Cocaine
Pure cocaine was first used in the 1880s in eye, nose, and throat surgeries as an anesthetic and for its ability to constrict blood vessels and limit bleeding. However, many of its therapeutic applications are now obsolete because of 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 pose 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
According to the 2005 National Survey on Drug Use and Health, approximately 33.7 million Americans ages 12 and older had tried cocaine at least once in their lifetimes, representing 13.8% of the population ages 12 and older. Approximately 5.5 million (2.3%) has used cocaine in the past year and 2.4 million (1.0%) had used cocaine within the past month.

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.

Of an estimated 108 million emergency department (ED) visits in the U.S. during 2005, the Drug Abuse Warning Network (DAWN) estimates that 1,449,154 were drug-related. DAWN data indicate that cocaine was involved in 448,481 ED
visits.

Treatment
From 1995 to 2005, the number of admissions to treatment for cocaine decreased from 278,421 in 1995 to 256,491 in 2005. Cocaine admissions represented 16.6% of the total drug/alcohol admissions to treatment during 1995 and 13.9% of the treatment admissions in 2005.20

Broken down by type of cocaine, the number of treatment admissions for
non-smoked cocaine increased from 70,813 in 1995 to 71,255 in 2005 and
admissions for smoked cocaine decreased from 207,608 in 1995 to 185,236 in 2005.
The average age of those admitted to treatment for cocaine in 2005 was 38 years for smoked cocaine, compared with 34 years for non-smoked cocaine admissions.

Arrests & Sentencing
During FY 2004, cocaine was the primary drug involved in Federal drug arrests.
There were 12,166 Federal drug arrests for cocaine in FY 2004. The Drug
Enforcement Administration (DEA) made 7,082 arrests for powder cocaine and 3,921 arrests for crack cocaine during FY 2004.

During FY 2006, there were 5,841 Federal offenders sentenced for powder
cocaine-related charges and 5,623 sentenced for crack cocaine charges in U.S. Courts.


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