Cocaine is considered a highly addictive drug that can cause dependency in people who use it. It is classified as a Schedule II drug by the U.S. Drug Enforcement Administration (DEA), which means it has a high potential for abuse and can lead to severe physiological and psychological dependency.
Cocaine’s addictive properties are affected by the form in which it is ingested. The potency of the drug is more concentrated when it is in rock form than in other forms. Its addictive potential increases when it is smoked in rock form or injected intravenously compared to when the drug is snorted in powder form.
According to the National Institute on Drug Abuse (NIDA) cocaine works by increasing levels of the neurotransmitter dopamine in the brain, which is a natural chemical messenger that triggers a reward response in the brain. When dopamine builds up in the synapses between the brain cells, the brain perceives this as a pleasurable feeling that should be reinforced. This is why using cocaine creates a feeling of euphoria that makes users feel high.
With continued use of cocaine, the brain becomes adapted to the excessive amounts of dopamine in the brain and becomes less sensitive to the presence of the drug. This results in the development of tolerance. Larger quantities of the drug are then necessary to stimulate the same pleasurable response.
When this happens, people take larger quantities of cocaine to get the same high feeling that they experience on lower quantities. They may also begin to experience withdrawal symptoms when the drug leaves their system.
Unpleasant feelings that come from withdrawal symptoms trigger the brain to send messages to seek out more of the pleasurable substance to get back to feeling good. The brain’s messages can be hard to ignore. Ultimately, people give in to cravings for the drug because the desire to feel good again becomes too strong.
This cycle of using cocaine, experiencing the crash that comes along when the drug wears off, followed by uncomfortable withdrawal symptoms that are alleviated with more cocaine use, is how addiction originates in the brain and takes over a person’s willpower, even if they desire to stop using it.
Withdrawal symptoms contribute to addiction because the discomfort of withdrawal along with the associated cravings can drive compulsive drug-seeking behaviors that characterize addiction. The presence of withdrawal symptoms is a sign that dependency on a substance has developed, and the body has a physiological response to the lack of drugs in its system.
The National Library of Medicine states that withdrawal symptoms can occur even when there is still some cocaine in the bloodstream. As the drug is metabolized out of the body over the hours after the last dose has been consumed, the withdrawal symptoms will get stronger and more unpleasant, and intense drug cravings can develop.
When cocaine use is discontinued, such as at the end of a cocaine binge, the crash from the euphoric high begins almost immediately. Cravings become powerful and intense, and they can be difficult for a user to manage. They may have obsessive thoughts about obtaining more of the drug or become preoccupied with when they can next use the drug.
The psychological patterns triggered during the withdrawal process contribute to the nature of addiction. These cravings and obsessive thoughts about drug-seeking are part of the brain’s response to dependency, which can be extremely difficult to resist.
The physical withdrawal symptoms the body is going through accompany powerful psychological messages coming from the brain to continue drug-seeking behavior. This is why periods of withdrawal are associated with a high risk for relapse due to the body’s response to the lack of cocaine.
NIDA reports that animal studies have shown that with prolonged use of cocaine, the brain experiences changes in how the neurons respond to the neurotransmitter glutamate, which is involved in the brain’s reward and pleasure circuitry. This makes it harder to experience pleasure without cocaine
The stress pathways in the brain intersect with the reward pathways, which means that the brain’s stress response is also impacted by the damage cocaine does to the reward pathways. Studies demonstrate that animals with prolonged exposure to cocaine are more likely to seek out cocaine during times of stress.
Chronic cocaine use also reduces the functioning of the orbitofrontal cortex, which is associated with decision-making. This result means that prolonged exposure to cocaine contributes to poor judgment, lack of self-awareness, and inability to stop using in spite of negative consequences.
The potent effect cocaine has on the brain means that the drug can be highly addictive and difficult to stop using once dependency develops.
According to NIDA, cocaine is one of the more frequently abused drugs in the United States. Rates of abuse have remained relatively stable over the past few years.
In 2014, there were about 1.5 million current cocaine users, ages 12 and older, which is 0.6 percent of the population. Adults 18 to 25 have the highest rates of use, at about 1.4 percent.
Using cocaine repeatedly increases the chances that dependency will develop.
It is hard to say for sure how cocaine compares to other substances in terms of addiction rates. Collected data on drug use is impacted by many factors, including how many users develop a dependency after using the drug and how many people use the drug but do not develop an addiction.
Marijuana is the most commonly used illicit drug, according to the National Survey on Drug Use and Health, with 22.2 million current users in 2015. However, not all marijuana users develop an addiction.
Alcohol use is more predominant than marijuana use, with 71 percent of all adults consuming some alcohol, but only about 15.1 million adults, or about 6.2 percent of the population, had alcohol use disorder in 2015, according to the National Institute on Alcohol Abuse and Alcoholism.
The DEA categorizes cocaine in the same class as other addictive substances like Vicodin, methamphetamine, OxyContin, Adderall, Dilaudid, methadone, and Dexedrine.
There is some limited medical use for cocaine, though it is rarely used in this capacity any longer. Instead, it is primarily a recreational drug of abuse. Still, it maintains its Schedule II classification.
Opioids are also a potentially dangerous class of drugs with a high potential for addiction. Current estimates from the American Society of Addiction Medicine indicate that about 23 percent of people who use heroin will become addicted.
Given that all addictive substances have some risk for abuse and dependency, cocaine should be considered a drug with a high potential for addiction that can become problematic with regular use. Any use of cocaine can start a cycle of drug abuse that ultimately leads to addiction.
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