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HLT 214 - Substance Use and Abuse - Textbook

Chapter 7. Cocaine and Methamphetamine

Learning Objectives

At the conclusion of this chapter, students will be able to:

  1. Describe the recent historical overview of cocaine use and abuse.
  2. Distinguish between naturally occurring and synthetic stimulants and give examples for each. 
  3. Identify the different forms (cocaine vs crack) and routes of administration of cocaine and crack. 
  4. List commonly used street names for cocaine and crack cocaine.
  5. Describe the effects of stimulants  on neurotransmitter systems. 
  6. Describe the acute and chronic effects of commonly used stimulants.



As early as 1500s, cocaine was used only for religious and medical purposes by South American natives. The coca plant becomes a form of currency with the arrival of the Spanish conquistadors. The Spaniards initially ban the coca plant, but they soon realize that the indigenous Americans are more productive while working in the fields and mines when they use coca. The Spaniards begin paying the natives in coca leaves throughout the day for their labor. In mid 19th century German chemist Albert Niemann discovers how to extract cocaine from coca leaves (1860). With increase in cocaine-related deaths,  Cocaine is declared illegal in the US (1922).  Crack cocaine,  a new form of cocaine,  emerged in 1985. Crack cocaine  is a smokable form of cocaine sometimes called “rock” or “freebase”. Crack cocaine  is a hard, mineral-like substance, made by mixing baking soda or ammonia into the powder form of cocaine. This mixture is then heated with a lighter or torch until it heats into the “rocks” known as crack cocaine. It is most often vaporized in a glass pipe and inhaled, and many users also inject crack. Crack cocaine’s name comes from the cracking or popping sound it makes when heated. Other names for crack include rock(s), base, candy, cookies, kryptonite, sleet, hard, or most commonly, crack.  On the other hand, cocaine is known in the streets as coke, snow, flake, blow, and other names.1-2

Methamphetamine is a synthetic drug commonly manufactured in illegal, hidden laboratories, mixing various forms of amphetamine or other chemicals. The meth “cook” extracts ingredients from common pills for cold remedies and combines the substance with chemicals such as battery acid, drain cleaner, lantern fuel and antifreeze to increase its strength. Meth is a highly addictive drug that causes serious consequences on health, often including death. Using methamphetamine (meth) is not only illegal, but also dangerous. Methamphetamine is known in the street as meth, ice, glass, crank, crystal, speed, chalk, tweak, and other names.3-4

Pharmacology of Cocaine and Methamphetamine

Cocaine effects last 1 to 2 hours. Methamphetamine effects last 8 to 12 hours. Withdrawal from methamphetamine can cause more intense symptoms and last longer.

Many stimulant drugs exert their effect through the neurotransmitter called dopamine. 
Meth/cocaine = Increase in Dopamine = Mostly Pleasure + Some Negative Effects

Dopamine and Stimulant Use Over Time will result in
Stimulant use = Damaged dopamine system = Some pleasure + MANY negative effects
Use→Depression→Craving→Use Cycle = Addiction.

Acute Effects

Acute physiological effects include an increase in heart rate, blood pressure, pupillary size, respiratory rate, sensitivity to sound sensitivity, and body temperature. The effects also include a decrease in appetite, sleep deprivation, and slower reaction time. Acute psychological effects include elevated euphoria, increased alertness or wakefulness, feeling of increased strength/energy, feelings of increased invulnerability, feeling of increased confidence/competence, feelings of  increased sexual desire; a feeling of decreased boredom, loneliness, and shyness.

Chronic Effects

Chronic physiological effects include tremor, weakness, dry mouth, weight loss/malnutrition, increased sweating, sores, headaches, severe dental problems.   Chronic psychological effects include confusion, paranoia, loss of ability to concentrate and organize information, loss of ability to feel pleasure without the drug, insomnia and fatigue, mood swings, irritability and anger, depression, anxiety and panic disorder, risky sexual behavior.  Severe psychological effects include hallucinations, severe depression that can lead to suicidal thoughts or attempts, episodes of sudden, violent behavior, and severe memory loss that may be permanent.  In rare instances, sudden death can occur with cocaine use and the risk of sudden death is increased with multiple drug use, especially a concurrent use of alcohol and cocaine. 

The use of cocaine in pregnancy is associated with increased risk of premature birth, low birth weight, smaller than normal head size,  shorter than normal length, and  exposure to infection by the HIV, and Hepatitis viruses.  As cocaine-exposed children grow up, they may have trouble paying attention to tasks, thinking things through, and learning new information. 5

Chapter Review and Discussion Questions


  1. Discuss the difference between cocaine and crack cocaine.  
  2. Cocaine is a highly addictive illegal drug that can be snorted, smoked or dissolved and injected into a vein: Why is crack more likely to be abused or addictive than cocaine?
  3. Describe the short term and long-term effects of cocaine use and abuse. 
  4. List the adverse health outcomes of cocaine use in pregnancy. 
  5. Discuss the influence of methamphetamine use on sexual risk behavior.