Where the substance comes from
Cocaine is extracted from coca leaves grown in the Andes — Colombia, Peru, Bolivia. The base paste is refined locally, then the powder crosses the Atlantic in shipping containers, mainly to the large European ports. Every intermediary cuts it: levamisole (a veterinary antiparasitic that destroys white cells), phenacetin, lidocaine, caffeine, sometimes fentanyl. Street purity has risen sharply over the past decade, which mechanically raises the dose received.
A little history
Coca leaves have been chewed in the Andes for at least eight thousand years — remains have been found in dwellings in northern Peru — against hunger, fatigue and altitude sickness; the Incas made it a sacred plant reserved for the elite. The active ingredient, cocaine, was isolated in 1860 by Albert Niemann in Göttingen. A decade of enthusiasm followed: Vin Mariani (1863), a coca tonic praised by popes and kings; Coca-Cola in 1886, which contained it until 1903; Sigmund Freud, who recommended it in 1884 in Über Coca before changing his mind; and the same year Carl Koller, who made it the first local anaesthetic, a revolution for eye surgery.
The addictions that followed led to the first bans: the Harrison Act in the United States in 1914, the French narcotics law in 1916. Cocaine almost vanished from circulation for half a century, before returning in the 1970s as a fashionable drug, then, around 1984-1985, as cheap smokable crack that devastated the poor neighbourhoods of American cities and inspired laws of disproportionate severity.
The Colombian cartels of Medellín and Cali, then Mexican organisations and Balkan networks, made it one of the largest criminal markets in the world. Coca and cocaine production broke records in the 2020s, and Europe, through its big ports, has become a market as important as North America.
The forms it takes
- Powder, snorted, sometimes injected or rubbed on the gums.
- Crack and freebase, made by removing the hydrochloride with bicarbonate or ammonia, then smoked. The effect arrives in seconds, lasts ten minutes and leaves an immediate urge to repeat: the most rapidly addictive form.
- Mixtures: with alcohol the body makes cocaethylene, more cardiotoxic and longer lasting; with heroin (speedball) the risk of respiratory arrest is major.
What the user is looking for
Brief euphoria, a sense of power and ease, no fatigue or hunger, confidence, sexual disinhibition. The effect lasts thirty to sixty minutes nasally, then leaves an unpleasant come-down — irritability, low mood, exhaustion — that prompts another line. It is that come-down, more than the initial pleasure, that organises consumption.
Immediate unwanted effects
- Abrupt rise in blood pressure and heart rate, coronary artery spasm: heart attack is possible in a young person with no risk factor at all, including on a first use.
- Arrhythmia, stroke, seizures.
- Acute anxiety, persecutory feelings, tactile hallucinations (formication).
- Perforated nasal septum in regular nasal users.
- Sexual risk-taking: disinhibition and lowered vigilance account for a substantial share of STI transmission in party and chemsex settings.
Medium and long-term risks
Psychological dependence is strong and quick, without a spectacular physical withdrawal — which deceives people: they think they can stop because they do not shake. Then come blunted ordinary pleasure, depression, chronic insomnia, memory and attention problems and often rapid financial damage. Levamisole used as a cutting agent causes falls in white cells and skin necrosis. In pregnancy the risk of placental abruption and prematurity is major.
How to spot use
A running or bleeding nose without a cold, repeated sniffing, very dilated pupils, clenched jaw, talking non-stop, insomnia followed by whole days of sleep, a see-saw mood, money disappearing, small bags, rolled notes or bank cards, powder traces on flat surfaces. Analytically, cocaine is detectable in urine two to four days after use, longer in regular users; in hair, several months.
Why the effect is stronger in adolescents
At the same dose in a lighter body, the concentration reached is higher in an adolescent than in an adult. More importantly, the reward circuit matures well before the prefrontal cortex that is supposed to restrain it: the pull to repeat is stronger and the brake weaker, which markedly shortens the gap between first use and problem use. Use established before eighteen multiplies the risk of adult dependence whatever the substance — including legal ones such as the caffeine in energy drinks, alcohol or nicotine.
When to call an ambulance without hesitating
Loss of consciousness, seizures, severe confusion, slow or irregular breathing, blue lips, chest pain, very high temperature, uncontrollable agitation, suicidal thoughts. In those situations call the emergency services and say what was taken: treatment depends on it.