Cocaine: Composition, Therapeutic use, Treatment. Cocaine effects. Reactions with other drugs.

Last modified: Thursday, 25. December 2008 - 10:00 am


Official names: Powder cocaine, crack cocaine

Street names: Base, Bernice, blow, “C”, coke, dream, dust, flakes, nose candy, Peruvian marching powder, powder, rock, Stardust, snow, sugar, the devil’s dandruff, white lady

Drug classifications: Schedule II, stimulant


Key terms

ANESTHETIC: An agent that causes loss of sensation or unconsciousness.

COCA PASTE: An impure free base made from coca leaves. It is used mainly in South America. Coca paste is smoked and is highly addictive.

COCAETHYLEN E: A substance formed by the body when cocaine and alcohol are consumed together. Cocaethylene increases the chances of serious adverse reaction or sudden death from cocaine.

COCAINE BUGS: Hallucinations that feel like bugs crawling under the skin, occurring in heavy or binge users of cocaine. This sensation can be so intense that users will scratch their skin or use a knife to attempt to remove the bugs.

COCAINE PSYCHOSIS: A mental illness characterized by paranoia, disorientation, and severe depression. It is often the result of long-term cocaine abuse.

CRACK COCAINE: A highly addictive free-base cocaine that is smoked. Crack is made by combining powder cocaine and sodium bicarbonate.

FREE BASE: The form of cocaine that can be smoked. There are three free-base forms of cocaine: coca paste made from processed coca leaves; crack (which is made with powder cocaine and sodium bicarbonate); and “free base” (which is made with powder cocaine, ammonia and ether. This form is rarely used since crack was discovered). All free base is highly addictive.

POWDER COCAINE (COCAINE HYDROCHLORIDE): A psychoactive substance derived from coca leaves. Powder cocaine is either snorted into the nose or mixed with water and injected into the veins. It is addictive when snorted and more so if injected.

SPEEDBALL: Also called “dynamite” or “whiz-bang,” a speedball is a combination of cocaine or methampetamine (stimulants) and heroin (a depressant). This combination increases the chances of serious adverse reactions and can be more toxic than either drug alone.



South Americans in the Andes Mountains legally and liberally chew coca leaves. By adding a little lime or plant ash, the naturally occurring cocaine alkaloid is released and absorbed into the cheek. This has a mild stimulating effect similar to drinking several cups of strong coffee. In this way, the mountain people have combated heat, cold, hunger, and fatigue for over 4,000 years. The leaves are used medicinally to alleviate problems of the digestive system, altitude sickness, and psychological ills. Used in the whole-leaf form, cocaine does not produce a “high” and is not addictive.

Coca leaves were not used in Europe or the United States because coca leaves do not travel well. But in 1860, a German chemist, Albert Niemann, separated cocaine from the leaf. In doing so, he unleashed the most powerful naturally occurring stimulant. In the salt form (cocaine hydrochloride), which is commonly known as powder cocaine, it travels very well. Soon, large quantities were being consumed abroad.

Initially, cocaine was thought to be a “cure-all,” and, like the whole-leaf form, powder cocaine was believed to be non-addictive. Due to this misinformation, from the 1860s until the early 1900s, the use of cocaine was unregulated. It was used widely in Europe and in the United States. People could buy anything from cocaine-laced beverages, such as Vin Mariani coca wine and Coca-Cola, to 99.9% pure powder cocaine. Vin Mariani was a wine and cocaine concoction endorsed by Pope Leo XVIII and by over 7,000 physicians. In the 1880s, John Pemberton created Coca-Cola — the nonalcoholic “health drink” containing 60 mg of cocaine. (It should be noted that Coca-Cola no longer uses cocaine in its products.) Cocaine was believed to remedy many conditions, including fatigue, toothache, hay fever, asthma, seasickness, and vomiting during pregnancy. No prescription was necessary, and cocaine could easily be purchased at grocery stores, drug stores, and through mail-order catalogues.

Bona fide scientific and medical research lagged behind the commercial marketing of cocaine. It was not until the 1880s that cocaine was seriously studied. A German physician did a study on the effects of cocaine on the Bavarian army. He wrote a paper on the endurance-enhancing qualities of cocaine. This paper was read by Dr. Sigmund Freud, who then experimented on himself. Freud discovered that cocaine affects the heart and produces a powerful “high.” He later prescribed cocaine for heart disease, psychiatry, and morphine addiction. He wrote his own paper, “On Coca,” extolling the virtues of the drug, which he claimed was non-addictive. In 1884, Karl Koller started using cocaine as a topical anesthetic for eye surgery and it was soon used in dentistry. In 1885, cocaine was used as a spinal anesthetic for dogs. William S. Halsted, considered to be the father of modern surgery, discovered that cocaine injected under the skin makes an effective local anesthetic for surgery.

It was not until the 1890s that public opinion began to shift against cocaine use. By then, reports of nasal damage, addiction, and cocaine-related deaths had begun to circulate. The toxic and addictive nature of cocaine became public knowledge. By the time the government stepped in to ban cocaine in 1914, most people were already shunning it.

In the 1970s there was a resurgence of powder cocaine use. This preceded the epidemic of crack cocaine in the 1980s. Because crack cocaine is cheaper than powder, it became more readily available to the young and the poor. Crack addiction and crime began to increase rapidly and this increase was publicized in the media. In response to public concern, the Anti-Drug Abuse Act of 1986 and 1988 was passed. Known sometimes as the 100:1 law, this federal law includes mandatory minimum sentences for first-time offenders. The penalties are much harsher for possession of crack cocaine than powder cocaine.

In a 2001 study entitled Global Illicit Drug Trends conducted by the United Nations Office for Drug Control and Crime Prevention (ODCCP), it was estimated that 14 million people used cocaine worldwide. Though cocaine use has leveled off in the United States, it still leads the world in cocaine abuse. In 1999, cocaine use was stable in the United States, but increased in Western Europe and in several South American countries. Because of the addictive and destructive nature of cocaine, there is a concerted worldwide effort to reduce the production and illicit use of cocaine.


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