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Cocaine FAQs

As is the case with other illicit drugs, many misconceptions about cocaine persist due to a lack of knowledge or inaccurate information. The following cocaine facts provide insights on this highly addictive and destructive drug.

How Long Does Cocaine Stay in Your System?

The faster the drug is absorbed, the more intense the euphoria and shorter its duration. Snorting cocaine produces a relatively slow onset of the high, lasting 15 to 30 minutes. In contrast, the high from smoking is more immediate, lasting about five to 10 minutes. Regardless of the method, the drug itself stays in the system long after the symptoms dissipate, between 3.3 and 5.5 hours. The primary active metabolite in cocaine called benzoylecgonine takes considerably longer (between one and two days) to be completely eliminated from the body and drug-screening tests check for benzoylecgonine. The length of time cocaine stays in the system is influenced by dosage, method of administration, time span and frequency of use, purity of cocaine and each person’s unique characteristics.1

Can Cocaine Use Cause Heart Problems?

The connection between cocaine use and heart problems has been the subject of ongoing research. A recent study showed that the small blood vessels in cocaine users were over-dilated, resulting in faster blood flow. The abnormalities were distinctive even when comparing cocaine users to nonusers with diabetes or high blood pressure. The findings suggest that even when there is no sign of damage to the arteries, cocaine use may damage small vessels, leading to symptoms such as chest pain and shortness of breath.2

Previous studies have shown cocaine use, even if occasional, can cause heart attacks in young, healthy people. Cocaine can damage the large arteries such as the aorta, cause stiffness in the vessels and lead to thrombosis due to its effects on platelets. Cocaine increases myocardial oxygen demand by increasing both heart rate and blood pressure, while decreasing oxygen supply via coronary vasoconstriction. Calcification and aneurysms occur frequently in the coronary arteries of cocaine users.2,3

What Is the Connection Between Cocaine and Stroke?

The connection between cocaine use and aneurysm-like bleeding and stroke has been known since the first cocaine-induced stroke was reported in 1977. The exact details of how cocaine impacts the brain’s blood vessels remains elusive. Some researchers theorize that age, vascular risk factors, the manner of cocaine ingestion, dose effect, and potential contaminants are confounding factors. In order to analyze the true risk of cocaine and stroke and the pathophysiological mechanisms involved, these factors need to be identified and analyzed in context with one another, which presents a huge challenge.4

In an animal study, researchers used a laser-based method to measure how cocaine disrupts blood flow in the brains of mice, providing clues as to how cocaine induces microischemia, a precursor to stroke. This is a condition in which there is insufficient blood flow to the brain to meet metabolic demand, albeit to a smaller degree than brain ischemia. The images reveal that after 30 days of chronic cocaine injection or repeated acute injection of cocaine, there is a dramatic drop in blood-flow speed.5

Is One Method of Cocaine Use Safer Than Another?

Cocaine is used in various ways: oral (chewing), intranasal (snorting), intravenous (mainlining or injecting) and inhalation (smoking). While each method has some specific health repercussions, all of them can lead to absorption of toxic levels of cocaine, possible acute cardiovascular or cerebrovascular emergencies, seizures or sudden death. In 2014, cocaine ranked second to heroin for drug-related deaths, with 5,586 people losing their lives during overdoses.6,7 Treatment for cocaine addiction should be sought before suffering these potentially fatal and long-term consequences.

  1. How Long Does Cocaine Stay In Your System? Mental Health Daily website. http://mentalhealthdaily.com/2015/10/02/how-long-does-cocaine-stay-in-your-system/ Accessed January 11, 2017.
  2. Cocaine’s Heart Damage Often Undetectable. Live Science website. http://www.livescience.com/48796-cocaine-heart-damage-undetectable.html Published November 18, 2016. Accessed January 11, 2017.
  3. Schwartz BG, Rezkalla S, Kloner RA. Cardiovascular Effects of Cocaine. Circulation. 2010;122:2558-2569.
  4. Merenda A, Muir KW, Koch S. Cracking the Role of Cocaine in Stroke. Stroke. 2016;47:909-910
  5. Your brain on cocaine: Researchers photograph the devastating effect drug has on bloodflow in the brain for first time. Daily Mail website. http://www.dailymail.co.uk/sciencetech/article-2737103/Your-brain-cocaine-Researchers-photograph-effect-drugs-bloodflow-brain-time.html Published August 28, 2014. Accessed January 11, 2017.
  6. Cocaine – Frequently Asked Questions. Very Well website. https://www.verywell.com/cocaine-frequently-asked-questions-66710 Updated November 14, 2016. Accessed January 11, 2017.
  7. Kimberly Leonard. These Are the Drugs Killing the Most People in the U.S. US News and World Report. December 20, 2016. http://www.usnews.com/news/articles/2016-12-20/heroin-cocaine-among-top-drug-killers-in-us Accessed January 11, 2017.
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