"COCAINE" By Office of National Drug Control Policy Overview: Pure cocaine was first used in the 1880s as a local anesthetic in eye, nose, and throat surgeries because of its ability to provide anesthesia as well as to constrict blood vessels and limit bleeding. Many of its therapeutic applications are now obsolete though due to the development of safer drugs. Cocaine is the most potent stimulant of natural origin. This substance can be snorted, smoked, or injected. When snorted, cocaine powder is inhaled through the nose where it is absorbed into the bloodstream through the nasal tissues. When injected, the user uses a needle to release the drug directly into the bloodstream. Smoking involves inhaling cocaine vapor or smoke into the lungs where absorption into the bloodstream is as rapid as by injection. Each of these methods of administration poses great risks to the user. Crack is cocaine that has been processed from cocaine hydrochloride to a free base for smoking. Crack cocaine is processed with ammonia or sodium bicarbonate (baking soda) and water. It is then heated to remove the hydrochloride producing a form of cocaine that can be smoked. Extent of Use: During 2002, there were an estimated 1,059,000 new cocaine users in the United States. The average age of those who first used cocaine during the year was 20.3 years. According to the 2003 National Survey on Drug Use and Health, approximately 34.9 million Americans ages 12 and older had tried cocaine at least once in their lifetimes, representing 14.7% of the population ages 12 and older. Approximately 5.9 million (2.5%) has used cocaine in the past year and 2.3 million (1.0%) had used cocaine within the past month. Among high school students surveyed as part of the 2003 Monitoring the Future Study, 3.6% of eighth graders, 5.1% of tenth graders, and 7.7% of twelfth graders reported using cocaine at least once during their lifetimes. In 2002, these percentages were 3.6%, 6.1%, and 7.8%, respectively. Regarding the ease by which one can obtain powder cocaine, 21.6% of eighth graders, 29.6% of tenth graders, and 37.4% of twelfth graders surveyed in 2003 reported that powder cocaine was "fairly easy" or "very easy" to obtain. Approximately 23% (22.5%) of eighth graders, 29.6% of tenth graders, and 35.3% of twelfth graders reported that crack cocaine was "fairly easy" or "very easy" to obtain. Nearly 44% of eighth graders, 52% of tenth graders, and 46% of twelfth graders surveyed in 2003 reported that using powder cocaine once or twice was a "great risk." Nearly 49% of eighth graders, 58% of tenth graders, and 47% of twelfth graders reported that using crack cocaine once or twice was a "great risk." The Centers for Disease Control and Prevention also conducts a survey of high school students throughout the United States, the Youth Risk Behavior Surveillance System. Among students surveyed in 2003, 8.7% reported using some form of cocaine at least one time during their life. 4.1% reported being current users of cocaine, meaning that they had used cocaine at least once during the past month. During 2003, 9.2% of college students and 14.7% of young adults (ages 19-28) reported using cocaine at least once during their lifetimes. Approximately 5.4% of college students and 6.6% of young adults reported past year use of cocaine, and 1.9% of college students and 2.4% of young adults reported past month use of cocaine. According to data from the Arrestee Drug Abuse Monitoring Program, a median of 30.1% of adult male arrestees and 35.3% of adult female arrestees tested positive for cocaine at arrest in 2003. The adult male samples were compiled from 39 U.S. sites and the adult female samples were compiled from 25 sites. Health Effects: Cocaine is a strong central nervous system stimulant. Physical effects of cocaine use include constricted blood vessels and increased temperature, heart rate, and blood pressure. Users may also experience feelings of restlessness, irritability, and anxiety. Evidence suggests that users who smoke or inject cocaine may be at even greater risk of causing harm to themselves than those who snort the substance. For example, cocaine smokers also suffer from acute respiratory problems including coughing, shortness of breath, and severe chest pains with lung trauma and bleeding. A user who injects cocaine is at risk of transmitting or acquiring diseases if needles or other injection equipment are shared. Cocaine is a powerfully addictive drug and compulsive cocaine use seems to develop more rapidly when the substance is smoked rather than snorted. A tolerance to the cocaine high may be developed and many addicts report that they fail to achieve as much pleasure as they did from their first cocaine exposure. Smoking crack delivers large quantities of the drug to the lungs, producing effects comparable to intravenous injection. These effects are felt almost immediately after smoking, are very intense, but do not last long. For example, the high from smoking cocaine may last from 5 to 10 minutes. The high from snorting can last for 15 to 20 minutes. Cocaine continues to be the most frequently mentioned illicit substance reported to the Drug Abuse Warning Network (DAWN) by hospital emergency departments (ED) nationwide. During 2002, it was mentioned 199,198 times and was present in 30% of the ED drug episodes during the year. While cocaine ED mentions were statistically unchanged from 2001 to 2002, they have increased 47% since 1995 when there were 135,711 mentions. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest. An added danger of cocaine use is when cocaine and alcohol are consumed at the same time. When these substances are mixed, the human liver combines cocaine and alcohol and manufactures a third substance, coca ethylene. This intensifies cocaine's euphoric effects, while also possibly increasing the risk of sudden death. Treatment: From 1992 to 2002, the number of admissions to treatment in which cocaine was the primary substance of abuse decreased from 267,292 in 1992 to 241,699 in 2002. The cocaine admissions represented 17.5% of the total drug/alcohol treatment admissions during 1992 and 12.8% of the admissions during 2002. Broken down by type of cocaine, the number of treatment admissions for non-smoked cocaine decreased from 84,010 in 1992 to 65,685 in 2002 and admissions for crack cocaine decreased from 183,282 in 1992 to 176,014 in 2002. The average age of those admitted to treatment for cocaine in 2002 was 37 years for smoked cocaine users and 34 years for non-smoked cocaine users. Arrests & Sentencing: The Drug Enforcement Administration made 10,518 cocaine-related arrests (includes crack) during FY 2003, representing 38.7% of the total arrests made by the DEA during the year. During FY 2002, most of the drug arrests made by Federal agencies were for cocaine. Cocaine was involved in 12,500 Federal drug arrests, or 37% of all Federal drug arrests in FY 2002. The DEA made 7,261 arrests for powder cocaine and 4,400 arrests for crack cocaine during FY 2002. Of the 25,609 Federal drug offense cases during FY 2002, powder cocaine was involved in 5,867 (22.9%) and crack cocaine was involved in 5,166 (20.17%). Production & Trafficking: Cocaine is extracted from the leaves of the coca plant, which is indigenous to the Andean highlands of South America. During 2000, the majority (approximately 75%) of the Andean coca was grown in Colombia, with Peru and Bolivia ranking second and third, respectively. The U.S./Mexico border is the primary point of entry for cocaine shipments being smuggled into the United States. Sources indicate that approximately 65% of the cocaine entering the U.S. crosses the Southwest border. Law enforcement, epidemiologic, and ethnographic Pulse Check sources indicate that prices for powder cocaine range from $25–$35 per gram in New York to $75–$150 in Detroit. One gram of powder cocaine usually sells for $100 in most cities reporting to Pulse Check. Crack cocaine tends to be sold in 0.1 and 0.2 gram rocks that generally sell for $10, but prices can range from $2–$40 depending on the size of the rock. Most of the Pulse Check sources indicate that powder and crack cocaine are both sold in central city areas. Suburban areas are also frequently mentioned as areas for powder cocaine sales. Settings for cocaine sales include cars, parties, schools, college campuses, raves, supermarkets, and shopping malls. Sources also indicate that adulterants are often found in powder cocaine. These adulterants include caffeine (in Miami), chalk, laundry detergent, and rat poison (in Memphis), meat tenderizer (in Boston), baby laxatives (in Baltimore and Memphis), and talcum or baby powder (in Billings, El Paso, and Washington, D.C.). During FY 2003, Federal agencies seized 245,499 pounds of cocaine under the Federal-wide Drug Seizure System (FDSS). FDSS contains information about drug seizures made within the jurisdiction of the United States by the DEA, Federal Bureau of Investigation, U.S. Customs Service, U.S. Border Patrol, and U.S. Coast Guard. Legislation: Cocaine was first Federally regulated in December 1914 with the passage of the Harrison Act. This Act banned non-medical use of cocaine; prohibited its importation; imposed the same criminal penalties for cocaine users as for opium, morphine, and heroin users; and required a strict accounting of medical prescriptions for cocaine. As a result of the Harrison Act and the emergence of cheaper, legal substances such as amphetamines, cocaine became scarce in the U.S. However, use began to rise again in the 1960s, prompting Congress to classify it as a Schedule II substance in 1970. Schedule II substances have a high potential for abuse, a currently accepted medical use in treatment in the United States with severe restrictions, and may lead to severe psychological or physical dependence. Cocaine can currently be administered by a doctor for legitimate medical uses, such as a local anesthetic for some eye, ear, and throat