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Cocaine is an alkaloid drug extracted from the leaves of the coca plant. It is a stimulant of the central nervous system that produces euphoria (a sense of well being). Crack cocaine is a powerful drug. It is a form of cocaine that is cheap and widely available. It comes in small lumps that look like soap. It is often referred to as rock, freebase, and white tornado. For this discussion, all forms will be referred to as the generic term cocaine. Tachyphylaxis or tolerance to the effects of cocaine often sets in. This creates a tendency among many users to escalate the dosage. Cocaine is snorted, injected, or smoked. It is often mixed with other, less expensive, substances. Crack is made by cooking cocaine with baking powder. It is usually smoked in a water pipe. Crack is the most addictive form of cocaine. Although coca preparations have been used for over 4000 years, cocaine was not isolated until 1844. It received little attention until 1863. A German army physician, Dr. Theodor Aschenbrandt, obtained a supply of pure cocaine and issued it to Bavarian soldiers during their autumn maneuvers. He reported an increase in the ability of the soldiers to endure fatigue. One fascinated reader of Dr. Aschenbrandt's account was a poverty-stricken, twenty-eight-year-old Viennese neurologist, Dr. Sigmund Freud. Some of Freud's initial findings on cocaine as a psychoactive drug were amply confirmed by subsequent research. Additional research revealed that repeated use of large doses of cocaine produces a characteristic paranoid psychosis in all or almost all users, and the tendency to overuse or abuse cocaine is widespread. The hallucination that ants, insects, or snakes are crawling on or under the skin is a peculiar characteristic of this psychosis. By 1890, the addicting and psychosis-producing nature of cocaine was well understood. Cocaine was often being used as a local anesthetic for anesthesia. In the United States, cocaine was being widely used in Coca-Cola, tonics, and other patented medicines. Cocaine was outlawed in the U.S. in 1914. By the mid-1980s, cocaine had supplanted heroin as the drug said to be most dangerous and quickly addictive. In 1995, an estimated 1.5 million Americans were current cocaine users. This represents 0.7 percent of the population aged 12 and older. Cocaine produces the effect of reducing mucous membrane swelling and enlarging nasal and bronchial passages. This most likely gave users the idea of sniffing cocaine, a common use even today. It is also a stimulant that speeds up the nervous system, heartbeat, and breathing. Cocaine addiction differs from many other types of addiction in at least two respects. Even after prolonged uses of large doses of cocaine, if a user is deprived of the drug, they will not suffer from a significant withdrawal crisis like alcoholic delirium tremens or opiate withdrawal syndrome. The physical effects of withdrawal are minor. Cocaine withdrawal is characterized by depression for which cocaine appears to be the only remedy. The compulsion to resume cocaine is very strong. Overdoses of the drug can lead to convulsions and even death. Moreover, cocaine addiction can lead to a severe psychosis while the user is still on the drug. This is quite contrary to most other withdrawal syndromes which set in hours or days after the drug is withdrawn. Large doses of pure cocaine produce significant feelings of tension and excess agitation. Cocaine users discovered that mixing cocaine with morphine or heroin relieves these feelings. Morphine and heroin users discovered the combination increases both the "bang" or "rush" and the mood elevation produced by their particular drug. This mixture is commonly known as "speed" or "crank".
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