How Cocaine Is Made and Its Dangers

In a study of cocaine users, the average time taken to reach peak subjective effects was 3.1 minutes. Subjective effects not commonly shared with other methods of administration include a ringing in the ears moments after injection (usually when over 120 milligrams) lasting 2 to 5 minutes including tinnitus and audio distortion. A 2001 study reported that the sharing of straws used to "snort" cocaine can spread blood diseases such as hepatitis C.

Cocaine Overdose

In Peru, the National Coca Company, a state-run corporation, sells cocaine-infused teas and other medicinal products and also exports leaves to the U.S. for medicinal use. The free and legal commercialization of dried coca leaves under the form of filtration bags to be used as "coca tea" has been actively promoted by the governments of Peru and Bolivia for many years as a drink having medicinal powers. While rarely used medically today, its accepted uses include serving as a topical local anesthetic for the upper respiratory tract and as an antihemorrhagic agent to stop bleeding in the mouth, throat, and nasal cavities.

• Diagnosis is challenging due to symptom overlap and undisclosed drug use, making clinical suspicion and drug history essential for proper management.
• Tell them you love and support them but can't support their drug use.
• The prolonged or compulsive use of cocaine in any of its purified forms can cause severe personality disturbances, inability to sleep, and loss of appetite.
• In Peru, the National Coca Company, a state-run corporation, sells cocaine-infused teas and other medicinal products and also exports leaves to the U.S. for medicinal use.
• Cocaine’s effects appear almost immediately after a single dose and typically disappear within a few minutes to an hour.

Coca leaves

Re-administering cocaine beyond this threshold does not significantly increase DAT occupancy but still results in an increase of euphoria which cannot be explained by reuptake inhibition alone. Conflicting findings have challenged the widely accepted view that cocaine functions solely as a reuptake inhibitor. Research studies have suggested that the affinity for the transporter is not what is involved in the habituation of the substance so much as the conformation and binding properties to where and how on the transporter the molecule binds. An overabundance of 5-HT3 receptors is reported in cocaine-conditioned rats, though 5-HT3's role is unclear.

What are the risks of using cocaine?

The biosynthesis of cocaine has long attracted the attention of biochemists and organic chemists. While domestic clandestine laboratories could theoretically reduce reliance on offshore production and international smuggling—as seen with illicit methamphetamine—manufacture and synthetic production of cocaine remains rare. Although the chemical synthesis of cocaine is technically feasible, it is generally considered impractical due to its high cost, low efficiency, and challenges in stereoselective synthesis compared to extraction from natural plant sources.

People with cocaine use disorder may benefit from community-based programs. Cocaine use may make the brain’s stress receptors more sensitive to stress, so people react more strongly to stressful situations. Withdrawal is the term for the physical and mental symptoms people have when they suddenly stop using a drug.

Cocaine-exposed babies also tend to have smaller heads, which generally reflect smaller brains. Cocaine base/crack can be smoked because it vaporizes with little or no decomposition at 98 °C (208 °F), which is below the boiling point of water. Some local statutes in the US treat spoons that are too small and thus "unsuited for the typical, lawful uses of a spoon" as drug paraphernalia. Cocaine's desired euphoric effects are delayed when snorted through the nose by about five minutes. Cocaine use leads to increases in alertness, feelings of well-being and euphoria, increased energy and motor activity, and increased feelings of competence and sexuality. Cocaine eye drops have traditionally been used by neurologists when examining people suspected of having Horner syndrome.

How do I find help for cocaine use disorder?

Today, the US Drug Enforcement Administration (DEA) classifies cocaine as a Schedule II drug, recognizing its high potential for abuse but still permitting its limited use for medical purposes. Cocaine is not included on the WHO Model List of Essential Medicines; the list formally excludes "cocaine and its combinations" as therapeutic alternatives to ophthalmological preparations. It is legal for people to use coca leaves in the Andean Community, such as Peru and Bolivia, and Argentina, where they are chewed, consumed in the form of tea, or are sometimes incorporated into food products.

Who Controls the Cocaine Trade?

• The mechanisms of drug euphoria or reward are only somewhat understood but are now believed to involve several dispersed brain structures called “hedonic hotspots” that produce especially intense pleasure when activated simultaneously.4,5 Their activation involves several different chemical messengers including the body’s naturally occurring opioids.
• The rate and extent of absorption from inhalation of cocaine is similar or greater than with intravenous injection, as inhalation provides access directly to the capillary bed.
• Cocaine effects, further, are shown to be potentiated for the user when used in conjunction with new surroundings and stimuli, and otherwise novel environs.
• When nasal damage is too severe for reconstruction, a nose prosthesis may be used to restore appearance and quality of life.
• Although researchers have focused on adaptations in the brain’s reward system, drugs also affect the brain pathways that respond to stress.
• Insufflating (snorting) cocaine commonly causes increased mucus production due to irritation and inflammation of the nasal passages.

Crack cocaine is the drug in rock or chunk form. To make cocaine, the leaves are chemically processed and treated to form a powder. Programs use a voucher or prize-based system that offers patients who abstain from cocaine and other drugs with rewards. One form of behavioral therapy that shows positive results in people with cocaine use disorders is contingency management (CM), also called motivational incentives. It reduces blood flow in the gastrointestinal tract, which can lead to tears and ulcerations.3 Many people who use cocaine chronically lose their appetite and experience significant weight loss and malnourishment. This result suggests that strengthening OFC activity may be a good therapeutic approach to improve insight and awareness of the consequences of drug use among people who use cocaine.14

Cognitive-behavioral therapy (CBT)

The highest prevalence of cocaine use was in Australia and New Zealand (2.1%), followed by North America (2.1%), Western and Central Europe (1.4%), and South and Central America (1.0%). Decades later, the cocaine boom marked a sharp rise in illegal cocaine production and trade, beginning in the late 1970s and peaking in the 1980s. Violence linked to the cocaine trade continues to affect Latin America and the Caribbean and is expanding into Western Europe, Asia, and Africa as transnational organized crime groups compete globally. That’s why we have a comprehensive set of treatment providers and don't charge for inclusion. But with proper treatment, you can begin to heal.

Cocaine Withdrawal

Reward refers to the euphoria or high produced when taking the drug (equivalent to “liking”); reinforcement refers to the desire to take the drug again (“wanting”). Cocaine is typically used orally, intranasally, intravenously, or by inhalation. Share sensitive information only on official, secure websites. When the Spanish arrived in South America, they initially banned coca but soon legalized and taxed it after seeing its importance to local labor.

How Common Is Cocaine Use?

Specific routes of cocaine administration can produce their own adverse effects. This can lead to increased irritability, restlessness, panic attacks, paranoia, and even psychosis, in which the individual loses touch with reality and experiences auditory and visual hallucinations.2 With increasing doses or higher frequency of use, the risk of adverse psychological or physiological effects increases.2,3 Some people take cocaine in binges, in which cocaine is used repeatedly and at increasingly higher doses. Because cocaine's effects wear off sooner, this can lead to an opioid overdose.22,23 Many people who use cocaine also use alcohol, and this combination can be particularly dangerous.

The major countries in the cocaine trade include those where coca plants are grown and processed, such as Colombia, Bolivia and Peru. Along the supply chain, cocaine is cut with adulterants to reduce its purity and create a larger profit margin.3,12 Common cutting agents include amphetamines, baking sugars, caffeine, acetaminophen, cornstarch, flour, talcum powder and certain anesthetics.1,2,4 Some adulterants, or cutting agents, can be filtered out through the creation of crack cocaine.1 While there are some core ingredients that must be included in the production of cocaine, there are several that can be used interchangeably.17 Manufacturers may utilize different chemicals than one another based on factors such as availability, financial limitations, and personal preferences.

Since the 1980s, the cocaine trade was dominated by centralized, hierarchical drug cartels such as Medellín and Cali, along with their successors and early FARC factions. Experimentally, cocaine injections can be delivered to animals such as fruit flies to study the mechanisms of cocaine addiction. In animal studies, nicotine exposure in mice increases the likelihood of later cocaine use, with clear molecular changes in the brain. The Consolidated Counterdrug Database (CCDB) is a U.S. government dataset created in the 1990s that compiles vetted data on cocaine trafficking and seizures in the Western Hemisphere "transit zone," involving 26 U.S. agencies and 20 foreign partners. When the paste is smoked, individuals are exposed not only to the addictive effects of the drug itself but also to the dangerous residual chemicals, which can cause significant harm to the lungs, nervous system, and overall health.

Such areas are chosen for coca cultivation due to their remote locations, minimising chances of detection. The UNODC approximated that 97,622 hectares of primary forest were cleared for coca cultivation during 2001–2004 in the Andean region. Due to the illegal nature of coca production, farmers make little effort in soil conservation and sustainability practices as seen in the high mobility and short life of coca plots in Colombia. Many of these hazardous substances, such as solvents and acids, remain in the paste after processing. Seizures rose by 68% from 2019 to 2023, while the number of users increased from 17 million in 2013 to 25 million in 2023, according to the UNODC World Drug Cocaine and Alcohol Mix Report 2025.

These include holders, transporters (also called mules), delivery people, counters of cash and incoming drugs, lookouts, backup personnel, and enforcers of debt payments.14 The continued use of cocaine can lead to serious problems, including tolerance, dependence, and eventually addiction. Every month, 150,000 people search for addiction or mental health treatment on Recovery.com.