fact sheet - cocaine use in South Africa
Fact sheet prepared by:
Alcohol & Drug Abuse Research Group
Medical Research Council

What is cocaine?

• Cocaine is a central nervous stimulant extracted from the leaves of the coca plant (Erythroxylon coca).
• There are two chemical forms of cocaine: cocaine hydrochloride (HCL) which has the appearance of a white, crystalline powder; and "freebase" cocaine. Crack is a specific form of freebase cocaine which is processed from cocaine HCL by the addition of an alkaline substance (e.g. bicarbonate of soda), to form smokeable rocks.

Modes of administration

• Cocaine HCL is usually administered intranasally (sniffing/snorting), or less frequently, intravenously, through injection.
• Crack cocaine is mainly ingested through smoking/inhalation.

Short-term effects

• Cocaine is a stimulant which causes the pulse rate to increase and blood pressure to rise. It leads to changes in neurotransmitter functioning, resulting in feelings of euphoria, self-confidence, heightened awareness, and alertness. This "rush" may result in a loss of fatigue, a loss of appetite, and heightened sexual arousal.
• In large doses, cocaine may lead to paranoia, violent and erratic behaviour, dizziness, and dilated pupils.
• The rush occurs within 5 to 10 minutes of snorting cocaine powder, and tapers off within 15 minutes to an hour (depending on the purity). If crack is smoked, the rush begins within about 10 seconds.

Long-term effects
The following are among long-term effects that have been reported from cocaine use:

• Crack cocaine and cocaine powder are psychologically and physically addictive, and when the "high" wears off, the addicted user is left craving more stimulation.
• For the addicted user of crack cocaine or cocaine powder, the "high" is short-lived and is sometimes followed by feelings of irritability, depression, paranoia, and anxiety. These are symptoms of withdrawal. Withdrawal symptoms may also include nausea, vomiting, insomnia, shaking fits, and muscle weakness.
• Increased risk of strokes, heart attacks, and seizures.
• Gastrointestinal complaints (diarrhoea).
• Respiratory problems from smoking crack cocaine: chronic bronchitis, "crack lung" syndrome, and respiratory failure.
• Perforated nasal septum from snorting cocaine powder.
• Reduction of body's ability to resist and fight infection.
• Adverse psychological consequences: cocaine psychosis, depression, anxiety, and insomnia, impaired memory and concentration, impaired psychological development (especially for adolescents), and impaired social and occupational functioning.
• Use during pregnancy may place child at risk for later developmental difficulties, such as poor attention and learning. There may also be an increased risk of miscarriages, premature birth, and fetal abnormalities.
• Crack cocaine may have a pro-sexual effect and lead to risky sexual behaviour. Prolonged crack cocaine consumption has been associated with an increased risk for contracting an STD or HIV.
• There has been a link between violent crime and crack consumption in the USA with crime often being committed to support the crack cocaine addiction.

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