Cocaine is a naturally occurring pain blocker (anesthetic) that is extracted from the leaves of the coca shrub (Erythroxylum/Erythroxylon coca). This plant grows in the Andes Mountains of South America. The drug is very powerful and highly addictive.
Cocaine is available either as paste, white powder, or crystal form (aka crack cocaine) and is one of the most dangerous drugs out there. The powder is often cut or mixed with other substances like sugar, cornstarch, talcum powder and other drugs like amphetamines. Today, cocaine is a multi-billion dollar business1 of global proportions, with users coming from all walks of life – young, old, rich poor etc. We can be sure that a large percentage of cocaine users and abusers belong to the work force, a fact that is no secret to many employers and safety managers. Workplace drug testing is one of the many measures that safety and productivity can be preserved in a diverse work environment. Cocaine is practically a standard test in many multi-panel drug test kits today.
Screening Cut-off and Detection Time
Just like any drug, screening for cocaine is guided by clear cut-off levels that vary depending upon the type of sample used. There are also different cut-off levels for screening and GC/MS confirmatory testing because they use different testing methodologies.
Different methods – different cut-off levels.
The immunoassay tests done during initial screening are intended to detect a wide range of compounds that are chemically similar and that react with antibodies contained in the reagents. The GC/MS confirmatory tests on the other hand look for specific metabolites that identify and quantify a specific drug.
|Screening Cut-off||GC/MS Cut-off (confirmatory)||Approximate Detection Time|
|Urine test||300 ng/ml (COC)||150 ng/ml||2-4 days|
|150 ng/ml (COC150)||150 ng/ml||2-4 days|
|Saliva test||300 ng/ml||150 ng/ml||1-3 days|
|Nail||500 pg/mg||200 pg/mg||from 3-6 months after use|
|Hair follicle test||300-500 pg/mg||200-500 pg/mg||From 5-7 days after use up to 90 days|
DEA Drug Class
Cocaine is classified under Schedule II of the Controlled Substances Act which lists drugs, substances or chemicals that have a high potential for abuse, the usage of which can potentially lead to severe physical and psychological dependence but with accepted medical uses. Drugs under this class are considered dangerous and require a prescription.
Some examples of drugs that fall under this class include:
- Hydromorphone (Dilaudid)
- Meperidine (Demerol)
- Oxycodone (OxyContin)
Cocaine is a stimulant. It is what they call in the streets an “upper”. Stimulants increase a person’s energy and alertness temporarily. Aside from cocaine, the other most commonly used stimulant is amphetamine. Prescription stimulants are available in either tablet or capsule form. The “down” that shortly follows the “up” provided by stimulants include depression, apathy and exhaustion. This seemingly unshakeable exhaustion then quickly drives the user to want the drug again, until he is no longer trying to get “high”, he is simply trying to feel some semblance of energy. Repeated use of stimulants in high enough doses can lead to high body temperature, irregular heartbeat, hostile feelings and paranoia.
Forms and Routes of Administration
Cocaine is administered in any of a variety of ways depending on which form it comes in:
- Oral – For cocaine to be administered orally, it has to be either in leaf or powder form. The leaves are mixed with an alkaline substance like lime, chewed into a wad, and “parked” between the gum and cheek in much the same manner as chewing tobacco so that its juices may be swallowed or absorbed slowly by the mucous membrane of the inner cheek. The alkaline substance is what enables the cocaine alkaloid in the leaves to be extracted. Another way is to simply make a tea out of the leaves by steeping them in water. While many consider oral ingestion an inefficient way of absorbing cocaine into the body, it is still considered an alternative way of administration because even a single cup of coca leaf tea can cause a subject’s urine to test positive for cocaine metabolites.
The powder form of the drug may be mixed with a drink or rubbed along the gum line. This numbs the gum and teeth which earned cocaine its nickname “numbies”, “cocoa puff” or “gummers”. Another oral method is when a small amount of cocaine is wrapped in rolling paper and then swallowed. They call this a “snow bomb”
- Snorting – Also called insufflation, intranasal administration, “sniffing” or “blowing”, this is the most common route of administration of powdered cocaine for recreational use. The nose and sinuses are lined with mucous membranes which absorb the snorted cocaine into the body. It is estimated that some 30-60% is absorbed in this way, much higher or certainly more efficient than oral ingestion.
- Injection – Compared to snorting and oral ingestion, injecting cocaine directly into the body assures 100% absorption into the blood stream, and provides the quickest way by which a “high” is achieved. Cocaine is a vasoconstrictor, and because users often require subsequent injections within a few hours of each other, they become harder and harder to administer.
- Inhalation (Smoking) – Smoking is done by inhaling the vapors that result from heating freebase or crack cocaine. This is done by using small glass tubes called pipes, also called “horns”, “stems”, “straight shooters” or “blasters”. The effects of smoking cocaine are felt almost immediately and while very intense, they only last for a few minutes, 15 minutes tops.
- Adderall XR
- Dexedrine Spansule
Uses of Amphetamines
As bad as its reputation as a recreational drug, cocaine did and does have some very useful applications in the field of medicine. It has been used as a local anesthetic for eye, nasal and laryngeal surgery. It is also a vasoconstrictor which helps stem the bleeding during surgery. This application has somewhat diminished as newer and safer anesthetics, albeit without the vasoconstrictor property, entered the market. Being a controlled substance, pharm grade cocaine for injection is available in 4% solution and is only ever used legally under medical supervision.
Native South Americans chewed on coca leaves to help:
- deal with hunger;
- boost muscle stamina and strength for hard mountain labor; and to
- counter motion and high-altitude sickness due to the thin Andean mountain air.
When first discovered by the Western world, it was used as a:
- blood clotting agent; and
- muscle relaxer.
In the late 19th century, cocaine was also promoted as a:
- cure for asthma
- cure for whooping cough
Other popular uses some of which may or may not be medically supervised include:
- Pain management for terminally ill patients
- Toothache drops
- To stop nosebleeds
- To normalize bowel function
- To treat depression
- To get a boost of energy
- To boost confidence in social situations
According to appearance
- Gold dust
- Haven dust
- That white B
- Snow white
- White powder
- White fluff
- White dust
According to 70s & 80s American Culture
- Love Affair
- King’s Habit
- White Pimp
- Movie Star Drug
- Star-Spangled Powder
- Studio Fuel
- Late Night
- Society High
According to How the Word “Cocaine” Sounds
- lady caine
- Big C
According to Closest Description of the Drug
- Candy C
The frontal lobe of the brain of cocaine users has shown evidence of abnormal brain structure, as identified by University of Cambridge scientists. Of 120 individuals brain-scanned, of which half were cocaine-addicted, they found widespread loss of gray matter among the cocaine users. The magnitude of loss was directly related to the length of abuse. This loss results to accelerated aging of the brain.
The part of the brain that processes our reward system (basal ganglia) was found to be much enlarged among cocaine users. Following is a list of other long-term damage to the brain that results from prolonged cocaine abuse.
- Blood vessel damage
- Cognitive deficits
- Dopamine deficiency
- Emotional dysfunction
- Poor Stress response
- Prefrontal cortex impairment
- Receptor dysregulation
- Stroke risk
Cocaine provides a fleeting, intense high followed immediately by intense depression, restlessness and a craving for more of the drug. Cocaine users typically don’t sleep or eat regularly/properly. Regardless of how much is used or how often, cocaine causes the following short-term effects:
- Anxiety and paranoia
- Bizarre sometimes violent behavior
- Constricted blood vessels
- Convulsions and seizures
- Dilated pupils
- Disturbed sleep patterns
- Increased blood pressure
- Increased body temperature
- Increased heart rate
- Increased respiration
- Intense drug craving
- Intense euphoria
- Loss of appetite
- Panic and psychosis
- Sudden death from high doses
- Tactile hallucination
The longer a person uses cocaine, the more tolerant of the drug he/she becomes. This tolerance makes it necessary to use higher and higher doses just to get the same high. Along with the short term effects that a user experiences upon each use of the drug, the brain and body will soon show evidence of damage to the system, as follows:
- Bone density decrease
- Chronic coughing
- Chest pains
- Heart problems
- High blood pressure
- Organ damage
- Reproductive damage (infertility)
- Tooth decay
- Weight loss
- Blood vessel damage to heart and brain
- Nasal tissue damage due to snorting
- Respiratory failure due to smoking
- Hallucinations (auditory and tactile)
- Sexual problems
- Risky behavior
- Severe depression
- Erratic behavior
Cocaine addiction is a disease of the brain’s reward center. It doesn’t take long for a cocaine user to develop tolerance and subsequent addiction. Tolerance means the body needs more and more of the drug because it has grown resistant to its effects. How does one recognize if he/she is already addicted to cocaine? If the person feels the need to keep using despite all the personal and professional complications that using the drug has caused in his/her life, that person is most probably cocaine dependent.
The risk for developing addiction increases if there are underlying mental or physical medical conditions that remain untreated. Using cocaine often masks these underlying conditions, like an undiagnosed depression.12A person suffering from it will be drawn to the temporary highs that cocaine provides; that intensely pleasurable feeling of euphoria that makes cocaine such an attractive option.
The coca plant is one of the oldest, most powerful and most dangerous stimulants of natural origin. There is some evidence of communal chewing of coca leaves as far back as 8000 years ago.
Beginning with the Valdivian culture (3500 BC-1800 BC), all subsequent cultural groups along the coast of Ecuador have depicted their consumption of coca leaves on the design of their sculpture and lime pots (caleros). Among the tribes of the Northern Peruvian Coast, coca consumption began around 2000 BC as depicted on caleros discovered in Huaca_Prieta. Traces of coca have also been found in mummies dating back 3000 years or around 1000 BC. Even back then, the coca plant was recognized primarily for its stimulating properties and as a local anesthetic2, aside from its other medicinal uses; for elevating one’s mood, helping with digestion, suppressing appetite and for helping the locals cope with the thin Andean mountain air by increasing their respiration speed.
More extensive archeological evidence will later be found from sites dating back to the 6th century AD Moche period, and much later from the Inca civilization3 which began during the early 13th century but is most recognized for the height of the Inca Empire (1438 -1533).
Chewing coca is believed to have been restricted to the eastern Andes before it was introduced to the Inca. They believed that the plant came from divine origins. Its cultivation was monopolized by the state and only nobility and a few favored classes were allowed to use it.
Towards the end of the Inca Empire Spain has invaded Peru and coca became more easily accessible. Soon the invaders from the West have adopted the local habit of (almost constantly) chewing on coca leaves and lime. Reports began to filter back into the Old World about this amazing plant, how it sustains the natives thru hunger and hard labor, and how one priest (Bernabe Cobo) chewed on it to relieve his toothache.
Despite the excitement over coca, it wasn’t a very sturdy plant to transport back and it wasn’t until 1859 when German scientist Carl Scherzer finally succeeded in importing a large quantity of good quality leaves into Germany. He passed the leaves to chemistry professor Friedrich Wohler of the University of Gottingen, who gave them to Albert Niemann, his graduate student who was looking for an appropriate topic for his doctoral thesis. Niemann successfully isolated pure cocaine in white crystalline form. Testing it on himself, he experienced numbness when he put some of the cocaine on his tongue. His work didn’t progress much as Niemann died the year after. It was in 1865 when a colleague of Niemann’s (Wilhelm Lossen) finally explained or made clear the chemical formula for cocaine.2
In the 1880s, the popularity of cocaine rose within the medical community when it began to be used as an anesthetic during surgeries of the eye, nose and throat. It also served to limit bleeding by constricting the blood vessels. In 1884, Austrian psychoanalyst Sigmund Freud was the first to widely promote cocaine as a cure for sexual impotence and depression. In his published article “Über Coca”, he called cocaine a “magical substance” and used it regularly himself. One of his friends suffered from hallucinations because of cocaine, and one of his patients died from the high dosage he prescribed, but he still believed that “there is no lethal dose for humans”.
In 1886, pharmacist John Pemberton invented Coca-Cola, with coca as a main ingredient. Needless to say, its “euphoric and energizing effect” sent sales through the roof.
By the 1890s, reports of addiction started to emerge and the potential dangers were finally being recognized. Public pressure forced Coca-cola to remove cocaine from its product in 1903, but cocaine-laced elixirs, wines and tonics were still available and being promoted by the likes of actress Sarah Bernhardt and Thomas Edison. The silent film industry was openly promoting it and this influenced millions of people.
Snorting cocaine became all the vogue by 1905, and medical literature and hospitals began reporting cases of nasal damage. In 1912, 5000 cocaine-related deaths were reported by the U.S. government in a single year alone.
In 1914, the Harrison Narcotic Act was passed4. It prohibited imports of cocaine and coca leaves except for pharmaceutical purposes. It may have contributed to the decrease of non-medical cocaine use, apart from the fact that pharmaceutical amphetamines started coming out in the 1930s. This lull lasted for some 3 decades, until the Controlled Substances Act of 1970 started to regulate the manufacture of pharmaceutical amphetamines. Cocaine took the limelight back with a vengeance, and it didn’t help that crack cocaine was synthesized in the 1980s. Cocaine was once again at the forefront of illicit drug use. As of 2008, cocaine was the 2nd most trafficked illegal drug in the United States.5