The spread of cocaine use among Americans during the early twentieth century began to attract the attention of the medical community and national leaders. Government officials decided to investigate the use of cocaine and learned that large numbers of citizens were buying cocaine not in the form of additives to foods, beverages, and medicines intended to treat specific medical conditions, but in its pure form for the pleasurable sensation the drug induced. Evidence that cocaine consumption might have slipped beyond the bounds of medical use caused alarm.

Declared Illegal

As cocaine use rose, hospitals began reporting an alarming increase of illness linked to the drug. In 1912, for example, five thousand deaths were directly or indirectly attributed to cocaine. In 1914 the U.S. government responded by declaring cocaine a controlled substance, making its use illegal except when prescribed by a doctor. As a result, cocaine use dropped dramatically and imports of coca leaves, which in 1914 had been estimated at about 450 tons, fell by two-thirds. Consumption of cocaine continued to decline through the 1930s and 1940s, in part because discretionary income fell sharply during the Great Depression and in part because many men who might have had the opportunity and money to use the drug were fighting World War II. This trend of declining use, however, would not continue indefinitely.

Cocaine During the 1970s

Cocaine’s Changing Image in the 1980s

Despite growing concerns about its possible dangers, cocaine use in America grew through the early 1980s. In 1985, estimates by various government health agencies placed the number of people who had used it at least once at about 7 million. Of this number, about 5.5 million used it occasionally; about 600,000 were considered habitual users, denned by using it more than 51 times a year.

During this period, evidence pointing to the health risks of cocaine use continued to surface. Stories of death due to cocaine overdoses on college campuses and in affluent neighborhoods began replacing the glittery talk of recreational use by sports and movie stars. For example, the death of college basketball star Len Bias from a cocaine overdose received front-page coverage. Not only were overdoses becoming recognized as a problem, but gradually people began to recognize that once the initial euphoria wore off, cocaine had the insidious quality of inducing a state of depression that triggered a craving for more. Just as ominously, the medical professions began to recognize that many recreational users were showing signs of the ill effects of heavy use.

As it became clear that more and more people were regularly using cocaine, medical researchers began to study the drug’s psychological as well as physiological effects. What these scientists discovered was unsettling.

Short-Term Psychological Effects

Long-Term Psychological Effects

Long-term cocaine use causes clearly visible psychological changes in users. Although doctors cannot say conclusively how long-term cocaine use affects the chemistry of the brain, subtle changes take place that constitute what clinicians call cocaine psychosis. Those who experience cocaine psychosis lose contact with reality and the ability to function normally. The most common manifestations of cocaine psychosis are hallucinations, paranoia, depression, and anxiety.

The user who suffers from cocaine psychosis may experience hallucinations that are highly animated and dramatic sensory distortions, such as seeing objects suddenly change form. One of the most common hallucinations among long-term cocaine users is the sense that insects are crawling on their bodies. So distinctive is this hallucination that the imagined insects are known as “coke bugs.” Other hallucinations may take the form of hearing people laughing and talking when no one else is in the room, or smelling the aroma of food when none is present.

In addition to hallucinations, addicts may experience periods of paranoia; that is, they may think that people with hostile or harmful intentions are plotting against them. The most common example of paranoid thinking among cocaine users is falsely believing that the police are tapping their telephones.

Depression, a dulled mood and loss of energy and enthusiasm for normal activities, also often accompanies the paranoia and hallucinations. Excessive cocaine use commonly leads to a disinterest in friends, school, or usual family activities. Adding to the misery of a cocaine psychosis sufferer is the anxiety that goes with constant uncertainty over finding the next fix of cocaine.

Antisocial Behavior

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