Cocaine is the main stimulant found in the Andean South America coca bush that for millennia has been chewed to help with altitude sickness and lethargy.
The concentrations in the plant give a lift not a lot stronger than coffee, but extracted and turned into powder it can cause a great feeling of euphoria and a surge of energy.
The high is so nice in fact, that millions of people around the world have become addicted to it with major mental and physical health issues that come from a strong stimulant being introduced into the body.
There are four broad ways of consuming cocaine. These are:
Smoked and injected versions of cocaine have to be processed even further as in its natural form, cocaine is not water-soluble and needs to be chemically altered to dissolve in water.
Snorted and ingested cocaine is absorbed by the body’s fats and enters the nervous system another way.
Intravenous (IV) cocaine use provides a very quick, powerful high that gives feelings of euphoria and wellbeing.
Cocaine freebase is fat-soluble and cannot in its raw state be injected into the bloodstream.
The user needs to process the substance (1) in order to be soluble in water. As part of the ‘cooking up’ process, an acid such as vinegar or lemon juice is added to the powder to make it soluble.
Once ‘cooked’ it is dissolved in water and drawn into the syringe for injection.
As with the speed of the high coming, so the feelings drop away very quickly too. They are replaced with depression, troubles in focusing the mind and an inability to relax.
This is a major reason that so many introduced to intravenous use become dependent and addicted so quickly as they feel the need more to feel the way they did.
PRO TIP: Learn how long cocaine stays in your system.
When introducing a powerful stimulant into your body there will be consequences as the nervous system tries to rebalance itself, and there are physical harms too.
In the next sections, we will look at the specific risks associated with injecting cocaine but here we will look at the risks from all cocaine use.
Cocaine use causes mental health issues(2)
The central nervous system will respond to cocaine by releasing large quantities of dopamine and glutamate into the synapses, causing the powerful high.
This can make people edgy and aggressive.
As the body recovers you will often feel very depressed as a comedown from the high.
In early-stage use, this is as the nervous system recovers from the storm of neurotransmitters.
The feelings of depression can become extremely powerful, often leading to people wishing to kill themselves and sometimes self-harming.
Cocaine can also make you psychotic. Whether when high or between fixes, you may hallucinate, feel paranoid and anxious and can experience feelings of confusion.
Thanks to the rush of stimulants into the body, most of the body will be impacted in some way (3):
These issues can affect anyone who uses cocaine. We will now look at what happens to people who use cocaine intravenously.
These issues are added to with injecting cocaine as we will discuss in the next section.
On top of the issues associated with all cocaine use, there are issues peculiar to intravenous users.
Particularly if the intravenous drug user does not take care with their equipment such as needles, spoons and syringes, there can be a lot of problems associated with cocaine use. Initially these manifest as:
These are only for early-stage use. As dependence and addiction progress other issues may manifest thanks to the risks associated with adulterated substances and blood-borne diseases.
As the user feels the side effects of withdrawal, so they seek more and more to avoid the negative sensations described above.
This leads to dependence and cocaine addiction.
Thanks to the effects of IV cocaine use, the nervous system loses its ability to give reward feelings for any normal activity such as sex or eating food.
Ultimately, the user will find that the only substance that can give pleasure of any kind is cocaine. This means that they will constantly seek it to feel pleasure.
In addition, the user will feel edgy between fixes and crave the drug to feel ‘normal’.
This is an uncomfortable sensation that leads to greater use of the substance.
As the addiction disease progresses, so a variety of physical problems can emerge from persistent abuse of cocaine.
These include:
These can form even without cutting agents in the substance, as we will discuss in the next section.
By the time it reaches the user, most powder sold as cocaine has been adulterated in some ways with ‘cutting agents’ (4).
Commonly substances such as talcum powder, baking powder, sugar and laxatives are added.
Often medicines for humans and animals like ephedrine, methamphetamine, and even animal dewormed have been found in the mix.
You can access testing kits to test the purity of the compound you have been sold but many IV users do not use them.
Side effects can include:
Between them, these can add to the misery of cocaine abuse.
Particularly where gear is shared, there are noticeable rates of blood diseases among IV cocaine users.
In 2018(5), the UK government estimated (5) that one in six intravenous users of all street drugs shares their equipment.
The paper also estimated:
Thankfully, thanks to the relatively low population of IV drug users, the risks of HIV and Hepatitis remain quite low.
With HIV and Hepatitis B however, you don’t get a second chance if you share with the wrong friend.
All of the mental health problems we have described above come from the central nervous system’s efforts to achieve balance when cocaine is introduced to the system (6).
When cocaine reaches the brain, it triggers a powerful release of neurotransmitters across the nerves’ synapses.
The feelings of despair and wishing to die come as the high passes and the storm in the nervous system passes.
One of the best ways to get rid of the sad feelings is to get high again. This forces more and more synaptic storms. The issue is that it takes time to recover and ultimately this means that the body responds less each time.
The feelings of euphoria are replaced by a feeling of ‘normality’ as only IV cocaine use can make this feeling possible. Ultimately this means physical addiction.
As we discussed in the previous section, the nervous system becomes dependent on cocaine to function.
This is where the person who injects cocaine urgently needs help as without it they can be in trouble.
Withdrawal effects include:
At this stage, it is best to get help, as we will describe in the final section.
Unlike heroin addiction, there is no licensed medication for cocaine withdrawal.
A supervised detox with trained medical professionals and support workers is key for recovery.
Longer-term treatments for cocaine addiction include cognitive behavioural therapy (CBT), couples therapy and reward schemes for abstinence.
Most who begin the withdrawal and treatment process succeed but as with so many other addictions this is not immediate and won’t necessarily happen the first time around.
With the proper support along the way, you will find your way out. It does require effort and time to achieve those goals.
Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline.
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