Once considered a harmless source of pleasure and therapeutic benefit, today the drug cocaine is vilified as the cause of great misery and suffering for many who have succumbed to its euphoric effects. Yet, by nearly all acounts, cocaine is here to stay, despite the billions of dollars that government agencies around the world spend each year to eliminate it. From the streets of cities as large as Los Angeles, New York, and Chicago, to small rural towns, Americans consume more cocaine than does any other citizenry in the world. An estimated 80 percent of all South American cocaine — approximately one thousand tons annually — finds its way to America's consumers. The size of the market for cocaine is staggering by any measure. An estimated 40 million Americans admit to having tried cocaine, either in powdered form or as crack. Moreover, between 2 and 4 million people admit to regular use of or addiction to cocaine. Faced with such numbers, American political and spiritual leaders have labeled cocaine use an epidemic. Cocaine use swept across America during the 1970s, glamorized by rock stars, Hollywood personalities, and heroes of professional sports. Their widely publicized use of the drug brought it to the Read more [...]

At the beginning of the twentieth century, the medicine cabinets and pantries in many American homes held a variety of pills and foods containing cocaine as an ingredient. At the time, cocaine was considered to offer considerable benefits as an energy booster and as a topical remedy to relieve minor pain such as toothache. For example, in 1900, Sears, Roebuck, and Company advertised a product called Coca Wine. The advertisement for the wine boasted that it "sustains and refreshes both the body and brain... It may be taken at any time with perfect safety ... it has been effectually proven that in the same space of time more than double the amount of work could be undergone when Peruvian Wine of Coca was used, and positively no fatigue experienced." At the turn of the last century, both the medical profession and the pharmaceutical industry believed the claims that cocaine was useful and safe as an energy booster and for pain relief. Doses of the ingredient in foods and medicines were quite small, and most consumers did not experience problems from occasional use of such products. The few people who studied and wrote about cocaine during this era also believed that it had the potential to become a panacea — a wonder Read more [...]

The use of coca changed somewhat when the Spanish conquistadors first came to South America during the mid-sixteenth century. After the Spanish conquered the mountain tribes they forcibly converted them to Catholicism; Catholic priests, wishing to stamp out what they saw as a pagan practice, forbade the chewing of coca leaves. The Spanish, however, also forced the Indians to labor in the mines and fields and quickly observed that the workers tired more quickly when deprived of their coca leaves. To remedy this situation, the Spanish overseers distributed leaves to workers three to four times a day to increase their energy levels and productivity. The overseers began chewing the leaves as well and noted the same pleasant effects that the Indians experienced. The Spanish sent shipments of the leaves back to Europe, where they became quite popular among the wealthy. The chewing of coca leaves did not, however, become widespread because shipping large quantities of leaves was not economically feasible and attempts to grow coca in Europe failed because the climate there was not suitable. For nearly two hundred years, interest in coca leaves and their effect on the mind and body languished; for the most part the coca Read more [...]

In the decades since research began, doctors have come to recognize that of the body's many systems, the cardiovascular system experiences the most noticeable short-term effects of cocaine use. The first of these is a rapid increase in the user's heart rate, which results in the heart pumping a greater volume of blood through the body. This is essentially the same effect that results from strenuous physical activity except that when cocaine is the cause, blood vessels narrow, forcing the heart to work not just faster but harder. Occasionally, cocaine also causes temporary rapid or erratic heart rhythms, increased blood pressure, and increased body temperature. The central nervous system also experiences temporary physiological changes. As the cocaine carried by the bloodstream enters the brain, the electrical activity of the brain is temporarily altered as the cocaine is absorbed by cells called neurons. The absorption of cocaine alters the chemistry of the brain to increase production of the chemical dopamine. This change in brain chemistry is responsible for the sense of euphoria, sometimes referred to as a "rush" that is usually described in pleasurable terms as a sudden sense of excitement. In most healthy Read more [...]

Researchers found little, if any, lingering effects from occasional use of cocaine. The long-term physiological effects for persistent cocaine use over many years are dramatic, however. Although the kidneys filter out cocaine after each use, the cumulative effect of hundreds of cocaine doses eventually alters the body's physiology and leads to physical damage. The organ that suffers the most damage is the brain. The more frequently cocaine users ingest the drug, the more frequently the blood vessels in the brain are narrowed and fail to adequately provide needed oxygen. Deprived of oxygen, brain cells die, so frequent cocaine use eventually compromises the brain's function. Furthermore, as the blood pressure in the millions of tiny constricted blood vessels and capillaries that supply the brain builds, they gradually break, causing hemorrhage. Dr. Thomas Kosten described this phenomenon during congressional testimony in 1999: If these vessels are blocked for even a few minutes, brain cells die and thinking, feeling, moving and life itself can cease. Cocaine blocks these blood vessels by constricting them and filling them with abnormal clotting cells called platelets. A large blockage like this leads to strokes in some Read more [...]

The immediate psychological effect of cocaine ingestion is euphoria. The intensity of this effect depends on how fast the drug reaches the brain; that is, the faster cocaine reaches the brain, the more intense the euphoria. For the first few minutes after inhaling powdered cocaine, or the first few seconds after injecting it, the user experiences the onset of the euphoria, known as a rush. Users describe such feelings as a heightened state of pleasure, a profound sense of mastery over their personal affairs, a sense of cleverness, and an unquestioned confidence in their ability to achieve their goals. Many users claim that the drug helps them perform many physical and intellectual tasks more quickly. As one youth describes it, cocaine made him feel "as if I was going up in a flying machine" or "as if I was a millionaire and could do anything I pleased." In addition to the sense of euphoria, many users describe being more energetic, talkative, and more acutely aware of the sensations of sound, taste, color, and touch. Officer Gordon James Knowles of the Pearl Harbor Police Narcotics Division questioned a cocaine user and dealer named Carl, whose description of the initial rush also explains its value as an escape from Read more [...]