American comedian and actor Sam Kinison once said “There’s no happy ending to cocaine. You either die, you go to jail, or else you run out.” Ironically, Kinison died at age 39 when he met a road accident due to a 17-year old driver high on cocaine. Cocaine, a psychoactive drug, is obtained from the leaves of cocoa plant (Erythroxylon coca) mostly found in South America. It is the oldest known drug that has been abused by man. It is chemically called benzoylmethylecgonine, while the name cocaine is derived from the plant that it is derived from ‘Coca’ and the suffix of alkaloid, which is its source ‘-aine’. It is often classified as the substance of psychoactive/psychotropic class of drugs. It is a stimulant of the Central Nervous System, which creates a feeling of ‘euphoria’ or ‘high’ in the user. Apart from being a powerful central nervous system stimulant, cocaine is highly addictive, which causes numerous side effects on virtually every organ system of the body. It is ranked as the second most popular recreational drug in the United States, which alone accounts for the 50% of its total consumption all over the world.
This drug has traditionally been used as a topical anesthetic or numbing medicine for traumatic or other surgical procedure to relieve the pain. It has been used for stimulating and medicinal properties by indigenous people of South America for over five thousand years. As the Spaniards arrived on the continent, they banned the use of the plant initially. However, when the stimulating properties of the coca plant came to the fore, Spaniards allowed its cultivation, while collecting 10% of the value of the product as tax. The coco leaf remains have been found alongside the Peruvian mummified bodies, revealing that ancient Peruvian civilizations used to chew the leaves of coca plant for medicinal and stimulant purposes.

The first commercial production of Cocaine was described by a German scientist Albert Niemann in 1860s by preparing a white powdery salt called Cocaine Hydrochloride, which is the commercially produced form of cocaine. Following the endorsement of its use for the treatment of psychiatric ailments like depression by the renowned psychiatrist Sigmond Freud, it was extensively studied for its chemical properties as well as its adverse effects on the human body. Its use increased for quite some time, whereby it was even added to drinks and beverages by beverage giants like Coca cola. However, its use was stopped after people learned of its side effects.
Cocaine is used as a drug by injecting it into the veins, snorting (using a straw, or rolled paper) or smoking as such. The form of cocaine that is smoked is known as Freebase cocaine. Cocaine alters the functioning of the brain by enabling it to adapt to highly fluctuating levels of dopamine, serotonin and norepinephrine, leading to a feeling of ecstasy and extreme pleasure following its consumption for about 15 minutes to three hours, depending on the mode of administration of cocaine into body. The increase in excitement is caused by increased stimulation of nerve cells by dopamine.
As the dopamine increment reaches threshold levels, bran responds to this increment by reducing the number of dopamine receptors in the nerve cells, or destroying the high levels of dopamine, which eventually leads the cocaine addict to a condition called ‘Crash’ or ‘binge’. This condition is characterized by symptoms such as Exhaustion, Depression, Irritability, anger, agitation, feeling of hopelessness, and intense desire for the drug.

Cocaine is even more deadly for the first time users as compared to the addicts. Cocaine addiction increases the chances of ‘myocardial infarction’ or ‘heart attack’ in users by 2.5 times as compared to normal people. The symptoms of the cocaine addiction include insomnia or sleeplessness, abrupt loss of weight, horrible and vivid dreaming, aching etc. Cocaine smoking causes numerous side effects on the pulmonary as well as immune systems. It leads to chest pain, breathlessness, asthma, fever, running nose, lung trauma and accumulation of bronchial fluid in the lung, increase in the number of RBCs in the blood, a condition known as polycythemia, which increases the viscosity of blood and leads to heart attack and stroke in the brain. Its use also makes an addict susceptible to numerous autoimmune diseases such as Sustemic Lupus Erythromatosus, Vasculitis, and other systemic diseases such as kidney failure.Snorting of cocaine causes degradation of the cartilage separating the two nostrils or nasal septum, owing to the presence of hydrochloric acid in cocaine powder.
Cocaine or its metabolites can be detected in the biological fluids of the addict’s body by various monitoring techniques which include commercial immunoassay screening tests, whereby the cocaine metabolites cross-react with immunoassay antibodies. Various metabolites can in turn be differentiated by chromatographic techniques.
Cocaine is produced mainly in the South American countries, Columbia being the largest producer. It produces 75% of the total cocaine production of the world. The other producers include Peru, Bolivia and Mexico.
Crack or crack cocaine
Crack is the adulterated or impure form of cocaine. It is whitish crystalline and brittle form of cocaine, which is produced to increase the bulk quantity of cocaine. It was named so due to the sounds it produces while being smoked or during the preparation process. It emerged as a new form of cocaine in early 1980s when cocaine was extremely popular and highly consumed addictive drug in the world.
Crack is prepared from powdered form of cocaine by dissolving it in mixture of water with baking soda (sodium bicarbonate) or ammonia.

Some of the physiological effects associated with crack cocaine include a feeling of euphoria, loss of appetite, weight loss, extreme confidence, high concentration, insomnia, increased alertness, feeling more energetic and increased craving for cocaine, which is immediately replaced by the diametrically opposite symptoms of lack of concentration, lethargy, sleepiness, feeling of hopelessness, paranoia and depression. If the next dose is not taken soon, it increases to the level of severe hallucinations (hearing of tinging sound) for the addict.
The short-term physiological effects also include dilation of pupils, fever, constriction of blood vessels, increase in the heart output, blood pressure, while administration of larger amounts of cocaine lead to muscle twitches, tremors, , irritability and cardiac or respiratory arrest. It may even lead to death in rare cases.
Crack is considered the most addictive form of cocaine. When taken with alcohol, it produces a chemical known as ‘Cocaethylene’ in the liver, which produces a feeling more intense and euphoric than crack itself. It drastically increases the blood pressure and heart rate, leading to potentially fatal consequences. Chronic use of cocaine or crack can lead to irreparable damage to vital organs of the body such as brain, liver, heart, lungs, spleen throat, nose and tongue. Cocaine acts as a potent stimulant of parasympathetic nervous system. It leads to interference in the overall functioning of adrenaline and epinephrine, increasing the risk of stroke.
Apart from the effects causes in the short term, it causes numerous long term consequences complications such as HIV/AIDS, hepatitis B and C which are caused due to sharing of infected needles by addicts, permanent damage to cartilage of the nasal septum. Besides it exerts disastrous effects on pregnant women, leading to frequent stillbirths, miscarriages, and fetal deformities owing to teratogenic nature of cocaine.
It causes millions of deaths worldwide due to rash driving, brutal crimes and drug related violence, especially in the countries such as Mexico, Columbia, Ecuador and Puerto Rico that form the trafficking routes to major cocaine consumption markets. Most of the cocaine that is smuggled into the continental United States or Europe is sold in the range of $80 to $120 per gram.
A significant portion of the drug is consumed by the population aged 15-34. This age group represents 3.5 million users or 87.5% of all users worldwide. Male users are proportionately more addicted as compared to females in the ratio of approximately 4:1. A substantial portion of the drug is used by people of higher social strata. It is predominantly used in the clubs and discotheques in the west and central Europe.
Attempts of using defoliants on the coca plantations have failed and more resistant mutant strains of the plants have developed as a result of the defoliation, which have put further pressure on other natural flora and crop plantations in the region.
Despite continuous efforts of various governments of controlling the production of cocaine and its trafficking, cocaine continues to be one of the most abused drugs in the world. According to a report published by United Nations in 2007, Spain is the country having leading usage of cocaine, followed by United States, United Kingdom and Canada. The demand for cocaine continues to remain high, thanks to the consistently thriving black market and severe penalties being slapped for the possession and trafficking of this drug.
Rehabilitation centers and de-addiction centers have had a limited success, as the craving for the drug causes intense and violent suicidal tendencies among the people on rehabilitation. Controlling the prevalent illegal trafficking and production needs sustained governmental and non-governmental efforts in spreading the awareness as well as increased policing of the trafficking routes as well as transnational crackdown on the drug cartel and mafia. It also needs increased research on the development of chemical substitutes of the drug for controlling the craving for the drug by current addicts.