Cocaine has traditionally been regarded as one of the most addictive drugs, although with the rise of highly addictive drugs such as crack cocaine, crystal meth and addictive prescription painkillers, this perception is changing.
Several factors affect how addictive a drug is, including the pharmacological mechanism of the drug, the purity of the actual drug ingested, the set and setting in which the drug is taken, and most importantly, individual characteristics of the person taking the drug.
Pharmacological Mechanism of Cocaine
Cocaine takes effect quickly, and wears off quickly, giving cocaine users a tendency to want to use more, often during the same time period. The exact time that it takes for cocaine effects to occur varies, depending on the route of administration -- that is, whether it is smoked, injected, taken orally, or snorted (sniffed through a tube into the nose). Cocaine has a relatively short half-life, which means that the cocaine high occurs quickly -– under one minute if smoked, under two minutes if injected, around 30 minutes if taken orally, and 15 to 60 minutes if snorted.
Consequently, the comedown occurs relatively soon after, typically between one and three hours after taking the cocaine. An interesting aspect of cocaine is the tendency for users to binge and crash. This pattern of excessive use for a period, followed by exhaustion and much more limited use, has been observed in laboratory conditions when animals are given unlimited access to cocaine, as well as in humans who are allowed to self administer the drug, even when they can choose to receive money instead of repeat doses.
The binge and crash pattern of cocaine use, often followed by periods of abstinence or low use, may make cocaine seem less addictive than other drugs, such as heroin, which users are more likely to use in an ongoing pattern to avoid withdrawal. However, some experts believe that cocaine is actually a more dangerous and addictive drug than heroin, because of the volatile, compulsive pattern of cocaine use, and the higher fatality rate seen in animals given unlimited access to cocaine.
Addiction and Purity of Cocaine
Illicitly purchased cocaine may be as little as 10% pure, with up to 90% of the substance being made up of other things that are mixed or “cut” with the cocaine. The substances used to cut cocaine are chosen because they look, taste or feel like cocaine.What is in Cocaine?
Some of the cheaper drugs cocaine is cut with, such as amphetamine and crystal meth, may also be used, which can be addictive in themselves. Some of these drugs have cross-tolerance with cocaine, which can increase cocaine addiction, even when you aren’t getting the real thing.
Set and Setting and Cocaine Addiction
Research with drug users has shown that set and setting are of crucial importance to whether someone becomes addicted, or whether they remain in control of their drug use. Even animals have a tendency to use cocaine in areas they associate with the drug, over and above areas they preferred before cocaine exposure. Using cocaine in situations that feel good may make it harder to enjoy the same situation without the drug in future.
Animal and human studies have also shown an increase in cocaine self-administration when food is restricted. This has important implications for people who are restricting their food intake to aid weight loss, particularly if they are also using cocaine as an appetite suppressant or to increase their energy level or raise their metabolism. This is an extremely dangerous approach to weight loss, and increases the risk of cocaine addiction as well as other health problems.
Cocaine Addiction and Individual Characteristics
Many people thinking about whether or not cocaine is addictive make the mistake of focusing on the drug rather than the person taking it. Statistically, the rate of addiction among people who have ever taken cocaine seems quite low -– research shows about 80% of cocaine users are not addicted two years later. However, the remaining 20% may be in for serious problems.
About 4% of people who try cocaine are addicted according to DSM-IV criteria two years later, and a further 16% may be in an early “prodromal” stage of cocaine addiction. Smoking crack cocaine and being younger at the time of your first cocaine use are significant risk factors. For longer-term cocaine users, the picture becomes more gloomy, as cocaine users typically fluctuate between periods of no use and low use, and with periods of heavy and binge use, interrupted with periods of incarceration. So the answer to the question, "Is cocaine addictive?" is yes, but whether or not you become addicted if you take cocaine, and how that addiction plays out, is quite individual.
You are more likely to develop an addiction to cocaine if you have low self esteem, if you have a mental health problem such as anxiety, depression or psychosis, if anyone in your family has an addiction or mental health problem, or if you have a history of abuse. If any of these issues are affecting you, you should avoid cocaine use, or indeed any substance use, and seek help for the problem itself, rather than trying to overcome or avoid it through cocaine use.
Your family doctor can help you with these problems and refer you to a specialist who can give you appropriate treatment.
Bergman, J. and Katz, J. "Behavioral Pharmacology of Cocaine and the Determiniants of Abuse Liability." In Cocaine Abuse: Behavior, Pharmacology, and Clinical Applications. Edited by Stephen Higgins and Jonathan Katz. Academic Press. San Diego CA. 1998.
Bozarth, M.A. (1989). "New perspectives on cocaine addiction: Recent findings from animal research." Canadian Journal of Physiology & Pharmacology 67, 1158-1167.
Carroll, M. and Bickel, W. "Behavioral-Environmnetal Determinants of the reinforcing functions of cocaine." In Cocaine Abuse: Behavior, Pharmacology, and Clinical Applications. Edited by Stephen Higgins and Jonathan Katz. Academic Press. San Diego CA. 1998.