From Chapter One of the book
How to Quit Drugs for Good

How to Quit Drugs for Good

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Cocaine comes from the coca plant, Erythroxylon coca. Its green leaves contain the nutrients thiamine, riboflavin, and vitamin C and the psychoactive alkaloid cocaine.

For centuries, the indigenous people of the Andes Mountains have eaten coca leaves. They mix the leaves with an alkali (lime) that helps release the cocaine from the roughage. About 90% of the Indians indulge—some of them all day long—but the total amount of stimulant they ingest compares to the amount of stimulant Americans get from drinking coffee. The Indian who chews two ounces of leaves gets about 0.7 grains of cocaine per day. A typical cocaine abuser might take six to eight grains per day, or about 10 times what the Indian ingests.


Cocaine. People make cocaine (known technically as cocaine hydrochloride) through a lengthy process using various chemicals and solvents. Starting with coca leaves and sulfuric acid, producers draw off the liquid and then add more acid, along with lime, water, gasoline, potassium permanganate, and ammonia. This creates a paste that is further refined by using kerosene, methyl alcohol, and more sulfuric acid. The result is the white crystalline powder that has a bitter, numbing effect when tasted. AKA: Coke, Snow, Snow White, Charlie, Toot, Nose Candy, C, C-Dust, Girl, Lady, Lady-Caine.

Crack. Crack is a form of “freebase” but is safer to produce than the original freebase, which required the chemical ether. Crack is made by boiling powdered cocaine with sodium bicarbonate. This “frees” the cocaine “base” from the cocaine hydrochloride. The base separates from solution as chunks of crack. AKA: Rock, Hard Rock, Pebbles, Stones, Gravel, Baby T, Cookies, Fries, Fifty-One, One-Fifty-One, Pony, White Ghost, Sleet.

Combinations. Some users will inject a combination of cocaine and heroin (AKA: Speedball, Dynamite, Murder One, Whizz-Bang). Some users will smoke crack with other smokable substances, such as tobacco (AKA: Coolie), marijuana or hashish (see previous section), PCP (AKA: Space Dust), opium, or amphetamines.

How It’s Used

Most people go for the coke high by snorting, that is, by inhaling cocaine hydrochloride into the nose. Some users dissolve this substance in water and inject it. Others smoke crack.

The high from snorting begins within three to five minutes, peaks at 20 to 30 minutes, and lasts 40 to 50 minutes overall. For those who shoot, the “rush” hits within a few seconds and peaks within two to three minutes. Smoking delivers great quantities of cocaine—from lungs to blood to brain—within seconds, providing a rush that is similar to shooting up. Those with a needle habit might shoot up every 10 to 20 minutes for hours on end, and dedicated “crack stars” might toke up every five to 10 minutes for hours. Users refer to their continued, repetitive use over long periods of time as “missions” or “runs.”


Between 9% and 11% of Americans have tried cocaine. About 1.9% have used it within the past year, and 0.8% have used it within the past month. That’s almost 1.8 million people who are current users.

When asked specifically about crack, about 2.2% of Americans say they’ve tried it. About 0.6% have used it within the past year, and 0.3% have used it within the past month. That’s equivalent to about 668,000 current users.

The Joy of It

Cocaine acts as a stimulant. It exhilarates. It brings on feelings of intense pleasure and euphoria. It wakes us up.

When high, we feel full of energy and confidence. Often we become more talkative, more physically active, or both. Cocaine depresses our appetite while heightening our sense of potency. We might feel more potent sexually, physically, or mentally.

When injecting cocaine, different people get different effects. Some might feel nauseous or experience upset stomach. Others might experience physical or even mental distress. Yet, almost universally, any unpleasant side effects will give way to an overpowering high or “rush.” Users variously describe this rush as “sheer pleasure,” “a total body orgasm,” or “body electrification.” Crack smokers report the same kind of riveting sensations from the rush. However, on a single run each successive shot or toke becomes less electrifying. Nevertheless, the user remembers that initial blast and keeps trying to replicate it. This is called “chasing the high.”

In his 1967 book Pimp: The Story of My Life, “Iceberg Slim” described the rush from cocaine injection as follows:

“I shivered when it daggered in…. I saw the blood-streaked liquid draining into me. It was like a ton of nitro exploded inside me. My ticker went berserk. I could feel clawing up my throat. It was like I had a million ‘swipes’ in every pore from head to toe. It was like they were all popping off together in a nerve-shredding climax.

“I was quivering like a joker in the hot seat at the first jolt. I tried to open my talc-dry mouth. I couldn’t. I was paralyzed. I could feel a hot ball of puke racing up from my careening guts. I saw the green, stinking puke rope arch into the black mouth of the waste basket….

“I felt like the top of my skull had been crushed in. It was like I had been blown apart and all that was left were my eyes. Then tiny prickly feet of ecstasy started dancing through me. I heard melodious bells tolling softly inside my skull.

“I looked down at my hands and thighs. A thrill shot through me. Surely they were the most beautiful in the Universe. I felt a superman’s surge of power.”

The Problems It Causes

Heart problems. Cocaine increases the blood pressure and heart rate in every user. In many users, it causes irregular heartbeat (arrhythmia).

Lung problems. Cocaine dilates the bronchioles (the breathing tubes in the lungs). In fact, this action can offer temporary relief of asthma symptoms. However, symptoms of asthma increase when coming off cocaine, even among people who don’t have asthma. In other words, the bronchioles become more restricted than usual, and breathing becomes strained.

If you smoke crack, your lungs take an extra hard hit because of the direct effects of the smoke. Some symptoms include constant hacking cough, bronchitis, coughing up blood (hemoptysis), and excessive fluid in the lungs (pulmonary edema). Also, recent studies have linked crack smoking with lung cancer.

Nose and throat problems. If you snort coke, your chances of getting nose and throat problems increase significantly. Symptoms include inflammation of the lining of the nose (rhinitis), nasal bleeding, thinning of the lining of the nasal passages (nasal mucosa atrophy), inflammation of the sinuses (sinusitis), hoarseness, and difficulty swallowing.

Danger of infection. If you shoot up coke, you run the risk of various infections. These include infections on the skin (abscesses) or infections under the skin (cellulitis) at injection sites, infection of the liver (hepatitis B), infection of the heart valves (bacterial endocarditis), AIDS, and the spread of infection throughout the body (sepsis).

Gastrointestinal problems. Cocaine raises the blood sugar by causing the liver to convert glycogen into glucose. Over a long period of time, this can lead to malfunction of the liver or pancreas. The pancreas produces insulin to regulate blood sugar. In every user, cocaine depresses the appetite, which over time can lead to weight loss. Coke also depletes the body’s store of vitamins, causing various vitamin deficiencies. On using, it often causes dry mouth and in some users causes vomiting or diarrhea.

Sexual dysfunction. When injected or smoked, cocaine can produce a spontaneous ejaculation. However, having sex while high is generally more difficult. Men find it hard to maintain an erection. Women typically cannot reach orgasm.

Anxiety. Prolonged use of coke can lead to anxiety. Those who are affected become nervous, fidgety, and tense. Also this can generalize. We can experience the symptoms of anxiety long after we stop using.

Depression. Every time we come off cocaine, we get depressed. The longer the run and the more we used on the run, the deeper our depression becomes. It also generalizes. We can experience depression for months, even years, after breaking a long-term cocaine addiction. As part of our depression, we often find that nothing feels pleasurable anymore. That’s why, during a bout of depression, our coke cravings are highest. We can remember how much pleasure we felt when using. But in recovery, we gradually experience greater and greater pleasure in our lives as our brain chemistry slowly returns to normal.

Mental illness. Cocaine can precipitate a mental illness or can cause us to appear mentally ill for a period of time. Coke commonly fills us with paranoia. We might begin thinking that someone’s at the door or at the window. We think we hear them. We might start looking out the curtains every few seconds. Some of us experience paranoid fears after just two hits of crack or two shots of coke. But the longer the run, the more likely we are to get paranoid fears, and the worse the fears become. They usually go away within a few days after we stop using. However, a small percentage of long-term heavy users fall into a paranoid psychosis that remains for life. Aside from delusions (such as the idea that “people are out to get me”), users can also hallucinate. These can be visual (seeing things that aren’t there), auditory (hearing things), or tactile (feeling things). One type of tactile hallucination induced by cocaine is sometimes called “coke bugs,” the feeling that bugs are crawling on your skin.

Seizure and stroke. Research proves that cocaine use causes seizures in some people and strokes in others. Although grievous, these side effects are rare, occurring in a small percentage of people.

Danger of overdose. In significantly high doses, cocaine can kill in one of two ways: by causing heart attack or by causing respiratory failure. What’s a significantly high dose? Some experts figure the fatal dose of cocaine to be about one gram. This might be enough to take the life of a newcomer, but there are reports of heavy users having survived more than 20 grams.

Occasionally, a famous person dies of cocaine overdose, someone such as Len Bias, who makes the front page and becomes the lead story on the television news. Yet for every well-publicized cocaine death, there are hundreds more about which we never hear. It does happen, but, compared to overdose deaths from other substances such as heroin, death from cocaine overdose is relatively rare.


When going through cocaine withdrawal, you can expect to be tired, depressed, and hungry. You might also have little patience, become easily irritated, or have a negative outlook on life.

You’ll almost certainly feel intense cravings for more substance. The longer and heavier your use, the longer it’ll take these cravings to go away. In recovery, cravings can remain intense for months. Gradually, the intensity and frequency of cravings decrease, but even years later a craving might occasionally pop up.