What Is Cocaine? Definition, Effects & Addiction

Published: February 2026 | Last Updated: February 2026 | Reading Time: 6 min

What Is Cocaine?

Cocaine is a powerful stimulant drug derived from the leaves of the coca plant (Erythroxylum coca), which is native to South America. In its purified form, cocaine hydrochloride is a fine white crystalline powder that has been used medically as a local anesthetic since the mid-1800s, though its recreational use and addiction potential have made it one of the most controlled substances worldwide.

Forms of Cocaine

Cocaine is encountered in two primary forms. Cocaine hydrochloride is a water-soluble powder that can be snorted, dissolved and injected, or rubbed onto mucous membranes. Crack cocaine is cocaine that has been processed with baking soda or ammonia to create a freebase form — small rocks or crystals that are heated and smoked. The term "crack" refers to the crackling sound produced when the substance is heated.

Legal Classification

Cocaine is classified as a Schedule II controlled substance under the U.S. Controlled Substances Act. This means it has a high potential for abuse but retains limited accepted medical uses — primarily as a topical anesthetic for ear, nose, and throat surgeries.

How Cocaine Affects the Brain

Cocaine's primary mechanism of action involves blocking the dopamine transporter (DAT), the protein responsible for recycling dopamine back into the neuron that released it. By preventing reuptake, cocaine causes a massive accumulation of dopamine in the synaptic cleft, producing the drug's characteristic euphoria.

The Dopamine Surge

Under normal circumstances, dopamine is released in response to pleasurable stimuli and then rapidly recycled. Cocaine disrupts this cycle, causing dopamine levels to spike dramatically — up to 3-4 times higher than natural rewards produce. This overwhelming signal to the brain's reward system creates an intense but short-lived high and powerfully reinforces drug-seeking behavior.

Cocaine also affects serotonin and norepinephrine transporters, contributing to its mood-altering and stimulant effects. The increased norepinephrine is responsible for many of cocaine's physical effects, including elevated heart rate, blood pressure, and body temperature.

Short-Term Effects

The immediate effects of cocaine vary by route of administration but generally include intense euphoria and heightened confidence, increased energy and alertness, reduced appetite, dilated pupils, elevated heart rate and blood pressure, and hypersensitivity to sight, sound, and touch. These effects are intense but brief — lasting 5-10 minutes when smoked, 15-30 minutes when snorted, and slightly longer when injected.

Health Risks and Dangers

Cardiovascular Complications

Cocaine is particularly dangerous to the cardiovascular system. It constricts blood vessels while simultaneously increasing heart rate and blood pressure, creating conditions that can trigger heart attacks, arrhythmias, aortic dissection, and sudden cardiac death — even in young, otherwise healthy individuals with no prior heart conditions.

Neurological Risks

Cocaine use can cause strokes, seizures, headaches, and cerebral hemorrhage. Chronic use leads to changes in brain structure and function, particularly in areas involved in decision-making, stress regulation, and impulse control.

Other Complications

Route-specific risks include nasal septum perforation from chronic snorting, respiratory damage from smoking crack, and infectious disease transmission from injection drug use. Cocaine-related overdose deaths have risen dramatically in recent years, often involving co-use with synthetic opioids like fentanyl.

Cocaine Addiction

Cocaine is one of the most psychologically addictive substances known. The intense but fleeting nature of the high drives compulsive redosing patterns, and the brain rapidly develops tolerance, requiring increasing amounts to achieve the same effect.

How Addiction Develops

Repeated cocaine use causes neuroadaptive changes in the brain's reward and stress circuits. The brain reduces its natural dopamine production and receptor density, leading to a diminished ability to experience pleasure from normal activities (anhedonia). This creates a cycle where the individual needs cocaine simply to feel normal.

Treatment Approaches

Unlike opioid or alcohol addiction, no FDA-approved medications currently exist specifically for cocaine use disorder. Treatment relies primarily on behavioral interventions including cognitive-behavioral therapy (CBT), contingency management (providing tangible rewards for maintaining abstinence), community reinforcement approach, and therapeutic community programs.

Frequently Asked Questions

How quickly can someone become addicted to cocaine?

Addiction can develop rapidly, particularly with crack cocaine. Some individuals report feeling compelled to use again after just one or two exposures. However, addiction typically develops over weeks to months of repeated use as neuroadaptive changes accumulate.

What is the difference between cocaine and crack?

Both contain the same active compound. Cocaine hydrochloride is a powder that is snorted or injected, while crack is a freebase form that is smoked. Smoking delivers cocaine to the brain in seconds, producing a more intense but shorter high, which contributes to crack's higher addiction potential.

Can cocaine cause a heart attack in young people?

Yes. Cocaine-related heart attacks can occur in healthy individuals in their 20s and 30s with no prior cardiovascular disease. Cocaine is responsible for approximately 25% of heart attacks in people under age 45.

Is cocaine ever used medically?

Yes, but very rarely. Cocaine hydrochloride solution (4-10%) is occasionally used as a topical anesthetic and vasoconstrictor during ear, nose, and throat procedures. It is the only local anesthetic that also constricts blood vessels.

References

1. National Institute on Drug Abuse. (2024). Cocaine DrugFacts.
2. Drug Enforcement Administration. (2023). Cocaine.
3. Substance Abuse and Mental Health Services Administration. (2023). Key Substance Use and Mental Health Indicators.
4. Goldstein, R.A., et al. (2009). Cocaine: History, Social Implications, and Toxicity. Disease-a-Month.
5. Kampman, K.M. (2019). The treatment of cocaine use disorder. Science Advances.

This article was reviewed by the Valley Spring Recovery Center Editorial Team. For more information about cocaine addiction treatment, call (201) 781-8812 or visit our admissions page.

Valley Spring Recovery Center — Evidence-based addiction treatment in Norwood, New Jersey.