Appearance
Cocaine is a white powder substance which comes from coca leaves or is manufactured synthetically. It is a local anaesthetic and acts as a stimulant to the central nervous system.

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The early Spanish explorers noticed how the native people of South America chewed coca leaves as a restorative. Cocaine was first available commercially in the early 1880s in the form of a medicinal wine called Vin Mariani, that contained 11 percent alcohol and 6,5 mg of cocaine in every ounce.

Originally Coca-Cola contained both cocaine and caffeine, but the cocaine was removed in 1906. In 1914 cocaine was declared an illegal substance in the US. Cocaine could be bought over the counter at Harrods until 1916.

Crack was developed in 1985 and rapidly emerged a problem. To obtain crack-cocaine, ordinary cocaine hydrochloride is concentrated by heating the drug in a solution of baking soda until the water evaporates. This type of base-cocaine makes a crackling sound when heated, hence the name ‘crack’.

Crack does not ignite like cocaine, which contains volatile solvents, is liable to do. Crack is the cheapest form of cocaine available and is more concentrated than the powder, which is snorted. It can be up to 90 percent pure and is highly addictive.

Cocaine in South Africa

Cocaine is also called coke, crack, dust, snow.

There has been a tremendous increase in cocaine and crack use in South Africa over the last decade. Both crack and cocaine have become drugs of choice amongst the high-income upper middle and upper classes.

Because of its prohibitive cost – supporting even a weekend cocaine habit can easily cost several thousand rand – it is mainly used by highly paid professionals. Its energy-giving properties and its reported ability to hone someone’s mental skills temporarily have made it popular among those in high stress, wheeling-and-dealing jobs.

Crack appears to be more addictive than cocaine, and rehabilitation centers countrywide report an increase of crack users checking in for rehabilitation.

How is it used?

Cocaine is inhaled, injected, smoked or applied directly to the nasal membrane or gums. When inhaled it is usually a dose of between 125 and 150 mg.

Effects of cocaine

Within minutes of taking this drug, the user experiences a general sense of euphoria and excitement. The ‘rush’ cocaine gives is very intense. Confidence increases tremendously and the user experiences a feeling of strength. Cocaine also suppresses the appetite. This high reaches a climax after about 15-20 minutes and the effects start wearing off after an hour.

This is often followed by a feeling of intense depression, which encourages the user to take more cocaine in order to feel better.

Cocaine acts by blocking the reuptake of the neurotransmitters dopamine, norepinephrine and serotonin in the brain. As a result these neurotransmitters stay in the synaptic cleft of the brain for a longer time. Research has also shown that cocaine can cause the release of dopamine from neurons in the brain.

Cocaine can also affect the peripheral nervous system. These effects include constriction of blood vessels, dilation of the pupil and irregular heart beat.

Other immediate physiological effects on the body include increased heart rate and blood pressure, nausea, rapid breathing, twitching, paleness, blurred vision and nasal congestion.

Symptoms of excessive use
Death from cardiac or respiratory arrest is often a symptom of excessive cocaine use. Other physiological symptoms of excessive long term use are ulceration of the nasal membrane, weight loss, tremors, insomnia, impotence, constipation and seizures.

Effects of excessive use on the personality include a sudden onset of deceptive behaviour, stealing, a superior attitude, being short-tempered, work-related problems, depression, being accident-prone, confusion, anxiety, paranoia, dulled emotional responses and a loss of interest in sex.

Death is often the result of excessive cocaine use. Cocaine can cause a tremendous increase in blood pressure that can lead to bleeding on the brain. If blood vessels constrict, this can also lead to a stroke. Respiratory and heart failure could also result in death.

What does the detoxification process look like?
Generally the withdrawal from cocaine is nothing as severe as from a substance like heroin. The withdrawal process seems to be characterized by a deep sense of craving and intense depression, which makes the prospect of regressing doubly attractive. It is estimated that approximately 80 percent of users do not manage to ‘get clean’ after the first try.

Cocaine exerts its euphoric effect by maintaining high levels of neurotransmitters which bind to specific receptors in the brain that are responsible for the feelings of reward and satisfaction.

Studies suggest that the brain’s response to continued elevated levels of neurotransmitters is to reduce the numbers of receptors to that transmitter, a process that may not be reversible. Subsequently, withdrawal from cocaine can result in profound depression, which may last for years.

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