Cocaine, one of the oldest known drugs, has been an abused substance for over 100 years. However, it has gained greatly in popularity especially within the last two decades. The White House Office of National Drug Control Policy reports that Americans spend more on cocaine than on all other illegal drugs combined. Between the years of 1988 to 1995, it was estimated that around $38 billion was spent on cocaine alone. Other costs attributed to cocaine use is money spent on cocaine treatment and prevention programs, emergency room visits and related healthcare costs, lost job productivity, lost earnings, cocaine-related crime, and social welfare are all estimated to cost billions annually. According to the National Institute on Drug Abuse (NIDA), there are about 1.7 million people in the U.S. who regularly use cocaine, and so it is not surprising to see that cocaine is the leading cause of heart attacks and strokes for people under the age of 35. In order to combat this problem, we must understand how cocaine acts on the brain.

Cocaine addiction causes lasting changes in brain function that are very difficult to reverse. The answer lies within the brain's reward system, which is beneath the cerebral hemispheres called the nucleus accumbens. This area is connected to the ventral tegmental area (VTA), which produces the neurotransmitter dopamine. In a normally functioning brain, when an action is performed that satisfies a need, dopamine is released into the nucleus accumbens, which produces a pleasurable feeling: the reward. Therefore, the action will most likely be repeated to achieve the reward again. Normally, rewards come only with effort and after a delay. However cocaine and other drugs provide a shortcut to this sequence5. Once cocaine has crossed the blood-brain barrier and enters the VTA it accumulates rapidly, and begins to act upon the nucleus accumbens. There it binds to dopamine transporters and inhibits the brain from reabsorbing the neurotransmitter, causing a build-up of dopamine. A euphoric rush is given that may last several minutes. After multiple uses, the brain can no longer produce the amount of dopamine to feel the same effects. Therefore, the need for it becomes stronger, and more cocaine must be taken to release the dopamine, thereby causing addiction.


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