It can be difficult to separate the idea of cocaine from the glamour to which it's been attached for so many decades. If tabloids have any truth to them (and that's a big IF), life as a celebrity in the '80s and '90s consisted of expensive sports cars, leggy models and parties plentiful with cocaine. Tarantino's True Romance stylized it, BLOW made it look really sexy, and who could forget that picturesque white mountain in Scarface?
Undoubtedly, Hollywood and the papped party scene glamorized the substance, but it's the everyday settings in which it's consumed that we need to talk about: as a pick-me-up on a Friday night after work in that all too familiar pattern of a drink, a line, a cigarette.
This behaviour is showing no signs of slowing. Canadians ranked second in cocaine use around the world, according to the 2019 Global Drug Survey. Which might not be a surprise since the survey found that cocaine is cheaper in Canada, costing about $85 a gram versus the global average of $120 per gram.
And while we might think of cocaine as traditionally a masculine drug, use seems to be spread equally between genders. The Guardian reported that, as of 2014, women are just as likely to consume drugs as men.
Everyone knows that cocaine — like other drugs — is highly problematic, not only because of what it does to our health, but for the way it is sourced and transported to Europe. According to VICE, drug cartels in Mexico account for roughly 55% of the country's murders and the continued demand for recreational drugs only helps to perpetuate that staggering rate. And yet, sadly, ethical culpability is rarely something one considers on a Friday night around 11pm.
We spoke to Nicky Walton-Flynn, Founder of Addiction Therapy London and Co-Founder of Wellness Hub UK, about why women in particular might be more susceptible to casual misuses of cocaine, and what the side-effects of a causal habit might be. She levelled that: "The pressures placed on women now, whether perceived or actual, drive lots of people to extreme measures. For obvious reasons, such as increased confidence and energy, cocaine has become to the go-to recreational substance of choice for young women and it's relatively cheap."
Here's a run-down from Walton-Flynn on what that once-or-twice a week coke intake is actually doing to our individual and collective physical and mental health.
Tell us a bit about your work? How do you help cocaine addicts?
I work in private practice and offer an integrative model of talking therapy. I mostly work with people who are interested in stopping taking cocaine. I rarely work with harm minimization models, simply because my experience is that they don’t work when addressing cocaine addiction. My clients aim to work towards a lifestyle of abstinence. Initially, I help people understand that, once addicted to cocaine, returning to being an occasional user is unrealistic. Psycho-education is an essential aspect of initial addiction therapy. I encourage my patients to identify the wider consequences of their cocaine use. For example: physical illness, lost days at work, loss of job, being estranged from friends and family, being in debt.
What constitutes a cocaine addiction?
Addiction is often referred to as a "progressive condition," so once tolerance levels build up, an increased amount of the substance is required to achieve the same effect. It is not possible to say that if you use X grams of cocaine weekly over a six month period that you will become addicted. It is possible to be a "functional cocaine addict" for a period of time before needing to seek help.
Addiction doesn’t happen to everyone. There is no certainty that if you use cocaine, you will develop an addiction, but probability is high due to its interference with reward pathways in the brain. The propensity to addiction is linked to a range of contributory factors; for example family history of addictions, childhood experiences, recent or historical trauma. These will influence motivation for taking cocaine and one’s propensity to become addicted.
Cocaine is one of the most psychologically addictive drugs because of how it stimulates and increases levels of the feel good neurotransmitter dopamine in the brain
How does a cocaine habit turn into an addiction?
Through continued and increased use over a period of time. Cocaine is one of the most psychologically addictive drugs because of how it stimulates and increases levels of the feel good neurotransmitter dopamine in the brain. It interferes with the pleasure and reward pathways in the brain.
What are the side effects of cocaine over a prolonged period of time?
Because cocaine affects the reward pathways in the brain, increased use over time results in an inability to gain pleasure and reward from what would be considered “normal” pleasures. An example is sex. If cocaine is used repeatedly in sex, the ability to enjoy and experience sexual pleasure without cocaine becomes diminished. As well as affecting the reward pathways, cocaine also affects the brain pathways that respond to stress. In my experience, I often see a presentation of cocaine addiction co-occurring alongside a stress disorder. Cocaine use elevates stress hormones, but people then seek out more cocaine to alleviate their stress, creating the addictive cycle.
In most cases, people will experience an intense euphoria followed by intense flatness of mood and depression
What are the short-term effects of cocaine use?
The short-term side effects of cocaine use are loss of appetite, malnourishment, increased heart rate and blood pressure, constricting blood vessels, increased rate of breathing, dilated pupils, headaches, disturbed sleep patterns, nausea and abdominal pain and hyper-stimulation. As well as bizarre, erratic, sometimes violent behaviour and risky sexual behaviour. Hallucinations, hyper-excitability, irritability, anger. In most cases, people will experience an intense euphoria followed by intense flatness of mood and depression. In extreme cases: tactile hallucination that creates the illusion of bugs burrowing under the skin, itching and scratching, as well as high levels of anxiety and irritability paranoia; depression matched with an intense craving for the drug, panic and psychosis, convulsions, seizures and in rare cases, sudden death from high doses.
And the long-term effects of cocaine use?
The long-term effects of cocaine use are rather varied. From permanent damage to blood vessels of the heart and brain, to high blood pressure leading to heart attacks, strokes, and death, to liver, kidney and lung damage, to destruction of tissues in the nose if sniffed. Infectious diseases and abscesses if injected. Respiratory failure when cocaine is smoked. Malnutrition and weight loss as a result of appetite suppression. Tooth decay. Sexual health issues including reproductive damage and infertility (affecting both men and women.) Disorientation, apathy, confusion and exhaustion. Irritability and high mood disturbances. Auditory hallucinations, increased frequency of dangerous and high risk taking behaviour — especially sexual behaviour and unpredictable and increased irrational behaviour leading to psychosis and/or delirium and clinical depression.
'I just want to have a good time, I’m not hurting anyone else, I’m only young once, I’ll stop when I settle down, when I get married, when I have children, when I’m 25, 28, 35….'. This is denial of one’s addiction.
Why do you think we have a more casual relationship to cocaine than other drugs?
Media glamorization combined with low prices makes it more affordable to a wider demographic. It is no longer exclusive to celebrities and high salaried professionals. Cocaine has been glamorized over recent decades in films, songs, media; it’s seen as cool. And importantly it makes us feel good — so we ask ourselves, “How can it be harming me?” There is also a lack of public awareness campaigns that educate young people about the reality of its dangers.
What kind of behaviour should people watch out for?
A key indicator of whether a person’s use of cocaine has progressed from being a social habit they are in control of, to dependency, is when they are unable to keep to their decision not to buy cocaine despite having made a decision to have a cocaine-free night. This decision will typically happen once alcohol has been consumed. This is a clear indicator that there is a shift in power, i.e. the drug has control over you; you are no longer in charge of your own using patterns and the choice has been taken away. This is dependency/addiction. It is at this stage that we observe denial of the dependency: “I do have a choice, I just want to have a good time, I’m not hurting anyone else, I’m only young once, I’ll stop when I settle down, when I get married, when I have children, when I’m 25, 28, 35….” This is denial of one’s addiction and is the most common narrative I hear in my rooms. If someone recognizes this, I would invite them to seek help.
More obvious signs: It takes longer to get over a night partying using cocaine, hangovers are more severe, there is a need to ingest more of the drug to achieve the same effect, the high doesn’t last as long as it did; feelings of flatness and depression arise sooner after taking a hit. Eventually the euphoria will cease altogether and the user will instead just experience anxiety and paranoia.
Young women are under increased pressure to be smart, funny, charming, sexy, beautiful, thin, clever, professional, high achieving... the list goes on. Cocaine makes young women feel these things and takes away those pressures, replacing them with momentary misguided feelings of success.
Why do you think young women are prone to the casual use of cocaine?
Cocaine evokes feelings of confidence and makes people feel “sexy.” Young women (20-35) are under increased pressure to be smart, funny, charming, sexy, beautiful, thin, clever, professional, high achieving... the list goes on. Cocaine makes young women feel these things and takes away those pressures, replacing them with momentary misguided feelings of success. Cocaine is also a disinhibiting drug so young women will feel confident to behave in ways that they might not if they were not under the influence of cocaine. For example, sexually.
How old is your typical client for cocaine addiction?
What are the common misconceptions you think people fall victim to when addressing their own drug habits?
Addiction is a condition that tells you that you haven’t got a condition. Denial. People reassure themselves by comparing their own use to someone they know who uses more than they do. Therefore they are OK. Telling themselves that everyone they know uses cocaine and thereby normalizing it. Minimizing their own use and the reality of the consequences of their use.
If you are struggling with substance abuse, please see here for a list of help hotlines by province in Canada.
This piece was originally published by Refinery29's UK edition and has been updated with Canadian cocaine use statistics.