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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. 1

Cocaine is the most potent stimulant of natural origin. 2 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. 3

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. 4


Extent of Use

According to the 2006 National Survey on Drug Use and Health, approximately 35.3 million Americans aged 12 and older had tried cocaine at least once in their lifetimes, representing 14.3% of the population aged 12 and older. Approximately 6.1 million (2.5%) has used cocaine in the past year and 2.4 million (1.0%) had used cocaine within the past month. 5

Data from the 2006 NSDUH also indicate that there were 977,000 persons aged 12 or older who had used cocaine for the first time within the past 12 months; this averages to approximately 2,700 initiates per day. This estimate was not significantly different from the number in 2005 (872,000). 6

Among students surveyed as part of the 2007 Monitoring the Future study, 3.1% of eighth graders, 5.3% of tenth graders, and 7.8% of twelfth graders reported lifetime use of cocaine. In 2006, these percentages were 3.4%, 4.8%, and 8.5%, respectively. 7

Percent of Students Reporting Cocaine Use, 2006–2007

8th Grade
10th Grade
12th Grade







Past month







Past year














Approximately 64.2% of eighth graders, 70.9% of tenth graders, and 59.9% of twelfth graders surveyed in 2007 reported that taking powder cocaine occasionally was a “great risk.” Additionally, approximately 82% of 12th graders surveyed in 2007 reported that using powder cocaine regularly was a “great risk.” 8

Percent of Students Reporting Risk of Using Cocaine, 2007

Say "great risk" to:
8th Grade
10th Grade
12th Grade

Try crack once/twice




Take crack occasionally




Try powder cocaine once/twice




Take powder cocaine occasionally




Regarding the ease by which one can obtain powder cocaine, 19.0% of eighth graders, 30.0% of tenth graders, and 41.2% of twelfth graders surveyed in 2006 reported that powder cocaine was "fairly easy" or "very easy" to obtain. 9

The Centers for Disease Control and Prevention (CDC) also conducts a survey of high school students throughout the United States, the Youth Risk Behavior Surveillance System (YRBSS) . Among students surveyed in 2007, 7.2% reported using some form of cocaine at least one time during their life. 3.3% reported being current users of cocaine, meaning that they had used cocaine at least once during the past month. 10

Percent of Students Reporting Cocaine Use, 2003–2007

Current use
Lifetime use

Approximately 7.7% of college students and 15.2% of young adults (ages 19–28) surveyed in 2006 reported lifetime use of cocaine. 11

Percent of College Students/Young Adults Reporting Cocaine Use, 2005–2006

College Students
Young Adults
Past month
Past year

According to data from the Bureau of Justice Statistics, approximately 46.8% of State prisoners and 43.3% of Federal prisoners surveyed in 2004 indicated that they used cocaine/crack at some point in their lives. 12

Percent of Prisoners Reporting Cocaine/Crack Use, 1997 and 2004

State Prisoners
Federal Prisoners
At time of offense
In month before offense
Ever in lifetime
* Used drugs at least once a week for at least a 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. 13

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. 14 A user who injects cocaine is at risk of transmitting or acquiring diseases if needles or other injection equipment are shared. 15

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. 16

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. 17

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. 18

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. 19



From 1996 to 2006, the number of admissions to treatment for cocaine decreased from 263,896 in 1996 to 250,135 in 2006. Cocaine admissions represented 16.1% of the total drug/alcohol admissions to treatment during 1996 and 13.9% of the treatment admissions in 2006. 20

Broken down by type of cocaine, the number of treatment admissions for non-smoked cocaine increased from 68,145 in 1996 to 71,660 in 2006 and admissions for smoked cocaine decreased from 195,751 in 1996 to 178,475 in 2006. The average age of those admitted to treatment for cocaine in 2006 was 38 years for smoked cocaine, compared with 33 years for non-smoked cocaine admissions. 21

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. 22

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. Approximately 98.3% of the powder cocaine cases and 96.0% of the crack cocaine cases involved trafficking. 23


Production & Trafficking

Cocaine is extracted from the leaves of the coca plant, which is indigenous to the Andean highlands of South America. 24 Much of the cocaine available in the United States is transported from South American nations, particularly Colombia, through the Mexico-Central America Corridor. Despite increasingly aggressive coca eradication efforts, U.S. Government estimates of coca cultivation in South America indicate that cocaine producers potentially produced 970 metric tons of pure cocaine in 2006, a 7% increase from 910 metric tons in 2005 and the highest level since 2002. 25

During the spring of 2007 Federal, state and local law enforcement agencies in several U.S. drug markets reported that cocaine availability decreased and that cocaine shortages were apparent in their jurisdictions. Cocaine shortages were most evident in the Great Lakes, New England, and Mid-Atlantic Regions of the country, but some major drug markets outside these areas also reported indications of decreased cocaine availability. These markets include Atlanta, Los Angeles, Phoenix, and San Francisco. 26

Analysis of cocaine purchases submitted for forensic examination by the DEA corroborates intelligence regarding the decline in domestic cocaine availability. From January through June 2007, the average price per pure gram of all domestic cocaine purchases increased 24%, from $95.89 to $118.70, while purity fell 11%, from 67% to 59%. 27

Epidemiologic sources indicate that prices for powder cocaine range from $20–$30 per gram in New York to $100 in Bangor (Maine), Cincinnati and Minneapolis and can cost as much as $200 per gram in Baltimore and Honolulu. Crack cocaine tends to have a low end street price $10 in such cities as Chicago, Baltimore, Boston and San Diego. 28

According to 2006 Federal-wide Drug Seizure System (FDSS) data, Federal agencies seized 150,738.7 kilograms of cocaine. 29 FDSS contains information about drug seizures made within the jurisdiction of the United States by the DEA, Federal Bureau of Investigation, U.S. Customs Service, U.S. Border Patrol, and U.S. Coast Guard. 30



Cocaine was first Federally-regulated in December 1914 with the passage of the Harrison Act. This Act banned non-medical use of cocaine; prohibited its importation; imposed the same criminal penalties for cocaine users as for opium, morphine, and heroin users; and required a strict accounting of medical prescriptions for cocaine. As a result of the Harrison Act and the emergence of cheaper, legal substances such as amphetamines, cocaine became scarce in the U.S. However, use began to rise again in the 1960s, prompting Congress to classify it as a Schedule II substance in 1970. 31 Schedule II substances have a high potential for abuse, a currently accepted medical use in treatment in the United States with severe restrictions, and may lead to severe psychological or physical dependence. 32 Cocaine can currently be administered by a doctor for legitimate medical uses, such as a local anesthetic for some eye, ear, and throat surgeries. 33


Street Terms 34

Common Terms Associated with Cocaine

Term Definition Term Definition
Blow Cocaine Bingers Crack addicts
Horn To inhale cocaine Oolies Marijuana laced with crack
Nose candy Cocaine Tornado Crack
Snowball Cocaine and heroin Wicky stick PCP, marijuana, and crack


Other Links

Breaking Cocaine Sources of Supply
An overview of coca eradication efforts in the Andean region of South America.

Cocaine Abuse and Addiction
This report provides information on powder and crack cocaine abuse, effects, and describes effective treatment.

A Collection of Articles That Address Research on Cocaine
This resource presents links to and full text of National Institute on Drug Abuse (NIDA) research articles concerning cocaine.

Common Drugs of Abuse: Cocaine
This site provides links to NIDA resources related to crack and cocaine.

Cocaine Publications
A listing of powder and crack cocaine-related publications from various sources.

Cocaine Smuggling in 2006
This report provides an overview of data related to cocaine smuggling during 2006. Topics covered in the report include coca cultivation and production; cocaine trafficking routes and methods; and cocaine seizures.

Estimation of Cocaine Availability, 1996-2000
This report discusses a new model that provides a basis for measuring the flow of cocaine from producer nations, through the transit zones, across the nation's borders, and throughout the U.S.



1 Drug Enforcement Administration, Drugs of Abuse , 2005

2 Drug Enforcement Administration Web site, Drug Descriptions: Cocaine

3 National Institute on Drug Abuse, InfoFacts: Crack and Cocaine , June 2007

4 Ibid.

5 Substance Abuse and Mental Health Services Administration, Results from the 2006 National Survey on Drug Use and Health: National Findings , September 2007

6 Ibid.

7 National Institute on Drug Abuse and University of Michigan, 2007 Monitoring the Future Study Drug Data Tables, December 2007

8 Ibid.

9 Ibid.

10 Centers for Disease Control and Prevention, Youth Risk Behavior Surveillance: Youth Online: Comprehensive Results

11 National Institute on Drug Abuse and University of Michigan, Monitoring the Future National Survey Results on Drug Use, 1975-2006, Volume II: College Students & Adults Ages 19-45 (PDF), 2007

12 Bureau of Justice Statistics, Drug Use and Dependence, State and Federal Prisoners, 2004 , October 2006

13 National Institute on Drug Abuse, InfoFacts: Crack and Cocaine , June 2007

14 Drug Enforcement Administration Web site, Drug Descriptions: Cocaine

15 National Institute on Drug Abuse, InfoFacts: Crack and Cocaine , June 2007

16 Ibid.

17 Ibid.

18 Substance Abuse and Mental Health Services Administration, Emergency Department Trends from the Drug Abuse Warning Network, Final Estimates 1995–2002 , July 2003

19 Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network, 2005: National Estimates of Drug-Related Emergency Department Visits , March 2007

20 Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) Highlights—2006 , February 2008

21 Ibid.

22 Bureau of Justice Statistics, Compendium of Federal Justice Statistics, 2004, December 2006

23 United States Sentencing Commission, 2006 Sourcebook of Federal Sentencing Statistics , 2007

24 Drug Enforcement Administration Web site, Drug Descriptions: Cocaine

25 National Drug Intelligence Center, National Drug Threat Assessment 2008 , October 2007

26 Ibid.

27 Drug Enforcement Administration, Cocaine Price/Purity Analysis of STRIDE Data , August 2007

28 Epidemiologic Trends in Drug Abuse Volume 1: Highlights and Executive Summary (PDF), January 2007, National Institute on Drug Abuse, July 2007

29 National Drug Intelligence Center, National Drug Threat Assessment 2008 , October 2007

30 Drug Enforcement Administration, Federal-wide Drug Seizure System, as reported in Sourcebook of Criminal Justice Statistics

31 U.S. Department of Justice, CIA-Contra-Crack Cocaine Controversy, Appendix C

32 Drug Enforcement Administration, Drugs of Abuse , 2005

33 National Institute on Drug Abuse, Cocaine: Abuse and Addiction , November 2004

34 Office of National Drug Control Policy, Drug Policy Information Clearinghouse, Street Terms: Drugs and the Drug Trade
Cocaine section