Cocaine
Cocaine is one of the most powerfully addictive drugs
of abuse. Most
clinicians estimate that
approximately
10 percent of people who
begin to use the drug "recreationally" will go on to serious,
heavy use.
Once having tried cocaine,
an individual cannot
predict
or control the extent to which he or she will continue
to use the drug.
Methods of Use
Cocaine use ranges from episodic or
occasional use to repeated or compulsive use, with a variety
of
patterns between these extremes. The major methods of administration
of cocaine are sniffing or snorting, injecting, and smoking (including
free-base and crack cocaine). Snorting is the
process of inhaling
cocaine powder through the nostrils
where it is absorbed into the
bloodstream through the nasal tissues. Injecting is the act of using a
needle to release the drug directly
into the bloodstream. Smoking
involves the inhalation of cocaine vapor or smoke into the lungs
where absorption into the bloodstream is as rapid as by injection.
There is great risk no
matter how cocaine is ingested. It
appears that compulsive cocaine use may develop even more rapidly if
the substance is smoked rather than taken intranasally. Smoking allows
extremely high doses of cocaine
to reach the brain very quickly and
brings an intense and immediate high. The injecting drug user is at
risk for transmitting or acquiring HIV infection/AIDS if needles or
other injection
equipment is shared.
"Crack" is the street name given to cocaine that has been processed
from cocaine hydrochloride to a free base for smoking. Rather than
requiring the more volatile method of
processing cocaine using ether,
crack cocaine is processed with ammonia or sodium bicarbonate (baking
soda) and water and heated to remove the hydrochloride, thus producing
a
form of cocaine that can be smoked. The
term "crack" refers to the
crackling sound heard when the mixture is smoked (heated), presumably
from the sodium bicarbonate.
Health and Psychological Hazards
Treatment
The widespread abuse of cocaine has stimulated extensive
efforts to develop treatment programs for this type of drug abuse.
According to the State Alcohol and Drug Abuse Profile, in FY 1994,
States reported 326,031 patients
entering treatment with cocaine as
the primary drug of abuse, representing 43 percent of treatment
admissions. Another study, NIDA's Drug Services Research Survey,
estimates that 31 percent of a sample of drug treatment clients had
used
cocaine or crack cocaine within 30 days prior to admission for
treatment. Data from treatment programs using different therapeutic
approaches indicate that outpatient cocaine treatment can be
successful. One report suggests that from
30
percent to 90 percent
of abusers remaining in outpatient treatment programs cease cocaine
use.
In addition to pharmacological treatments, behavioral interventions
also have been developed that
are effective
in decreasing drug use
by patients in treatment for cocaine abuse. Providing the optimal
combination of treatment services for each individual is critical to
successful
treatment outcome.
Cocaine
The use of cocaine among 8th-, 10th-, and
12th-graders continued a gradual upward climb; however, most increases
between 1995 and 1996 did not reach
statistical significance. In
1996, 4.5 percent of 8th-graders, 6.5 percent of 10th-graders, and 7.1
percent of 12th-graders used cocaine at least once in their lives. In
addition, in 1996, 1.3 percent of 8th-graders, 1.7 percent of
10th-graders, and 2.0 percent of
12th-graders had used cocaine within
the 30 days preceding the study.
Crack cocaine use increased among 8th-, 10th-, and 12th-graders
between 1992 and 1996. Study results showed that 2.9 percent of
8th-graders, 3.3 percent of 10th-graders, and 3.3 percent
of
12th-graders had used crack at least once; 1.8 percent of 8th-graders,
2.1 percent
of 10th-graders, and 2.1 percent of 12th-graders used
crack within
the preceding year.
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