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The highest prevalence of cocaine use was in Australia and New Zealand (2.1%), followed by North America (2.1%), Western and Central Europe (1.4%), and South and Central America (1.0%). Globally, in 2019, cocaine was used by an estimated 20 million people (0.4% of adults aged 15 to 64 years). Cocaine was first isolated from the leaves in 1860. In ancient Wari culture, Incan culture, and through modern successor indigenous cultures of the Andes mountains, coca leaves are chewed, taken orally in the form of a tea, or alternatively, prepared in a sachet wrapped around alkaline burnt ashes, and held in the mouth against the inner cheek it has traditionally been used to combat the effects of cold, hunger, and altitude sickness. Ĭoca leaves have been used by Andean civilizations since ancient times. In 2017, the Global Burden of Disease study found that cocaine use caused around 7,300 deaths annually. Illicitly sold cocaine is commonly adulterated with fentanyl, local anesthetics, levamisole, cornstarch, quinine, or sugar, which can result in additional toxicity. It also increases risk of stroke, heart attack, cardiac arrhythmia, lung injury (when smoked), and sudden cardiac death. Use of cocaine increases the overall risk of death and intravenous use particularly increases the risk of trauma and infectious diseases such as blood infections and HIV.

Addicts who abstain from cocaine experience cocaine craving and drug withdrawal, with depression, decreased libido, decreased ability to feel pleasure and fatigue.

Repeated use is likely to result in cocaine addiction. Ī single dose of cocaine induces tolerance to the drug's effects. Cocaine also blocks the serotonin transporter and norepinephrine transporter, inhibiting reuptake of serotonin and norepinephrine from the synaptic cleft into the pre-synaptic axon terminal and increasing activation of serotonin receptors and norepinephrine receptors in the post-synaptic neuron, contributing to the mental and physical effects of cocaine exposure. Cocaine blocks the dopamine transporter, inhibiting reuptake of dopamine from the synaptic cleft into the pre-synaptic axon terminal the higher dopamine levels in the synaptic cleft increase dopamine receptor activation in the post-synaptic neuron, causing euphoria and arousal. Ĭocaine crosses the blood–brain barrier via a proton-coupled organic cation antiporter and (to a lesser extent) via passive diffusion across cell membranes. As cocaine also has numbing and blood vessel constriction properties, it is occasionally used during surgery on the throat or inside of the nose to control pain, bleeding, and vocal cord spasm. Effects begin within seconds to minutes of use and last between five and ninety minutes. High doses can result in high blood pressure or high body temperature. Physical effects may include a fast heart rate, sweating, and dilated pupils. Mental effects may include an intense feeling of happiness, sexual arousal, loss of contact with reality, or agitation. Ĭocaine stimulates the reward pathway in the brain.

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It can also then be turned into free base form (typically crack cocaine), in which it can be heated until sublimated and then the vapours can be inhaled. After extraction from the plant, and further processing into cocaine hydrochloride (powdered cocaine), the drug is administered by being either snorted, applied topically to the mouth, or dissolved and injected into a vein. It is primarily obtained from the leaves of two Coca species native to South America Erythroxylum coca and E. It is also used in medicine by Indigenous South Americans for various purposes and rarely, but more formally as a local anaesthetic by medical practitioners in more developed countries. As an extract, it is mainly used recreationally, and often illegally for its euphoric and rewarding effects. Cocaine (from French: cocaïne, from Spanish: coca, ultimately from Quechua: kúka) is a tropane alkaloid and central nervous system (CNS) stimulant.

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