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Cocaine is a crystalline substance derived from the Coca plant. It is a stimulant that produces feelings of euphoria, increased drive and energy, elevated confidence, increased sexual interest, and heightened mental alertness. It can be snorted, smoked as Crack cocaine, vaporized and inhaled as Freebase, or injected.

American statistics show that about 15% of people will try cocaine, and of these about 15% go on to develop cocaine abuse or dependence at some point in their lives [ref].

How Cocaine Works

The effects of cocaine are felt almost immediately but are relatively short-lived, lasting only about 10-15 minutes in the Freebase form, and 30-60 minutes in the other forms. For this reason, users often require repeated doses in order to maintain the effects. Cocaine can be detected in urine up to five days after use, and in hair samples up to 3 months after use.

Cocaine seems to work principally by increasing the levels of dopamine in the brain by blocking dopamine reuptake. It also has similar effects on norepinephrine and serotonin.

Cocaine Intoxication

In addition to the effects described above, cocaine can also cause people to feel very anxious, apprehensive, fearful, irritable, angry, agitated or restless, and can induce psychosis and states of confusion.

Cocaine use can trigger Manic or Mixed Episodes, Anxiety Disorders or Psychotic Disorders.

In terms of physical symptoms, cocaine will increase one's heart rate and blood pressure, and can cause fever, nausea and loss of appetite. It can also cause life-threatening conditions such as heart arrhythmias, seizures, heart attacks, strokes and coma.

Cocaine Withdrawal

Withdrawal symptoms from cocaine can be experienced even after a single, average-sized dose, but will tend to be more severe in cases of heavy or prolonged use. They include fatigue, lethargy, mental slowness, difficulty concentrating, loss of interest and motivation, depressed moods (including suicidal thoughts), and irritability.

These symptoms can last for up to a week, but cocaine withdrawal can also trigger a Major Depression or an Anxiety Disorder. After long-term use, strong cocaine cravings and vivid dreams of using cocaine can continue for up to a year.

The physical symptoms of cocaine withdrawal are not life-threatening and medical monitoring is not required.

Treating Cocaine Abuse and Dependence

Treating cocaine use disorders follows the general treatment principles as outlined here. Although various medications have been tried for this purpose, none have been shown to be effective in any definitive way [ref, ref].

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