# Cocaine By [Hamazasp](https://paragraph.com/@hamazasp) · 2024-01-17 --- **Cocaine** (from [French](https://en.wikipedia.org/wiki/French_language): _cocaïne_, from [Spanish](https://en.wikipedia.org/wiki/Spanish_language): [_coca_](https://en.wikipedia.org/wiki/Coca), ultimately from [Quechua](https://en.wikipedia.org/wiki/Quechuan_languages): _kúka_)[\[14\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-14) is a [tropane alkaloid](https://en.wikipedia.org/wiki/Tropane_alkaloid) that acts as a [central nervous system](https://en.wikipedia.org/wiki/Central_nervous_system) (CNS) [stimulant](https://en.wikipedia.org/wiki/Stimulant). As an extract, it is mainly [used recreationally](https://en.wikipedia.org/wiki/Recreational_drug_use), and often [illegally](https://en.wikipedia.org/wiki/Prohibition_of_drugs) for its [euphoric](https://en.wikipedia.org/wiki/Euphoria) and [rewarding](https://en.wikipedia.org/wiki/Reward_system) effects. It is also used in [medicine](https://en.wikipedia.org/wiki/Medicine) by [Indigenous South Americans](https://en.wikipedia.org/wiki/Indigenous_South_Americans) for various purposes and rarely, but more formally, as a [local anaesthetic](https://en.wikipedia.org/wiki/Local_anaesthetic) or diagnostic tool by medical practitioners in more developed countries. It is primarily obtained from the leaves of two [Coca](https://en.wikipedia.org/wiki/Coca) species native to South America: [_Erythroxylum coca_](https://en.wikipedia.org/wiki/Erythroxylum_coca) and [_E. novogranatense_](https://en.wikipedia.org/wiki/Erythroxylum_novogranatense).[\[15\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-15)[\[16\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Pom2012-16) After extraction from the plant, and further processing into cocaine [hydrochloride](https://en.wikipedia.org/wiki/Hydrochloride) (powdered cocaine), the drug is [administered](https://en.wikipedia.org/wiki/Route_of_administration) by being either [snorted](https://en.wikipedia.org/wiki/Nasal_administration), applied [topically](https://en.wikipedia.org/wiki/Topical_administration) to the [mouth](https://en.wikipedia.org/wiki/Mouth), or dissolved and [injected](https://en.wikipedia.org/wiki/Injection_\(medicine\)) into a [vein](https://en.wikipedia.org/wiki/Vein). It can also then be turned into [free base](https://en.wikipedia.org/wiki/Free_base) form (typically [crack cocaine](https://en.wikipedia.org/wiki/Crack_cocaine)), in which it can be heated until [sublimated](https://en.wikipedia.org/wiki/Sublimation_\(phase_transition\)) and then the vapours can be [inhaled](https://en.wikipedia.org/wiki/Smoking).[\[12\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Zimmerman2012-12) Cocaine stimulates the [reward pathway](https://en.wikipedia.org/wiki/Mesolimbic_pathway) in the brain.[\[16\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Pom2012-16) Mental effects may include an [intense feeling of happiness](https://en.wikipedia.org/wiki/Euphoria), [sexual arousal](https://en.wikipedia.org/wiki/Sexual_arousal), [loss of contact with reality](https://en.wikipedia.org/wiki/Psychosis), or [agitation](https://en.wikipedia.org/wiki/Psychomotor_agitation).[\[12\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Zimmerman2012-12) Physical effects may include a [fast heart rate](https://en.wikipedia.org/wiki/Tachycardia), sweating, and [dilated pupils](https://en.wikipedia.org/wiki/Mydriasis).[\[12\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Zimmerman2012-12) High doses can result in [high blood pressure](https://en.wikipedia.org/wiki/Hypertension) or [high body temperature](https://en.wikipedia.org/wiki/Hyperthermia).[\[17\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-17) Onset of effects can begin within seconds to minutes of use, depending on method of delivery, and can last between five and ninety minutes.[\[12\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Zimmerman2012-12) As cocaine also has [numbing](https://en.wikipedia.org/wiki/Topical_anesthetic) and [blood vessel constriction](https://en.wikipedia.org/wiki/Vasoconstrictor) properties, it is occasionally used during surgery on the [throat](https://en.wikipedia.org/wiki/Pharynx) or [inside of the nose](https://en.wikipedia.org/wiki/Nasopharynx) to control pain, bleeding, and [vocal cord spasm](https://en.wikipedia.org/wiki/Laryngospasm).[\[18\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-18) Cocaine crosses the [blood–brain barrier](https://en.wikipedia.org/wiki/Blood%E2%80%93brain_barrier) via a proton-coupled [organic cation antiporter](https://en.wikipedia.org/wiki/Organic_cation_transport_protein)[\[19\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-How_do_psychostimulants_enter_the_h-19)[\[20\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Structural_Requirements_for_Uptake-20) and (to a lesser extent) via [passive diffusion across cell membranes](https://en.wikipedia.org/wiki/Passive_transport).[\[21\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-ReferenceA-21) Cocaine blocks the [dopamine transporter](https://en.wikipedia.org/wiki/Dopamine_transporter),[\[22\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-22) inhibiting [reuptake](https://en.wikipedia.org/wiki/Reuptake) of [dopamine](https://en.wikipedia.org/wiki/Dopamine) from the [synaptic cleft](https://en.wikipedia.org/wiki/Synaptic_cleft) into the pre-synaptic [axon terminal](https://en.wikipedia.org/wiki/Axon_terminal); the higher dopamine levels in the synaptic cleft increase [dopamine receptor](https://en.wikipedia.org/wiki/Dopamine_receptor) activation in the post-synaptic neuron,[\[23\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-23)[\[24\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-24) causing euphoria and arousal.[\[25\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-25) Cocaine also blocks the [serotonin transporter](https://en.wikipedia.org/wiki/Serotonin_transporter) and [norepinephrine transporter](https://en.wikipedia.org/wiki/Norepinephrine_transporter), inhibiting reuptake of [serotonin](https://en.wikipedia.org/wiki/Serotonin) and [norepinephrine](https://en.wikipedia.org/wiki/Norepinephrine) from the synaptic cleft into the pre-synaptic [axon terminal](https://en.wikipedia.org/wiki/Axon_terminal) and increasing activation of [serotonin receptors](https://en.wikipedia.org/wiki/Serotonin_receptor) and [norepinephrine receptors](https://en.wikipedia.org/wiki/Norepinephrine_receptor) in the post-synaptic neuron, contributing to the mental and physical effects of cocaine exposure.[\[6\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Monoamines:_Dopamine,_Norepinephrin-6) A single dose of cocaine induces [tolerance](https://en.wikipedia.org/wiki/Drug_tolerance) to the drug's effects.[\[26\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Ambre1988-26) Repeated use is likely to result in [addiction](https://en.wikipedia.org/wiki/Substance_use_disorder). Addicts who abstain from cocaine may experience [craving](https://en.wikipedia.org/wiki/Cocaine_dependence) and [drug withdrawal](https://en.wikipedia.org/wiki/Drug_withdrawal) symptoms, with [depression](https://en.wikipedia.org/wiki/Depression_\(mood\)), [decreased libido](https://en.wikipedia.org/wiki/Decreased_libido), [decreased ability to feel pleasure](https://en.wikipedia.org/wiki/Anhedonia), and fatigue being most common.[\[16\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Pom2012-16) Use of cocaine increases the overall risk of death, and intravenous use potentially increases the risk of trauma and infectious diseases such as [blood infections](https://en.wikipedia.org/wiki/Sepsis) and [HIV](https://en.wikipedia.org/wiki/HIV) through the use of shared [paraphernalia](https://en.wikipedia.org/wiki/Drug_paraphernalia). It also increases risk of [stroke](https://en.wikipedia.org/wiki/Stroke), [heart attack](https://en.wikipedia.org/wiki/Myocardial_infarction), cardiac arrhythmia, lung injury (when smoked), and [sudden cardiac death](https://en.wikipedia.org/wiki/Sudden_cardiac_death).[\[16\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Pom2012-16)[\[27\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Sor2014-27) Illicitly sold cocaine can be adulterated with [fentanyl](https://en.wikipedia.org/wiki/Fentanyl), [local anesthetics](https://en.wikipedia.org/wiki/Local_anesthetics), [levamisole](https://en.wikipedia.org/wiki/Levamisole), cornstarch, [quinine](https://en.wikipedia.org/wiki/Quinine), or sugar, which can result in additional toxicity.[\[28\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-Gold2009-28)[\[29\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-29) In 2017, the Global Burden of Disease study found that cocaine use caused around 7,300 deaths annually.[\[30\]](https://en.wikipedia.org/wiki/Cocaine#cite_note-30) --- *Originally published on [Hamazasp](https://paragraph.com/@hamazasp/cocaine)*