Cocaine & Crack
Also known As:
Blow, C, coke, crack, flake, freebase, rock, and snow.
What is it?
Cocaine and crack are drugs classified as stimulants, because they stimulate the user’s central nervous system (CNS). Cocaine is produced by chemically processing coca leaves and extracting the stimulating properties from the plant. Crack cocaine is produced by adding baking soda (and other chemicals) to powdered cocaine and cooking the product, to remove impurities and make the cocaine smokeable. Powdered cocaine is rarely pure and is usually “stepped on” (cut) and mixed with other products - such as caffeine, levamisole, novocaine, and amphetamines - to increase profits for traffickers.
How does it work?
Cocaine and crack cocaine interact with neurotransmitters in the brain, specifically norepinephrine and dopamine. The drug blocks the re-uptake of these chemicals in the synaptic cleft, causing the user to feel euphoric, alert, energetic, and confident, and elevating their mood.
When powdered cocaine is insufflated (snorted), the effects can be felt within a few minutes and last for 30 minutes to an hour. When powdered cocaine is intravenously injected into the bloodstream, effects are felt instantly and last roughly 15 minutes. Crack cocaine is only smokable and the effects are felt almost instantaneously, and last between 5-20 minutes.
Because of the short half-life of cocaine (and crack-cocaine), and the highly reinforcing effects it has on the dopaminergic system, users will typically consume the drug repeatedly over a shorter period of time compared to other longer-lasting stimulants (such as methamphetamine).
What does it look like?
Cocaine hydrochloride—the form in which cocaine is snorted or injected—is a white crystalline powder that looks similar to household products you would use in your kitchen, such as baking soda or flour. It is sometimes “cut,” or mixed, with things that look like it, such as cornstarch or talcum powder, or with other drugs, such as local anesthetics or amphetamines. If it is a purer form/hasn’t been cut with a lot of adulterants, it will have a slight shine to it, similar to that of fish scales. It has a bitter and numbing taste, which is specifically felt after snorting the drug, producing a very bitter flavour in the back of the user’s throat, known as “the drips”.
The base form of cocaine can be chemically processed to produce forms of cocaine that can be smoked. These forms, known as “freebase” and “crack,” look like crystals or small white/yellowish rocks. The taste of the drug is felt through smoking, which causes both a warm and numbing sensation in the mouth and lungs.
Cocaine is often used with other drugs, especially alcohol and cannabis. Cocaine and heroin, mixed and dissolved for injection, is called a “speedball” (CAMH, 2010).
Is there a safe dose?
Under prohibition and when using illicit drugs, there is typically no safe dose because you may not be certain about the contents or potency of the substance. Cocaine is commonly cut with levamisole (a veterinary medicine that causes health and skin problems) and can be cut and contaminated with other drugs such as caffeine and fentanyl.
As with all drugs, a dose or safe dose is dependent on both the tolerance of the user and their unique biology, if they have consumed other narcotics and their mental status. A standard dose or “line” of cocaine is roughly 1/10th of a gram. Crack cocaine is usually sold in rocks, and the size of a dose for one rock is slightly smaller than that of powdered cocaine, from 15mg-50mg.
Effects
The effects of using both cocaine and crack cocaine are that of euphoria, stimulating/energizing, suppression of fatigue, confidence, enhancement of sensory experiences (such as music, art or sexual encounters), increased sociability and suppression of appetite.
Effects include:
Feeling ‘high’, sense of wellbeing, relaxation, and heightened sensory experiences
Feeling euphoric, talkative, giggly, and lively
Feeling anxious, fearful and/or tense
Feeling sleepy or hazy
Physical effects include:
Red eyes
Dry mouth & throat
Irritated respiratory system (when smoking)
Increase in appetite
Elevated heart rate
Decrease in blood pressure
Drowsiness or restlessness
When the cocaine high fades, the person may begin to feel anxious and depressed, and have intense craving for more of the drug. Some people stay high by “bingeing,” or continually using the drug, for hours or days (CAMH, 2010).
Side effects and cautions
Risks related to cocaine use (CAMH, 2010):
Cocaine causes the blood vessels to thicken and constrict, reducing the flow of oxygen to the heart. At the same time, cocaine causes the heart muscle to work harder, which can lead to heart attack or stroke, even in healthy people.
Cocaine raises blood pressure, which can cause weakened blood vessels in the brain to burst.
A person can overdose on even a small amount of cocaine. Overdose can cause seizures and heart failure. It can cause breathing to become weak or stop altogether. There is no antidote to cocaine overdose.
When cocaine is used with alcohol, the liver produces cocaethylene, a powerful compound that increases the risk of overdose and sudden death beyond the risk of using cocaine alone.
High doses and prolonged use (CAMH, 2010):
At high doses or prolonged use over a period of time (binges), these drugs cause paranoia, sleep deprivation, anxiety, heart palpitations, irritability, aggression, hallucinations, increased body temperature, muscle spasms, and possible strokes.
Taking high doses of cocaine for a long time can lead to (CAMH, 2010):
panic attacks
psychotic symptoms, such as paranoia (feeling overly suspicious, jealous or persecuted), hallucinations (seeing, hearing, smelling, etc., things that aren’t real) and delusions (false beliefs)
erratic, bizarre and sometimes violent behaviour.
With regular use, people may become tolerant to the euphoric effects of cocaine. This means they need to take more and more of the drug to get the same desired effect. At the same time, people who use the drug regularly may also become more sensitive to its negative effects, such as anxiety, psychosis (hallucinations, loss of contact with reality) and seizures (CAMH, 2010).
Long term effects (CAMH, 2010):
Cocaine increases the same chemicals in the brain that make people feel good when they eat, drink or have sex. Regular cocaine use can cause lasting changes in this “reward system” of the brain, which may lead to addiction. Craving and psychiatric symptoms may continue even after drug use stops.
Regular long-term use of cocaine is associated with many serious health and behaviour problems. For example:
Snorting cocaine can cause sinus infections and loss of smell. It can damage tissues in the nose and cause holes in the bony separation between the nostrils inside the nose.
Smoking cocaine can damage the lungs and cause “crack lung.” Symptoms include severe chest pains, breathing problems and fever. Crack lung can be fatal.
Injection can cause infections from used needles or impurities in the drug. Sharing needles can also cause hepatitis or HIV infection.
Cocaine use in pregnancy may increase risk of miscarriage and premature delivery. It also increases the chance that the baby will be born underweight.
Cocaine use while breastfeeding transmits cocaine to the nursing child. This exposes the baby to all the effects and risks of cocaine use.
Cocaine use is linked with risk-taking and violent behaviours. It is also linked to poor concentration and judgment, increasing risk of injury and sexually transmitted disease.
Chronic use can cause severe psychiatric symptoms, including psychosis, anxiety, depression and paranoia.
Chronic use can also cause weight loss, malnutrition, poor health, sexual problems, infertility and loss of social and financial supports.
Addiction
Not everyone who uses cocaine becomes addicted, but if they do, it can be one of the hardest drug habits to break.
People who become addicted to cocaine lose control over their use of the drug. They feel a strong need for cocaine, even when they know it causes them medical, psychological and social problems. Getting and taking cocaine can become the most important thing in their lives.
Smoking crack, with its rapid, intense and short-lived effects, is the most addictive. However, any method of taking cocaine can lead to addiction. The amount of cocaine used, and how often people use the drug, has an effect on whether people get addicted.
Cocaine causes people to “crash” when they stop using it. When they crash, their mood swings rapidly from feeling high to feeling distressed. This brings powerful cravings for more of the drug. Bingeing to stay high leads quickly to addiction.
Symptoms of cocaine withdrawal can include exhaustion, extended and restless sleep or sleeplessness, hunger, irritability, depression, suicidal thoughts and intense cravings for more of the drug. The memory of cocaine euphoria is powerful, and brings a strong risk of relapse to drug use.
(CAMH, 2010)
Therapeutic Uses
Cocaine is extracted from the leaves of the Erythroxylum (coca) bush, which grows on the slopes of the Andes Mountains in South America. For at least 4,500 years, people in Peru and Bolivia have chewed coca leaves to lessen hunger and fatigue.
Cocaine is used by health care professionals to temporarily numb the lining of the mouth, nose, and throat (mucous membranes) before certain medical procedures (e.g., biopsy, stitches, wound cleaning). It is an anesthetic that works quickly to numb the area about 1-2 minutes after application. Cocaine also causes blood vessels to narrow, an effect that can decrease bleeding and swelling from the procedure (WebMD, n.d.)
Harm Reduction Tips
to reduce the possible harms of cocaine & Crack, the following is suggested:
Avoid consuming other substances if you are using cocaine or crack cocaine, the other substances could increase the risk of cardiac or respiratory issues (other stimulants such as amphetamines).
If you are using with other people, have your own personal consumption devices (i.e. straw, pipe, needle) so as to mitigate the risk of transmitting viruses (either known or unknown). Almost all cocaine will be cut with adulterants, so be sure to test the batch you have to see if it contains any other drugs (such as fentanyl), to reduce the risk of overdose.
Both cocaine and crack cocaine have a short duration of their effects (5-30 mins high) so users are more prone to binge use them, leading to periods of sleep deprivation, dehydration and lack of consumption of food. Be sure to take breaks from using to hydrate, eat and get sleep.
Legal Status
Cocaine, crack cocaine and all its derivatives and precursors are classified under the “Controlled Drugs and Substances Act” as Schedule I drugs. This means that these drugs are the most heavily policed, and even small possession can lead to criminal charges and “possible imprisonment for a term not exceeding seven years” (Government of Canada, 2019).
While both cocaine and crack are governed by the same laws and penalties for possession and trafficking in Canada, it is common for crack cocaine users to be more heavily policed due to racial and class-based biases. This is particularly true in the United States, where crack users face vastly disproportionate sentences compared to users of powdered cocaine (American Civil Liberties Union, 2006).
History of Cocaine
Pure cocaine was first isolated from the leaves of the coca bush in 1860. Researchers soon discovered that cocaine numbs whatever tissues it touches, leading to its use as a local anesthetic. Today, we mostly use synthetic anesthetics, rather than cocaine.
In the 1880s, psychiatrist Sigmund Freud wrote scientific papers that praised cocaine as a treatment for many ailments, including depression and alcohol and opioid addiction. After this, cocaine became widely and legally available in patent medicines and soft drinks.
As cocaine use increased, people began to discover its dangers. In 1911, Canada passed laws restricting the importation, manufacture, sale and possession of cocaine. The use of cocaine declined until the 1970s, when it became known for its high cost, and for the rich and glamorous people who used it. Cheaper “crack” cocaine became available in the 1980s.
(CAMH, 2010)
References
American Civil Liberties Union. (2006). Cracks in the system: 20 years of unjust federal crack cocaine law. Retrieved from https://www.aclu.org/other/cracks-system-20-years-unjust-federal-crack-cocaine-law
Centre for Addiction and Mental Health. (2010). Cocaine and Crack. Retrieved from https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/cocaine
Government of Canada. (2019). Controlled Drugs and Substances Act. Retrieved from https://laws-lois.justice.gc.ca/eng/acts/c-38.8/
Narconon. (n.d.). Pharmaceutical Use of Cocaine. Retrieved from https://www.narconon.org/drug-information/cocaine-circa-1860-1900.html
WebMD. (n.d.). Cocaine Topical. Retrieved from https://www.webmd.com/drugs/2/drug-1383/cocaine-topical/details
Image sources
Cocaine pile on black surface. (2019). ReachOut Australia. Retrieved from https://au.reachout.com/articles/cocaine
The contents of a safer use crack kit. V.I.A.. (2014). Retrieved from https://www.vancouverisawesome.com/2014/02/20/why-does-providing-crack-pipes-to-people-who-smoke-crack-matter/