Cocaine

Cocaine is a powerful stimulant drug made from the South American coca bush. Its street names include “coke,” “C,” “snow” and “flake.”

Cocaine is typically sold as a fine white powder. Street dealers sometimes “cut” it with substances like cornstarch or sugar, or painkillers like benzocaine.

Typically, cocaine is snorted through the nose. It may also be dissolved in water and injected intravenously. “Crack” is cocaine that is chemically changed so it can be smoked. Crack chunks are also known as “rock.”

All forms of cocaine generally have the same effects. However, as with most psychoactive substances, how it is used affects the intensity and onset time of effects. Injecting cocaine delivers it to the blood immediately, producing faster and more intense effects than those caused by snorting. Smoking cocaine causes the quickest and most intense effects, which may lead more quickly to addiction.

Effects on general health

Using cocaine speeds breathing and heart rate, and increases blood pressure. It dilates the pupils, decreases appetite and reduces the need for sleep.

Heavy cocaine users may feel depressed, restless, agitated and nervous. They may experience sleep disorders, eating and sexual problems, dramatic mood swings, delusions, hallucinations and paranoia. Repeated use of cocaine may cause long-lasting problems with memory, attention and behaviour.

Overdose can cause seizures, strokes, heart attacks, kidney failure, coma and death.

Effects on women's health

Women who use cocaine regularly may experience irregular or disrupted menstrual cycles.

Effects during pregnancy

There is no known safe level of cocaine consumption for pregnant women.

It is not clear whether a child's health problems are caused directly by a mother's use of cocaine during pregnancy or in combination with other factors including

• poor nutritional habits
• smoking
• alcohol consumption
• using more than one drug
• sleep problems
• a mother's general health before pregnancy
• genetics
• how much alcohol, tobacco or other drugs are consumed during pregnancy
• at what stage in the pregnancy a substance is consumed
• how long the substance has been used

The effects of drugs such as cocaine have been difficult to study because other factors also affect pregnancy. However, it is safest to avoid alcohol, tobacco and other drugs during pregnancy.

Withdrawal from cocaine is not physically dangerous to either the mother or the fetus. However, the risk of relapse carries with it the danger of exposure to cocaine and its harmful effects to both mother and fetus.

Effects on the fetus

Because cocaine passes the placental barrier, an unborn child uses cocaine with the mother.

If a mother uses cocaine by injection and contracts HIV or hepatitis B or C, she can pass these on to her unborn child.

Studies show that prenatal cocaine exposure may slow fetal growth. This restricted growth may result in a child being born with a small head, shorter body length and low birth weight. The fetus is at risk of increased heart rate and high blood pressure when exposed to cocaine in the uterus.

Effects on birth

Increased risks for both mother and baby exposed to cocaine include

• premature labour and delivery
• premature separation of the placenta from the wall of the uterus, a potentially very serious situation for both mother and baby
• miscarriage, stillbirth or sudden infant death syndrome (also known as SIDS or "crib death")

Effects on breastfeeding

A mother who uses cocaine should not breastfeed her child. Cocaine can remain in breast milk for more than 48 hours after a mother’s last use.5,12 Infants breastfed by mothers using cocaine may suffer seizures and extreme irritability because they become addicted to cocaine through their mother’s breast milk.

Effects on child development

Effects on early development

A newborn prenatally exposed to cocaine may have an increased incidence of irritability, tremors, rigid muscles, temperature instability and poor feeding habits. Hyper-alertness or a high-pitched cry may also indicate cocaine exposure.

Children exposed to cocaine in the uterus may be born with physical irregularities such as brain injuries and nervous system malformations; cardiac, cerebral and respiratory irregularities; and heart, intestinal, facial, limb and eye deformities.

Effects on long-term development

Children prenatally exposed to cocaine may experience behavioural and emotional difficulties throughout their lives. Increased irritability, attention-related problems, difficult temperament, sleep and eating disorders, hypersensitivity, restlessness, frustration, impulsivity and aggression are all symptomatic of prenatal cocaine exposure, and have all been noted in infants and even school-aged children who were exposed to cocaine prenatally. Cocaine exposure is also associated with oppositional defiant and attention deficit/hyperactivity disorders.

Language skills and ability to express emotions can be affected by physiological damage from cocaine exposure, which may lead to lifelong social difficulties. Cocaine-exposed children may have difficulties with verbal comprehension and expression. They may also experience difficulty in language and verbal development, including difficulty understanding and contributing to verbal conversation.

Both gross motor skill development (overall control of body movement) and fine motor skill development (co-ordination of body parts) may be slowed in children exposed to cocaine prenatally. Prenatal cocaine exposure is also associated with slowed height growth and disproportionate weight-to-height ratios throughout life.

Not everything is known about the effects of alcohol, tobacco and other drugs on child development. It is safest to avoid using them during pregnancy.