Cocaine is a powdered extract of the Coca plant. When modified chemically for smoking, it is referred to as crack cocaine. Cocaine base is water soluble, while the crack form is not. This means cocaine base can be dissolved in water and injected or snorted as the power into the nose. The lining of the nose and sinus cavity has enough water to dissolve the base drug and it is absorbed into the blood stream there.
Addiction risk
Cocaine is considered highly addictive and is classified as a Schedule 2 drug by the DEA. A landmark study published in 20051 showed that the risk of addiction was about 5% for those who had used cocaine for the first time in the past two years.
One of the reasons cocaine use becomes addictive is because the high is relatively short lived. The effects of snorting cocaine usually fall off in about an hour, and another dose is required to maintain the high. This leads to repeated binge style administration of multiple doses. Over time, the effect is to train the body to receive a regular supply of the drug.
Positive reinforcement
Cocaine, like other popular drugs, lives up to its reputation. It does cause euphoria and gives a sense of control. Sigmund Freud, who used cocaine, described it as, "You perceive an increase of self-control and possess more vitality and capacity for work…" It was said to make shy people outgoing, increase conversational skills, and make the fainthearted courageous.
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These effects make the drug attractive to users whenever life presents problems. Of course, this is an illusion. No problem is actually solved and many new problems are introduced because of cocaine use. But the repeated cycle of use and the positive reinforcement leads to even more frequent use. The deadly cycle of addiction has started.
Genetic basis
German studies2 have shown that cocaine addicts are 25% more likely to have a particular variant of a gene. This doesn’t explain addiction entirely, but it does imply that risk of addiction increases depending on genetic makeup. It is not known exactly what these genes are responsible for, but it is assumed they impact the reward neurons in the brain.
Because cocaine affects the pleasure centers in the brain, repeated use begins to dull the normal ability to enjoy life without it. Repeated activation of reward neurons (dopamine and serotonin pathways) leads to physical changes in brain chemistry so that the ‘cure’ for feeling bad is to use more cocaine, more often. Snorting cocaine gives a quick, but temporary return to a better mood.
The alteration in brain chemistry often leads, over time, to cocaine induced paranoia and aggression. This mimics symptoms of schizophrenia and a common hallucination is the feeling of bugs crawling under the skin (cocaine bugs).
Relapse rates among cocaine addicts have been estimated to be above 94%, making it one of the most addictive substances known and one of the hardest addictions to treat successfully.
References
- "Risk of Becoming Cocaine Dependent... ," Megan S O'Brien and James C Anthony, Journal of Neuropsychopharmacology
- "All in the family - scientists discover gene for cocaine addiction," The Guardian, Nov 2008
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