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What is Cocaine?

Cocaine is a powerfully addictive stimulant that directly affects the brain. Cocaine was been labeled the drug of the 1980s and '90s, because of its extensive popularity and use during this period. However, it is not a new drug. In fact, it is one of the oldest known drugs. The pure chemical, cocaine hydrochloride, has been an abused substance for more than 100 years, and coca leaves, the source, have been ingested for thousands of years.

Pure cocaine was first extracted from the leaf of the Erythroxylon coca bush, which grows primarily in Peru and Bolivia, in the mid-19th century. In the early 1900s, it became the main stimulant drug used in most of the tonics/elixirs that were developed to treat a wide variety of illnesses. Today, it is a Schedule II drug, meaning that it has high potential for abuse, but can be administered by a doctor for legitimate medical uses, such as a local anesthetic for some eye, ear, and throat surgeries.

There are basically two chemical forms of cocaine: the hydrochloride salt and the "freebase." The hydrochloride salt, or powdered form of cocaine, dissolves in water and, when abused, can be taken intravenously (by vein) or intranasally (in the nose). Freebase refers to a compound that has not been neutralized by an acid to make the hydrochloride salt. The freebase form of cocaine is smokable.

Cocaine is generally sold on the street as a fine, white, crystalline powder, known as "coke," "C," "snow," "flake," or "blow." Street dealers generally dilute it with such inert substances as cornstarch, talcum powder, and/or sugar, or with such active drugs as procaine (a chemically-related local anesthetic) or with such other stimulants as amphetamines.

What is Crack Cocaine?

Crack is the street name given to the freebase form of cocaine that has been processed from the powdered cocaine hydrochloride form to a smokable substance. The term "crack" refers to the crackling sound heard when the mixture is smoked. A heavily abused substance, crack is processed with ammonia or baking soda and water, and heated to remove the hydrochloride.

Because crack is smoked, the user experiences a high in less than 10 seconds. This rather immediate and euphoric effect is one of the reasons that crack became enormously popular in the mid 1980s. Another reason is that crack is inexpensive both to produce and to buy.

The costs of treating the abuse and addiction of all forms of coke continue to rise yearly. Funded treatment programs are being scaled back, while private pay drug treatment centers and detox can be extremely expensive.

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Treatment of Cocaine Abuse

The widespread abuse of cocaine has stimulated extensive efforts to develop treatment programs for this type of drug abuse.

NIDA's top research priority is to find a medication to block or greatly reduce the effects of cocaine, to be used as one part of a comprehensive treatment program. NIDA-funded researchers are also looking at medications that help alleviate the severe craving that people in treatment for cocaine addiction often experience. Several medications are currently being investigated to test their safety and efficacy in treating cocaine addiction.

In addition to treatment medications, behavioral interventions, particularly cognitive behavioral therapy, can be effective in decreasing drug use by patients in treatment for cocaine abuse. Providing the optimal combination of treatment services for each individual is critical to successful treatment outcome.


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