Kokain - Cocaine.svg
Clinical data
Trade namesNeurocaine,[3] other
SynonymsBenzoylmethylecgonine, coke
AHFS/Micromedex Detailed Consumer Information
  • US: C (Risk not ruled out)
Routes of
Topical, oral, insufflation, intravenous
Drug class
ATC code
Legal status
Legal status
Pharmacokinetic data
Metabolismliver CYP3A4
MetabolitesNorcocaine, benzoylecgonine, cocaethylene
Onset of actionseconds to minutes[9]
half-life1 hour
Duration of action5 to 90 minutes[9]
DB00907 ☑Y
10194104 ☑Y
D00110 ☑Y
CHEBI:27958 ☑Y
ChEMBL370805 ☑Y
100.000.030 Edit this at Wikidata
Chemical and physical data
Molar mass303.353 g/mol g·mol−1
3D model (Interactive image
Melting point98 °C (208 °F)
Boiling point187 °C (369 °F)
Solubility in water≈1.8 mg/mL (20 °C)
See also: data page
 ☒N☑Y (verify)

Cocaine, also known as coke, is a strong stimulant mostly used as a recreational drug.[10] It is commonly snorted, inhaled as smoke, or dissolved and injected into a vein.[9] Mental effects may include loss of contact with reality, an intense feeling of happiness, or agitation.[9] Physical symptoms may include a fast heart rate, sweating, and large pupils.[9] High doses can result in very high blood pressure or body temperature.[11] Effects begin within seconds to minutes of use and last between five and ninety minutes.[9] Cocaine has a small number of accepted medical uses such as numbing and decreasing bleeding during nasal surgery.[12]

Cocaine is addictive due to its effect on the reward pathway in the brain.[10] After a short period of use, there is a high risk that dependence will occur.[10] Its use also increases the risk of stroke, myocardial infarction, lung problems in those who smoke it, blood infections, and sudden cardiac death.[10][13] Cocaine sold on the street is commonly mixed with local anesthetics, cornstarch, quinine, or sugar, which can result in additional toxicity.[14] Following repeated doses a person may have decreased ability to feel pleasure and be very physically tired.[10]

Cocaine acts by inhibiting the reuptake of serotonin, norepinephrine, and dopamine.[10] This results in greater concentrations of these three neurotransmitters in the brain.[10] It can easily cross the blood–brain barrier and may lead to the breakdown of the barrier.[15][16] Cocaine is a naturally occurring substance found in the coca plant which is mostly grown in South America.[9] In 2013, 419 kilograms were produced legally.[17] It is estimated that the illegal market for cocaine is 100 to US$500 billion each year.[10] With further processing crack cocaine can be produced from cocaine.[10]

Cocaine is the second most frequently used illegal drug globally, after cannabis.[18] Between 14 and 21 million people use the drug each year.[10] Use is highest in North America followed by Europe and South America.[10] Between one and three percent of people in the developed world have used cocaine at some point in their life.[10] In 2013, cocaine use directly resulted in 4,300 deaths, up from 2,400 in 1990.[19] The leaves of the coca plant have been used by Peruvians since ancient times.[14] Cocaine was first isolated from the leaves in 1860.[10] Since 1961, the international Single Convention on Narcotic Drugs has required countries to make recreational use of cocaine a crime.[20]



Cocaine hydrochloride

Topical cocaine can be used as a local numbing agent to help with painful procedures in the mouth or nose.[21]

Cocaine is now predominantly used for nasal and lacrimal duct surgery. The major disadvantages of this use are cocaine's potential for cardiovascular toxicity, glaucoma, and pupil dilation.[21] Medicinal use of cocaine has decreased as other synthetic local anesthetics such as benzocaine, proparacaine, lidocaine, and tetracaine are now used more often.[21] If vasoconstriction is desired for a procedure (as it reduces bleeding), the anesthetic is combined with a vasoconstrictor such as phenylephrine or epinephrine. Some ENT specialists occasionally use cocaine within the practice when performing procedures such as nasal cauterization. In this scenario dissolved cocaine is soaked into a ball of cotton wool, which is placed in the nostril for the 10–15 minutes immediately before the procedure, thus performing the dual role of both numbing the area to be cauterized, and vasoconstriction. Even when used this way, some of the used cocaine may be absorbed through oral or nasal mucosa and give systemic effects.[citation needed] An alternative method of administration for ENT surgery is mixed with adrenaline and sodium bicarbonate, as Moffett's solution.[citation needed]


Cocaine is a powerful nervous system stimulant.[22] Its effects can last from 15 or 30 minutes to an hour. The duration of cocaine's effects depends on the amount taken and the route of administration.[23] Cocaine can be in the form of fine white powder, bitter to the taste. When inhaled or injected, it causes a numbing effect. Crack cocaine is a smokeable form of cocaine made into small "rocks" by processing cocaine with sodium bicarbonate (baking soda) and water.[24][9] Crack cocaine is referred to as "crack" because of the crackling sounds it makes when heated.[9]

Cocaine use leads to increases in alertness, feelings of well-being and euphoria, increased energy and motor activity, and increased feelings of competence and sexuality.[25]

Coca leaves

Coca leaves are typically mixed with an alkaline substance (such as lime) and chewed into a wad that is retained in the mouth between gum and cheek (much the same as chewing tobacco is chewed) and sucked of its juices. The juices are absorbed slowly by the mucous membrane of the inner cheek and by the gastrointestinal tract when swallowed. Alternatively, coca leaves can be infused in liquid and consumed like tea. Ingesting coca leaves generally is an inefficient means of administering cocaine.

Because cocaine is hydrolyzed and rendered inactive in the acidic stomach, it is not readily absorbed when ingested alone. Only when mixed with a highly alkaline substance (such as lime) can it be absorbed into the bloodstream through the stomach. The efficiency of absorption of orally administered cocaine is limited by two additional factors. First, the drug is partly catabolized by the liver. Second, capillaries in the mouth and esophagus constrict after contact with the drug, reducing the surface area over which the drug can be absorbed. Nevertheless, cocaine metabolites can be detected in the urine of subjects that have sipped even one cup of coca leaf infusion.

Orally administered cocaine takes approximately 30 minutes to enter the bloodstream. Typically, only a third of an oral dose is absorbed, although absorption has been shown to reach 60% in controlled settings. Given the slow rate of absorption, maximum physiological and psychotropic effects are attained approximately 60 minutes after cocaine is administered by ingestion. While the onset of these effects is slow, the effects are sustained for approximately 60 minutes after their peak is attained.

Contrary to popular belief, both ingestion and insufflation result in approximately the same proportion of the drug being absorbed: 30 to 60%. Compared to ingestion, the faster absorption of insufflated cocaine results in quicker attainment of maximum drug effects. Snorting cocaine produces maximum physiological effects within 40 minutes and maximum psychotropic effects within 20 minutes, however, a more realistic activation period is closer to 5 to 10 minutes. Physiological and psychotropic effects from nasally insufflated cocaine are sustained for approximately 40–60 minutes after the peak effects are attained.[26]

Coca tea, an infusion of coca leaves, is also a traditional method of consumption. The tea has often been recommended for travelers in the Andes to prevent altitude sickness.[27] However, its actual effectiveness has never been systematically studied.[27]

In 1986 an article in the Journal of the American Medical Association revealed that U.S. health food stores were selling dried coca leaves to be prepared as an infusion as "Health Inca Tea."[28] While the packaging claimed it had been "decocainized," no such process had actually taken place. The article stated that drinking two cups of the tea per day gave a mild stimulation, increased heart rate, and mood elevation, and the tea was essentially harmless. Despite this, the DEA seized several shipments in Hawaii, Chicago, Georgia, and several locations on the East Coast of the United States, and the product was removed from the shelves.[citation needed]


Lines of cocaine prepared for insufflation

Nasal insufflation (known colloquially as "snorting", "sniffing", or "blowing") is a common method of ingestion of recreational powdered cocaine.[29] The drug coats and is absorbed through the mucous membranes lining the nasal passages. Cocaine's desired euphoric effects are delayed when snorted through the nose by about five minutes. This occurs because cocaine's absorption is slowed by its constricting effect on the blood vessels of the nose.[9] Insufflation of cocaine also leads to the longest duration of its effects (60–90 minutes).[9] When insufflating cocaine, absorption through the nasal membranes is approximately 30–60%, with higher doses leading to increased absorption efficiency.[citation needed] Any material not directly absorbed through the mucous membranes is collected in mucus and swallowed (this "drip" is considered pleasant by some and unpleasant by others).

In a study of cocaine users, the average time taken to reach peak subjective effects was 14.6 minutes.[30] Any damage to the inside of the nose is because cocaine highly constricts blood vessels – and therefore blood and oxygen/nutrient flow – to that area. Nosebleeds after cocaine insufflation are due to irritation and damage of mucus membranes by foreign particles and adulterants and not the cocaine itself;[citation needed] as a vasoconstrictor, cocaine acts to reduce bleeding.

Rolled up banknotes, hollowed-out pens, cut straws, pointed ends of keys, specialized spoons, long fingernails, and (clean) tampon applicators are often used to insufflate cocaine. Such devices are often called "tooters" by users. The cocaine typically is poured onto a flat, hard surface (such as a mirror, CD case or book) and divided into "bumps," "lines" or "rails," and then insufflated.[31] The amount of cocaine in a line varies widely from person to person and occasion to occasion (the purity of the cocaine is also a factor), but one line is generally considered to be a single dose and is typically 35 mg (a "bump") to 100 mg (a "rail").[dubious ] As tolerance builds rapidly in the short-term (hours), many lines are often snorted to produce greater effects.[citation needed] A 2001 study reported that the sharing of straws used to "snort" cocaine can spread blood diseases such as hepatitis C.[32]


Drug injection by turning the drug into a solution provides the highest blood levels of drug in the shortest amount of time. Subjective effects not commonly shared with other methods of administration include a ringing in the ears moments after injection (usually when in excess of 120 milligrams) lasting two to 5 minutes including tinnitus and audio distortion. This is colloquially referred to as a "bell ringer". In a study of cocaine users, the average time taken to reach peak subjective effects was 3.1 minutes.[30] The euphoria passes quickly. Aside from the toxic effects of cocaine, there is also danger of circulatory emboli from the insoluble substances that may be used to cut the drug. As with all injected illicit substances, there is a risk of the user contracting blood-borne infections if sterile injecting equipment is not available or used. Additionally, because cocaine is a vasoconstrictor, and usage often entails multiple injections within several hours or less, subsequent injections are progressively more difficult to administer, which in turn may lead to more injection attempts and more consequences from improperly performed injection.[citation needed]

An injected mixture of cocaine and heroin, known as "speedball" is a particularly dangerous combination, as the converse effects of the drugs actually complement each other, but may also mask the symptoms of an overdose. It has been responsible for numerous deaths, including celebrities such as comedians/actors John Belushi and Chris Farley, Mitch Hedberg, River Phoenix, grunge singer Layne Staley and actor Philip Seymour Hoffman. Experimentally, cocaine injections can be delivered to animals such as fruit flies to study the mechanisms of cocaine addiction.[33]


Inhalation by smoking cocaine is one of the several ways the drug is consumed. The onset of cocaine's desired euphoric effects is fastest with inhaling cocaine and begins after 3–5 seconds.[9] In contrast, inhalation of cocaine leads to the shortest duration of its effects (5–15 minutes).[9] The two main ways cocaine is smoked are freebasing and by using cocaine which has been converted to smokable "crack cocaine". Cocaine is smoked by inhaling the vapor produced when solid cocaine is heated to the point that it sublimates.[34] In a 2000 Brookhaven National Laboratory medical department study, based on self reports of 32 abusers who participated in the study,"peak high" was found at mean of 1.4min +/- 0.5 minutes.[30] Pyrolysis products of cocaine that occur only when heated/smoked have been shown to change the effect profile, i.e. anhydroecgonine methyl ester when co-administered with cocaine increases the dopamine in CPu and NAc brain regions, and has M1- and M3- receptor affinity.[35]

Smoking freebase or crack cocaine is most often accomplished using a pipe made from a small glass tube, often taken from "love roses", small glass tubes with a paper rose that are promoted as romantic gifts.[36] These are sometimes called "stems", "horns", "blasters" and "straight shooters". A small piece of clean heavy copper or occasionally stainless steel scouring pad – often called a "brillo" (actual Brillo Pads contain soap, and are not used) or "chore" (named for Chore Boy brand copper scouring pads) – serves as a reduction base and flow modulator in which the "rock" can be melted and boiled to vapor. Crack smokers also sometimes smoke through a soda can with small holes on the side or bottom.[citation needed] Crack is smoked by placing it at the end of the pipe; a flame held close to it produces vapor, which is then inhaled by the smoker. The effects, felt almost immediately after smoking, are very intense and do not last long – usually 2 to 10 minutes.[37] When smoked, cocaine is sometimes combined with other drugs, such as cannabis, often rolled into a joint or blunt. Powdered cocaine is also sometimes smoked, though heat destroys much of the chemical; smokers often sprinkle it on cannabis.[citation needed] The language referring to paraphernalia and practices of smoking cocaine vary, as do the packaging methods in the street level sale.[citation needed]


Another way users consume cocaine is by making it into a suppository which they then insert into the anus or vagina. The drug is then absorbed by the membranes of these body parts. Little research has been focused on the suppository (anal or vaginal insertion) method of administration, also known as "plugging". This method of administration is commonly administered using an oral syringe. Cocaine can be dissolved in water and withdrawn into an oral syringe which may then be lubricated and inserted into the anus or vagina before the plunger is pushed. Anecdotal evidence of its effects is infrequently discussed, possibly due to social taboos in many cultures. The rectum and the vaginal canal is where the majority of the drug would be taken up through the membranes lining its walls.[citation needed]

Other Languages
Afrikaans: Kokaïen
العربية: كوكايين
asturianu: Cocaína
azərbaycanca: Kokain
বাংলা: কোকেইন
беларуская: Какаін
беларуская (тарашкевіца)‎: Какаін
български: Кокаин
bosanski: Kokain
català: Cocaïna
čeština: Kokain
Cymraeg: Cocên
dansk: Kokain
Deutsch: Kokain
eesti: Kokaiin
Ελληνικά: Κοκαΐνη
español: Cocaína
Esperanto: Kokaino
euskara: Kokaina
فارسی: کوکائین
føroyskt: Kokain
français: Cocaïne
Gaeilge: Cócaon
Gàidhlig: Còcein
galego: Cocaína
한국어: 코카인
հայերեն: Կոկաին
हिन्दी: कोकेन
hrvatski: Kokain
Ido: Kokaino
Bahasa Indonesia: Kokaina
interlingua: Cocaina
íslenska: Kókaín
italiano: Cocaina
עברית: קוקאין
Jawa: Kokaina
ಕನ್ನಡ: ಕೊಕೇನ್
ქართული: კოკაინი
қазақша: Кокаин
Kiswahili: Kokain
Latina: Cocainum
latviešu: Kokaīns
Lëtzebuergesch: Kokain
lietuvių: Kokainas
Luganda: Kokeyini
lumbaart: Cocaina
magyar: Kokain
македонски: Кокаин
മലയാളം: കൊക്കെയ്ൻ
მარგალური: კოკაინი
مصرى: كوكايين
مازِرونی: کوکائین
Bahasa Melayu: Kokaina
မြန်မာဘာသာ: ကိုကိန်း
Nederlands: Cocaïne
नेपाल भाषा: कोकेन
日本語: コカイン
norsk: Kokain
norsk nynorsk: Kokain
occitan: Cocaïna
ଓଡ଼ିଆ: କୋକେନ
ਪੰਜਾਬੀ: ਕੋਕੀਨ
پښتو: كوكايين
polski: Kokaina
português: Cocaína
română: Cocaină
русский: Кокаин
Scots: Cocaine
shqip: Kokaina
sicilianu: Cucaina
Simple English: Cocaine
slovenčina: Kokaín
slovenščina: Kokain
کوردی: کۆکایین
српски / srpski: Кокаин
srpskohrvatski / српскохрватски: Kokain
Basa Sunda: Kokain
suomi: Kokaiini
svenska: Kokain
தமிழ்: கோக்கைன்
ไทย: โคเคน
Türkçe: Kokain
українська: Кокаїн
اردو: کوکین
Tiếng Việt: Cocain
文言: 可卡因
Winaray: Kokayna
粵語: 可卡因
中文: 可卡因