Cocaine is a crystalline alkaloid obtained from the leaves of the coca plant. It is a stimulant, appetite suppressant and a sodium channel blocker that causes it to be an anesthetic at low doses. It is highly addictive because of its effect on the brain's reward pathways. Cocaine is more dangerous than many other stimulants because of its effect on the sodium channel in the body's chemistry, which, under higher dosages may cause sudden cardiac arrest. Cocaine is unique as a molecule because it has pockets that allow it to cross the blood-brain barrier quite quickly and easily (Sommers, 2008). High dosages or repeated use may also cause a breakdown in the blood-brain barrier, allowing the user to experience greater psychoactive episodes from other substances (Sharma, H., et al., 2009). Historical Background - From a historical perspective, the use of cocaine and other psychoactive substances is neither novel nor new. In fact, history tells us that almost every society had their own pharmacopeia of herbs, potions, and substances that not only contributed to healing, but also allowed the user to escape reality. However, it is the contemporary use of psychoactive drugs purchased through illicit or illegal channels and used by persons neither prescribed nor in quantities larger than necessary, that defines modern drug abuse. Before the First World War, cocaine and other substances were easily available in most major cities, particularly those with active international ports. It was the leisure class, who began to experiment with cocaine; as well as a substantial number of "society women" who ended up addicted because their doctor prescribed this drug to deal with female histrionics or to "cure" an excessive sexual appetite (Gootenberg, 2008). Within major cities, this problem began to spill over into other groups: prostitutes, child laborers, orphans, and even men and women of lower social classes seeking to escape the harshness of their lives. Between the widespread use and general overprescribing of both heroin and cocaine, by the turn of the century there was a clear epidemic of drug abuse hitting America's cities (Illegal Drugs in America: A Modern History 2009).

This epidemic contributed to a rising temperance movement. By the end of World War I, The Temperance League gained enough power to pressure lawmakers into drastic legislation for alcohol and other intoxicants, resulting in the infamous Volstead Act of 1919, which prohibited the sale of many substances, including cocaine (United States Government, 2008). Between the 1930s and late 1950s, political and social changes resulted in more urbanization in America, a repeal of Prohibition, and increased contact with the outside world. It was during this three-decade period that other drugs became popular in the recreational scenario: amphetamines, cocaine, heroin and marijuana. In fact, during World War II, amphetamines were regularly distributed both to soldiers and factory workers (many of whom were women) to enhance mood and endurance. . After the war, Cocaine was imported into the United States from South America even though the Harrison Narcotic Act of 1914 outlawed its sale (The American Drug Scene, 2008) (Incardi 2007).

It was during and after the 1960s, however, that the dramatic social upheaval and change in popular culture resulted in the burgeoning "American Drug Culture." A number of other substances (LSD, depressants, cocaine and heroin refined) became quite popular during this period, as well as the almost global proliferation of marijuana. During the1960s, for example, only 4 million Americans had ever tried drugs -- but by the end of the 1980s that total had risen to over 74 million, with an economic and social cost to the nation of several billion dollars per year. Crime and social policy issues surrounding illicit drugs continue to plague the nation, and even with the 1973 Executive Order establishing the Drug Enforcement Administration as a single unified agency to combat the illegal importation and manufacture of drugs, substance abuse remains a particularly serious problem in America. We know that substance abuse is clearly a part of the human culture, and of course, there are numerous theories designed to explain such behavior ((Kernaghan,...

In humans, it increases alertness, euphoria, energy, motor activity, feelings of sexuality and competence. In some individuals, it also increases anxiety, paranoia and restlessness. In addition, or with excessive dosages, it may cause tremors, convulsions, cardiac events and increased sweating and body temperature (World Health Organization, 2004).
With excessive use, cocaine may cause itching, hallucinations, delusions, hyperthermia, high blood pressure, arrhythmia and death. This is due to the way brain cells adapt to imbalances of transmitter levels in order to compensate for extremes. Receptors are either on or off in the brain, responding to stimuli and chemicals. Chronic cocaine use causes these receptors to misfire, and cells may go wild with on/off signals in no order -- causing the uptake and/or release of other chemicals that also contribute to an imbalance. After a time, there is a loss of transporters and proteins that can permanently damage dopamine neurons, causing a Ping-Pong effect in a rise in tolerance of the drug, requiring continually increased dosages to achieve the same effect. However, these increased dosages also damage the brain chemistry, often causing neurons to misfire and cause other effects as if the body is "confused" about what it should be doing (Karch, S., et al., 2009).

Addiction -- Cocaine dependence is both a psychological and physical desire to use cocaine on a regular basis. In fact, cocaine is so highly addictive that the risk of becomin dependent within 2 years of first use is about 6%, and after 10 years, even if use is not regular, almost 20%. Among adolescents the addiction rate is even higher (Sanches-Hervas, E., et al., 2012). However, new studies from The Netherlands suggest that the addictive properties of cocaine are often mitigated by the person's ability to make cognitive judgements, control their behavior and even their perpacity toward addiction. One study found "relative absence of desctructive and compulsive patterns over a ten-year period" concluding that many cocaine users can and do exercise self-control. "Our respondents applied two basic types of controls to themselves: 1) restricting use to certain situations and to emotional states in which cocaine's effects would be most positive, and, 2) limiting mode of ingestion to snorting of modest amounts of cocaine, staying below 2.5 grams a week for some, and below 0.5 grams a week for most. Nevertheless, those whose use level exceeded 2.5 grams a week all returned to lower levels" (O'Brien, M., et al., 2007).

Cocaine's addictive properties stem from its ability to increase dopamine transporters. Research also shows that not only is the molecule able to adjust to the brain-blood barrier and cause a "pereived need" for more and more cocaine, it also reduces a protein, called Rac1, that regulates brain plasticity. This produces a greater sensitivity to the rewarding effects of cocain, and eventually results in a large increase in the number of physical portrusions that grouw out of the neurons specifically in the reward center of the brain (Goldbaum, 2012).

Current Treatment - There are a number of therapies that are used with cocaine addiction, mostly involving therapy. Ironically, a recent study showed that combining psychotherapy and inducing gambling for the paitent it the best way to break the cocaine dependence cycle. According to the study, "after cocaine is used, it activates the reward center inside the brain. The brain released euphoric hormones and neurotransmitters such as dopamine, oxytocin and adrenaline then act as mood enhancers. The same occurs with gambling: the brain perceives a reward from winning or the potential of a reward. The reward causes intense moments of happiness, which compensate for the desire to use cocaine" (Petry & Alessi, 2010).

Programs that are modeled after Alcoholics Annoymous, like Cocaine Anonymous, are widely used to help those with cocaine addictions. Cognitive Behavioral Therapy is often combined with Motivational Therapy tend to have a rather low success rate over time, but are still widely used. Most believe that the reason these therapies have limited effect is because they are just not powerful enough to provide enough stimuli to the brain's reward center (Clarke & Myers, 2012). Alternative therapies include acupunture and hypnosis, all with varying effects and studies with relatively few conclusive results that can be extrapolated to the general population. According to many scientists, cocaine addiction may be almost impossible to stop because of the robust nature of its effect on the chemistry of the brain (Kalivas & Brady, 2012).

Pscyhological and Social Effects -- As with any addiction, there are many serious social and family effects of cocaine addiction. Many scholars find that social deviance is characteristic of cocain abusers, with antisocial behavior preceeding the actual addiction. Some studies suggest that addiction personalities are genetically based, others believe that the nature/nurture debate shows that children raised in families with abusive or substance issues tend to emulate…