Cocaine.

Cocaine was first used by Europeans in the nineteenth century when extract from the coca leaf was combined with various beverages. Cocaine comes as a white crystalline powder. However, a product called crack cocaine may come as an opaque crystal similar in size and shape to rock salt. A third form of cocaine is known as coca paste, which is an intermediate step in the production of cocaine. Cocaine is highly water and fat soluble and, therefore, it is readily absorbed and distributed throughout the body. Route of administration seems to be more important in determining cocaine's absorption rather than dose. It is believed that cocaine produces such a powerful and rapid dependency because it directly stimulates the pleasure centers of the brain responsible for the reinforcing properties of food, water and sex. Intranasal users do not seem to be as prone to addiction in the classic sense of the term as are those who smoke cocaine. However, they may develop a very rapid and profound psychological dependence on the drug which is just as intense as addiction to opiates or alcohol. Any user, regardless of the intensity of the use or the route of administration, is at risk of developing a problem with cocaine which may require treatment. Evaluation of cocaine abuse treatment has been sparse and no consensus exists regarding optimal treatment strategies. (LLL)