that men with cocaine use disorder have greater difficulty identifying emotional expression in female faces, affecting relationships and suggesting a target for intervention. In 1989 Fulton County, 40% of homicide victims had cocaine metabolites, especially Black and firearm victims.<\/p>\n