COCAINE
(Street Names: Coke, Snow, Crack, Rock)

October 2009 DEA/OD/ODE

Cocaine abuse has a long, deeply rooted history in U. S. drug culture, both urban and rural. It is an intense, euphorigenic drug with strong addictive potential. With the advent of the higher purity free-base form of cocaine ("crack"), and its easy availability on the street, cocaine continues to burden both law enforcement and health care systems in the U.S.

Licit Uses:

Cocaine hydrochloride (4% and 10%) solution is used primarily as a topical local anesthetic for the upper respiratory tract. The vasoconstrictor and local anesthetic properties of cocaine cause anesthesia and mucosal shrinkage. It constricts blood vessels and reduces blood flow, and is used to reduce bleeding of the mucous membranes in the mouth, throat, and nasal cavities. However, better products have been developed for these purposes and cocaine is rarely used medically in the U.S.

Cocaine is the principal alkaloid in the leaves of Erythroxylon coca, a shrub indigenous to the Andean region of South America. Cocaine is an ester of benzoic acid and methylecgonine. Ecgonine, an amino alcohol, is structurally similar to atropine and some local anesthetics. Cocaine is a local anesthetic and a strong central nervous system stimulant which produces intense euphoria. Inhalation of the vapors of cocaine base (crack), known as "basing" or "free basing," became a popular practice in the 1980s because of its rapid onset of action (7-10 seconds), ease of repeat administration, and an unwarranted belief by users that smoking cocaine was less harmful and less likely to produce addiction than injecting cocaine. Smoking cocaine base produces a sudden and intense ‘rush’ with an equally intense ‘high’ or euphoria lasting from 2 to 20 minutes. Tolerance develops to the euphoric effects of cocaine. Physiological effects of cocaine include constricted peripheral blood vessels, dilated pupils, and increased blood pressure and heart rate. Cocaine also produces restlessness, irritability, and anxiety in some users. High doses of cocaine or prolonged use can cause paranoia.

Cocaine can be packaged as a white crystalline powder (snow), or in paste, free-base, or rock form (crack). Crack can be sprinkled on marijuana or tobacco and smoked. It is also taken in combination with an opiate, like heroin; a practice commonly referred to as "speedballing." Intravenous and intramuscular injections, snorting, and smoking are the common routes of administration. All mucous membranes readily absorb cocaine. Cocaine smugglers who transport the drug by ingestion have died from the rapid absorption of cocaine through the bowel mucosa after swallowed cocaine-packed balloons inadvertently rupture in transit.

The widespread abuse of street cocaine of high purity has led to many adverse health consequences such as cardiac arrhythmias, ischemic heart conditions, sudden cardiac arrest, convulsions, strokes, and death. The availability of "crack" cocaine led to an increase in inhalation as the preferred route of administration for many abusers. In order to avoid the discomfort associated with post-euphoric ‘crash,’ crack or free base smokers continue to smoke often in marathon binges, until they become exhausted or run out of cocaine supply. The long-term use of inhaled cocaine has led to a unique respiratory syndrome in some abusers, and the chronic snorting of cocaine has led to the erosion of the upper nasal cavity.

User Population:

According to the 2008 National Survey on Drug Use and Health, 1.9 million Americans ages 12 and older used cocaine in the past month; a decrease from 2.1 million users in 2007. Cocaine use in youth 18-25 years decreased from 1.7% in 2007 to 1.5% in 2008. According to the 2008 Monitoring the Future Study, cocaine annual prevalence is 1.8%, 3.0%, and 4.4%, for 8th, 10th, and 12th graders, respectively. Cocaine abuse occurs in both genders and among various ethnic groups of the U.S.

Colombia produces about 90% of the cocaine powder reaching the U.S. According to the 2005 Colombia Threat Assessment, 90% of the cocaine shipped to the U.S. comes from the Central America - Mexico corridor. According to the Federal-Wide Drug Seizure System, U.S. Federal law enforcement officials seized 152,736 kg of cocaine in 2006, 140,959 kg in 2007, and 91,186 kg in 2008. According to the System to Retrieve Information from Drug Evidence, DEA forensic laboratories reported a total of 21,944 exhibits identified as cocaine in 2006, 19,694 cocaine exhibits in 2007, and 18,262 cocaine exhibits in 2008. In the first six months of 2009, 8,914 exhibits have been identified by DEA laboratories as cocaine. According to the National Forensic Laboratory Information System, 508,671 cocaine items/exhibits were submitted to state and local forensic laboratories in 2006, 475,244 cocaine items/exhibits in 2007, and 418,329 cocaine items/exhibits in 2008. From January to June 2009, 172,689 cocaine items/exhibits were submitted to state and local laboratories. The American Association of Poison Control Centers (AAPCC) tracks the number of poison exposures of various substances and their and outcomes. In 2006, the AAPCC reported 7,746 case mentions of cocaine (2,922 single exposures) and 25 deaths. In 2007, the number of cocaine case mentions decreased to 7,634 (2,748 single exposures) and deaths decreased to 20.

Cocaine is a schedule II substance under the Controlled Substances Act.

Comments and additional information are welcomed by the Drug and Chemical Evaluation Section, Fax 202-353-1263, telephone 202-307-7183, or Email ODE@usdoj.gov.