How is Cocaine Used?

By Craig Thompson Off
Using cocaine produces a feeling of euphoria in the user while causing blood pressure and heart rate to increase. Cocaine users report feeling energetic and alert while using the drug.

How is Cocaine Used?

The powdered form of Cocaine is either inhaled through the nose (snorted), where it is absorbed through the nasal tissue, or dissolved in water and injected into the bloodstream. Crack rock crystal can be smoked. The crystal is heated to create a vapor that is then absorbed into the bloodstream through the lungs.

The intensity and duration of cocaine’s pleasurable effects depend on the way it is administered. Injecting or smoking cocaine delivers the drug rapidly into the bloodstream and brain, producing a quicker and stronger but shorter-lasting high than snorting. The high from snorting cocaine may last 15 to 30 minutes; the high from smoking may last 5 to 10 minutes. In order to sustain their high, people who use cocaine often use the drug in a binge pattern – taking it repeatedly within a relatively short period of time, at increasingly higher doses. This practice can easily lead to addiction, a chronic relapsing disease caused by changes in the brain and characterized by uncontrollable drug-seeking no matter the consequences. In many countries cocaine has become a popular recreational drug.



Cocaine is a drug extracted from the leaves of the coca plant, and is also known as Big C, Blow, Coke, Flake, Freebase, Lady, Nose Candy, Rock, Snow, Snowbirds, and White Crack. It is a potent brain stimulant and one of the most powerfully addictive drugs whose annual street use revenues top $100 billion and exceed that of corporations as large as Starbucks. Using cocaine produces a feeling of euphoria in the user while causing blood pressure and heart rate to increase. Cocaine users report feeling energetic and alert while using the drug. Cocaine is distributed on the street in two main forms: cocaine hydrochloride is a white crystalline powder and “crack” is cocaine hydrochloride that has been processed with ammonia or sodium bicarbonate (baking soda) and water into freebase cocaine sold as white crystal chips, chunks or rocks.


How Does Cocaine Affect the Brain? 

Cocaine is a strong central nervous system stimulant that increases levels of dopamine in the brain, which is the neurotransmitter that regulates pleasure and movement circuits. In a non-user, dopamine is released by neurons in these circuits in response to potential rewards (like the smell of good food) and then recycled back into the cell that released it, thus shutting off the signal between neurons. Cocaine prevents the dopamine from being recycled, causing excessive amounts to build up in the synapse, or junction between neurons. This amplifies the dopamine signal and ultimately disrupts normal brain communication. It is this flood of dopamine that causes cocaine’s characteristic high.

Signs of Abuse

If a person is abusing cocaine, he or she will often disappear to use and then return in a very different mood. They might seem excited and act more confident, exhibiting a greater sense of well being and be more talkative. There may be traces of white powder around their nose, dilated pupils, runny/bloody nose, or oversensitivity to light. Symptoms also include disorientation, delusions, paranoia, antisocial behavior and aggressiveness. A person who has become addicted will be driven to use more at the expense of their family, career, work, or health. For those who inject, you may see needle marks on their body; for those who smoke it, there may be burn marks on their lips and fingers. You may also find syringes and/or crack pipes lying around.

Long-Term Effects of Abuse

Cocaine affects the body in a variety of ways. It constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure. It can also cause headaches and gastrointestinal complications such as abdominal pain and nausea. Because cocaine tends to decrease appetite, chronic users can become malnourished as well.

Most seriously, people who use cocaine can suffer heart attacks, enlarged hearts, or strokes, which may cause sudden death. Cocaine-related deaths are often a result of the heart stopping (cardiac arrest) followed by an arrest of breathing. With repeated use, cocaine can cause long-term changes in the brain’s reward system as well as other brain systems. With repeated use, tolerance to cocaine also often develops; many cocaine abusers report that they seek but fail to achieve as much pleasure as they did from their first exposure. Many users increase their dose in an attempt to intensify and prolong their high thereby also increasing the risk of adverse psychological or physiological effects.

People who use cocaine also put themselves at risk for contracting HIV, even if they do not share needles or other drug paraphernalia. This is because cocaine intoxication impairs judgment and can lead to risky sexual behavior.

Some effects of cocaine depend on the method of taking it. Regular snorting of cocaine, for example, can lead to loss of the sense of smell, nosebleeds, problems with swallowing, hoarseness, and a chronically runny nose. Injecting cocaine can bring about severe allergic reactions and increased risk for contracting HIV, hepatitis C, and other blood-borne diseases.

Binge-patterned cocaine use may lead to irritability, restlessness, and anxiety. Cocaine abusers can also experience severe paranoia – a temporary state of full-blown paranoid psychosis – in which they lose touch with reality and experience auditory hallucinations. Gangrene in the bowels from decreased blood flow is also a possibility for regular users.


Symptoms of an overdose include rapid heart beat, agitation, and fever. Seizures may occur during an overdose, and the addict may suffer a heart attack. This situation is a medical emergency and the victim should go to an emergency room for treatment.

Mixing with other Drugs

Cocaine is more dangerous when combined with other drugs or alcohol (poly-drug use). For example, the combination of cocaine and heroin (known as a “speedball”), may affect the respiratory system and slow down the user’s breathing, with severe consequences and a particularly high risk of fatal overdose. Cocaine and alcohol is another combination that you want to avoid, since it causes the body to produce a toxic substance called cocaethylene in the blood.


Cocaine detox is a psychological withdrawal rather than a physical one, and there is no technical medical process. However, it is highly advised to seek help. It is important to monitor vital functions because cocaine use may severely damage internal organs, especially the heart. The first few days of withdrawal are the hardest with extreme mood swings, sleeplessness, irritability, depression, and possible violence.

Drug Tests

Cocaine is a substance that is routinely screened for in drug tests, it will show up in the user’s urine for around 72 hours after use, for occasional users. For more frequent users, the drug stays in the body longer. Certain antibiotics can trigger a false positive reading on a drug test.

Legal Status

Under U.S. law, cocaine is considered a Schedule II controlled substance, but it can be used as a local anesthetic for certain medical procedures.