Cocaine AUSTRALIAN DRUG FOUNDATION
05 HOW DRUGS AFFECT YOU
This pamphlet is part of the “How Drugs Affect You� series. It aims to provide the facts about cocaine for anyone interested in understanding more about this drug. It has been written for the general public, including employees, employers, health professionals and their clients.
Other titles in this series include alcohol, amphetamines, analgesics, benzodiazepines, cannabis, drugs and their effects, ecstasy, GHB, hallucinogens, heroin, ice, inhalants, ketamine and tobacco.
05 HOW DRUGS AFFECT YOU
What is cocaine? Cocaine belongs to a group of drugs known as “stimulants”. Stimulants speed up the messages going between the brain and the body. Cocaine is extracted from leaves of the coca bush (Erythroxylum coca), which is native to South America. The coca leaf extract is then processed to create cocaine hydrochloride, freebase and crack. The leaves of the coca bush have long been chewed and brewed into tea by indigenous people in South America for its stimulant and appetite suppressant properties. Other names Some of the common names for cocaine include C, coke, nose candy, snow, white lady, toot, Charlie, blow, white dust and stardust. Freebase is also known as “base”, and crack is sometimes referred to as “rock” or “wash”
What it looks like The most common form of cocaine is cocaine hydrochloride. This is a white, crystalline powder with a bitter, numbing taste. Cocaine hydrochloride can be further processed to produce cocaine base, known as freebase and crack. Freebase is a white powder, while crack generally comes in the form of crystals that range in colour from white or cream to transparent with a pink or yellow hue. Cocaine hydrochloride is often mixed, or “cut”, with other substances such as lactose and glucose, to dilute it before being sold.
How is it used? Cocaine hydrochloride is most commonly “snorted”. It can also be injected. Some people rub it into the gums, where it is absorbed into the bloodstream. Others add it to a drink or food. Freebase and crack cocaine are usually smoked.
Cocaine in Australia According to the National Drug Strategy Household Survey1, in 2010:
»» 7.3 per cent of Australians aged over 14 years had used cocaine at some stage in their life
»» 2.1 per cent had used it in the previous 12 months »» the average age at which Australians first tried cocaine was 23.3 years.
Australian Institute of Health and Welfare (AIHW) 2011
1
2010 National Drug Strategy Household Survey: Report, Canberra: Australian Institute of Health and Welfare.
Effects of cocaine The effects of any drug (including cocaine) vary from person to person. How cocaine affects a person depends on many things including their size, weight and health, also whether the person is used to taking it and whether other drugs are taken around the same time. The effects of any drug also depend on the amount taken. This can be very hard to judge as the quality and strength of illicit drugs can vary greatly from one batch to another.
Immediate effects The effects of cocaine can last anywhere from a few minutes to a couple of hours, depending on how the cocaine is taken. When the immediate “rush” of the cocaine has worn off, the person may experience a “crash”. Low to moderate doses Some of the effects that may be experienced after taking cocaine include:
Body » increased body temperature » increased strength and energy » indifference to pain and localised pain relief
Mouth » dry mouth
Psychological effects » immediate “rush” feeling, feelings of euphoria » feelings of invincibility » a sense of wellbeing » increased talkativeness or quiet contemplation and rapture » increased confidence and a feeling of invincibility » feelings of great physical strength and mental capacity » increased libido » anxiety, agitation and panic » paranoia » unpredictable violent/ aggressive behaviour
Stomach » reduced appetite
Lungs » increased breathing rate
Heart » increased blood pressure and heart rate (after initial slowing)
Eyes » enlarged (dilated) pupils
Brain » feeling more awake, reduced need for sleep » increased performance on simple tasks
Low to moderate doses
Higher doses A high dose of cocaine can cause a person to overdose. This means that a person has taken more cocaine than their body can cope with. Not knowing the strength or purity of the cocaine increases the risk of overdose. Injecting cocaine increases the risk of overdose due to large amounts of the drug entering the blood stream and quickly travelling to the brain. Higher doses of cocaine can produce symptoms, including:
»» anxiety »» sleep disorders »» suspiciousness »» paranoia »» tremors and muscle
»» kidney failure »» hypothermia (low
»» nausea and vomiting »» rapid and weak pulse »» chest pain »» seizures, heart attack
»» brain haemorrhage »» stroke and convulsions.
twitches
body temperature)
»» seizures and stroke »» increased heart rate
and body temperature
All of these can lead to coma and death.
High doses and frequent heavy use can also cause a “cocaine psychosis”, characterised by paranoid delusions, hallucinations and bizarre, aggressive or violent behaviour. These symptoms usually disappear a few days after the person stops using cocaine. Coming down As the effects of cocaine begin to wear off, a person may experience:
»» tension and anxiety »» radical mood swings
»» depression »» total exhaustion.
Long-term effects Long-term effects of cocaine use include:
»» insomnia and exhaustion »» depression »» anxiety, paranoia
»» hypertension and
»» eating disorders
»» hallucinations »» cerebral atrophy
and psychosis
and weight loss
»» sexual dysfunction
irregular heart beat
»» sensitivity to light and sound
(wasting of the brain) and impaired thinking.
Some other long-term effects of cocaine are related to the method of using cocaine:
»» Repeated snorting damages the nasal lining and the
structure separating the nostrils (the nasal septum).
»» Smoking crack cocaine can cause breathing difficulties, chronic cough, bronchitis and other respiratory problems.
»» Cocaine is often “cut” with substances that are
poisonous when injected. They can cause collapsed veins, abscesses and damage to the heart, liver and brain. »» If injected into the skin, cocaine causes severe vasoconstriction, which may prevent blood flowing to the tissue, potentially resulting in severe tissue damage. Tolerance and dependence People who use cocaine regularly can develop dependence and tolerance to it. Tolerance means they need to take larger amounts of cocaine to get the same effect. Dependence on cocaine can be psychological, physical, or both. People who are dependent on cocaine find that using the drug becomes far more important than other activities in their life. They crave the drug and find it very difficult to stop using it. People who are psychologically dependent on cocaine may find they feel an urge to use it when they are in specific surroundings or socialising with friends. Physical dependence occurs when a person’s body adapts to cocaine and gets used to functioning with the cocaine present. Withdrawal If a dependent person stops taking cocaine, they may experience withdrawal symptoms because their body has to get used to functioning without cocaine. The craving for cocaine can last for months after stopping use. Some of the withdrawal symptoms that may be experienced include:
»» cravings for cocaine »» agitation »» depression or anxiety
»» extreme fatigue and exhaustion
»» disturbed sleep »» angry outbursts.
Cocaine and driving It is dangerous to drive after using cocaine. The effects of cocaine, such as increased confidence and feelings of invincibility, can affect driving ability. People with reduced inhibitions may take more risks when driving which increases the chance of an accident. The symptoms of coming down and withdrawal can also affect a person’s ability to drive safely.
Cocaine and the workplace Under occupational health and safety legislation, all employees have a responsibility to make sure they look after their own and their co-workers’ safety. The effects of cocaine such as increased confidence, anxiety and agitation can affect a person’s ability to work safely and effectively. The symptoms of coming down and withdrawal can also affect a person’s ability to work safely and effectively.
Pregnancy and breastfeeding Many drugs can cross the placenta and affect an unborn child. In general, using drugs when pregnant can increase the chances of going into labour early. This can mean that babies are born below the normal birth weight. If a mother uses cocaine while breastfeeding, the drug may be present in her breast milk. This may have an effect on the health of the baby. Check with your doctor or other health professional if you are taking or planning to take cocaine or any other drugs during pregnancy or while breastfeeding.
Cocaine and other drugs If cocaine is taken with a depressant such as alcohol the body is put under a lot of stress as it tries to deal with the competing effects. Using other stimulants such as ecstasy with cocaine can increase the risk of overdose. Using alcohol or other drugs such as benzodiazepines to help with the symptoms of the “comedown” after cocaine use can lead to a cycle of dependence on both drugs.
Cocaine and social problems All areas of a person’s life can be affected by drug use. » Disagreements and frustration over drug use can cause family arguments and affect personal relationships. » Legal and health problems can also add to the strain on personal, financial and work relationships.
Cocaine and the law Some local anaesthetics for minor ear, nose and throat surgery may contain cocaine. These are classed as restricted substances and only a doctor may prescribe them. All other cocaine products are illegal in Australia. Federal and state laws provide penalties for possessing, using, making, selling or driving under the influence of cocaine. Penalties can include fines, imprisonment and disqualification from driving. Some states and territories have programs that refer people with a drug problem to treatment and/or education programs where they can receive help rather than going through the criminal justice system. For more information contact a legal aid service in your state or territory.
Treatment options In Australia, there are many different treatment options for drug problems. Some aim to help a person to stop using a drug, while others aim to reduce the risks and harm related to their drug use. Treatment is more effective if adapted to suit each person’s situation. Some of the different options include individual counselling, group therapy, medication (pharmacotherapy), residential therapy and supervised/home withdrawal.
Preventing and reducing harms Many Australians take at least one psychoactive drug on a regular basis– they might take medication (i.e. over-thecounter or via a prescription), drink alcohol, smoke tobacco or use an illegal drug. All drugs have the potential to cause harm. As use increases, so does the potential for harm. Australia’s national drug policy is based on harm minimisation. Strategies to minimise harm include encouraging people to avoid using a drug through to helping people to reduce the risk of harm if they do use a drug. It aims to reduce all types of drug-related harm to both the individual and the community.
Cocaine, hepatitis and HIV Sharing needles, syringes and other injecting equipment can greatly increase the risk of contracting blood borne viruses such as hepatitis B, hepatitis C and HIV (human immunodeficiency virus—the virus that causes AIDS). The alcohol and drug service in your state or territory can provide information on where to obtain clean needles and syringes. Their telephone numbers are listed on the back of this pamphlet.
There is no safe level of drug use Use of any drug always carries some risk—even medications can produce unwanted side effects. It is important to be careful when taking any type of drug.
What to do if you are concerned about someone’s drug use If you are concerned about someone else’s drug use, there is confidential help available. Contact the alcohol and drug information service in your state or territory. The telephone numbers are listed on the back of this pamphlet.
What to do in a crisis If someone overdoses or has an adverse reaction while using cocaine, it is very important that they receive professional help as soon as possible. A quick response can save their life.
»» Call an ambulance. Dial 000. Ambulance officers are not obliged to involve the police.
»» Stay with the person until the ambulance arrives.
Find out if anyone at the scene knows cardiopulmonary resuscitation (CPR). »» Ensure that the person has adequate air by keeping crowds back and opening windows. Loosen tight clothing. »» If the person is unconscious, don’t leave them on their back—they could choke. Turn them on their side and into the recovery position. Gently tilt their head back so their tongue does not block the airway. »» If breathing has stopped, apply CPR. »» Provide the ambulance officers with as much information as you can—such as how much cocaine was taken, how long ago and any pre-existing medical conditions. For further tips on how to reduce the risks of using cocaine, call the alcohol and drug information service in your state or territory. The telephone numbers are listed on the back of this pamphlet.
For information, counselling or other assistance, contact the alcohol and other drug service in your state or territory.
ACT (02) 6207 9977
Tas. 1800 811 994
NSW (02) 9361 8000 (Sydney) 1800 422 599 (NSW)
Vic. 1300 85 85 84 (information)
NT 1800 131 350
QLD 1800 177 833 SA
1300 131 340
1800 888 236 (counselling)
WA (08) 9442 5000 (Perth) 1800 198 024 (WA)
Produced by the Australian Drug Foundation Š 2011. Celebrating more than 50 years of service to the community, the Australian Drug Foundation is Australia’s leading body committed to preventing alcohol and other drug problems in communities around the nation. www.adf.org.au For further copies of this pamphlet: Post: PO Box 818 North Melbourne Vic 3051 Street: 409 King Street West Melbourne Vic 3003 Email: druginfo@adf.org.au Web: www.druginfo.adf.org.au