The debate over whether or not cocaine is addictive is ongoing and complicated. The majority of mental health professionals take the view that regular cocaine users cannot voluntarily stop taking the drug. In this sense, cocaine meets the definition of an addictive drug. Moreover, these experts believe that cocaine use leads to physical changes in the brain that encourage continued use. Journalist Norbert R. Myslinski reports:

According to Prof. Karen Bolla of Johns Hopkins University, cocaine impairs memory, manual dexterity, and decision making for at least a month. Her study suggests damage to the brain’s prefrontal cortex, leading to loss of control over consumption of the drug. A deadly spiral is set up, making it more and more difficult for the addict to quit. Continued drug abuse becomes increasingly a matter of brain damage and less a matter of weak character.

Another study performed by researchers at Rockefeller University in New York City confirms Bolla’s conclusions and provides a detailed explanation of the brain chemistry of a chronic cocaine user. The Rockefeller University investigators found that repeated exposure to cocaine causes a change at the molecular level that alters a brain protein called cyclin-dependent kinase 5. The researchers believe that altering this protein leads to cocaine addiction. Dr. Alan I. Leshner, director of the National Institute on Drug Abuse (NIDA), says, “This research provides a valuable insight into the step-by-step molecular adaptations that the brain makes in response to drugs. These adaptations result in long-term changes at the cellular level that are involved in the development of addiction.”

The medical view that cocaine is addictive is generally shared by long-term cocaine users themselves. One self-confessed addict, when asked how cocaine use — particularly in the form known as crack — could be stopped, says, “You can’t… period. It will be on this earth as long as there is people. As long as there is people, there will be people smoking crack cocaine.” When asked what he would say to anyone thinking about trying cocaine, he says, “Don’t ever do it, don’t even try it once. You do it once, I don’t [care] who you are, you will be hooked for the rest of your life.”The urge to keep using the drug is strong enough to motivate some addicts to resort to extreme measures. Gilda Berger quotes a crack user in her book Crack: The New Drug Epidemic, who claims, “I’d kill for it!”

Powerful as the evidence is that cocaine is addictive, some medical researchers disagree over just how addictive the drug is. One of the most compelling arguments against strong addictive properties is the fact that a relatively small percentage of people who use cocaine actually become addicted. Various national agencies report an average cocaine addiction rate of about 1 percent of individuals who have tried the drug — lower than the addiction rate for nicotine among those who have tried tobacco. If cocaine is so addictive, they argue, why is the addiction rate so low?

As the debate over its addictive potential continues, the reality of nearly epidemic cocaine use in America remains, despite the fact that the drug is illegal in every state.

Cocaine Comparisons

Commonly used addictive drugs have many different characteristics. The following table, provided by Dr. Jack E. Henningfield in the New York Times article “Is Nicotine Addictive? It Depends on Whose Criteria You Use,” compares cocaine with five other drugs and ranks them according to five addictive characteristics. A rank of 1 indicates least effect; a rank of 6 indicates highest potency.

Dependence: How difficult it is for the user to quit; the relapse rate; the percentage of people who eventually become dependent; the rating users give their own need for the substance; and the degree to which the substance will be used in the face of evidence that it causes harm.

Withdrawal: Presence and severity of characteristic withdrawal symptoms.

Tolerance: How much of the substance is needed to satisfy increasing cravings for it, and the level of stable need that is eventually reached.

Reinforcement: A measure of the substance’s ability, in human and animal tests, to get users to take it again and again, and in preference to other substances.

Intoxication: Though not usually counted as a measure of addiction in itself, the level of intoxication is associated with addiction and increases the personal and social damage a substance may do.

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