COCAINE ABUSE

It is an all-too-common scenario: A person experiments with an addictive drug like cocaine. Perhaps he intends to try it just once, for "the experience" of it. It turns out that he enjoys the drug's euphoric effect so much that in ensuing weeks and months he uses it again, and again. But in due time, he decides he really should quit. He knows that despite the incomparable short-term high he gets from using cocaine, the long-term consequences of its use are perilous. So he vows to stop using it.

His brain, however, has a different agenda. It now demands cocaine. While his rational mind knows full well that he shouldn't use it again, his brain overrides such warnings. Unbeknown to him, repeated abuse of cocaine has brought about dramatic changes in both the structure and function of his brain. In fact, if he'd known the danger signs for which to be on the lookout, he would have realized that the euphoric effect derived from cocaine use is itself a sure sign that the drug is inducing a change in the brain. He also would have known that as time passes, and the drug is used with increasing regularity, this change becomes more pronounced and indelible. Finally his brain has become addicted to the drug.

And so, despite his heartfelt vow never again to abuse cocaine, he continues using it again and again. His drug use is now beyond his control. It is compulsive. He is addicted. While this turn of events is a shock to the cocaine abuser, it is no surprise at all to researchers who study the effects of addictive drugs. To them, it is a predictable outcome.

Nobody ever starts out using cocaine with the intention of becoming a drug addict. Every cocaine abuser starts out as an occasional user, experimenting once or a few times. The initial use is voluntary and is a controllable decision. But as time passes and the cocaine abuser continues, they go from being a voluntary to a compulsive cocaine abuser. This change occurs because the use of addictive drugs, such as cocaine, changes the brain over time. At times, this change can appear in dramatic and toxic ways. At other times it can occur in more subtle ways. However, it always appears in destructive ways that can result in compulsive and even uncontrollable cocaine abuse.

Cocaine's recent notoriety belies the fact that the drug has been used as a stimulant by people for thousands of years. Its properties as a stimulant have led people in the past to use it in a number of patent medicines and even in soft drinks. But cocaine's highly addictive nature and addicts' willingness to pay a high price for the drug have propelled it into the public eye. The crime and violence associated with its transportation, sale, and the celebrity nature of some of its victims has kept cocaine in the news.

In its pure form, cocaine is a white crystalline powder extracted from the leaves of the South American coca plant. On the street, pure cocaine is diluted or "cut" with other substances to increase the quantity. This increase the profits for its sellers. Cocaine users most often inhale the powder sharply through the nose, where it is quickly absorbed into the bloodstream. It can also be heated into a liquid and its fumes inhaled through a pipe in a method called "freebasing". Freebasing is also a common method of using another form of cocaine called "crack". Crack resembles small pieces of rock and is often called "rock" on the street.

Cocaine is highly addictive, especially in the crack form. In studies, animals addicted to cocaine preferred the drug to food. They would take cocaine even when it meant they would starve. Many users report being "hooked" after only one use. The addiction is both psychological and physical.

Users usually feel an initial "rush" or sense of well-being, of having more energy, and being more alert. This effect quickly wears off, often leaving the user feeling more "down" or depressed than before. This down feeling leads the addict to use more cocaine, sometimes just to feel "normal." Over a period of time, the amount of cocaine needed and the frequency of use to achieve a "high" have increase. Feelings of depression can become chronic.

Cocaine abusers frequently turn to other drugs to relieve the down feeling when more cocaine is not available. When used together, these drugs and cocaine can prove even more deadly than when used alone.

Despite a popular myth, cocaine does not enhance performance whether it be on the job, in sports, at school, or with a sexual partner. On the contrary, long-term cocaine abuse can lead to loss of concentration, irritability, loss of memory, paranoia, loss of energy, anxiety, and a loss of interest in sex. The controlling effect cocaine has on an addict's life can lead to exclusion of all other facets of life. A habit can cost an addict thousands of dollars a week to maintain.

Breaking a cocaine abuse habit is not easy. How long and how difficult a task it may be varies from person to person. Treatment can be costly and the craving for cocaine may persist for long periods of time.