According to the 2008 National Survey of Drug Use & Health, the number of young adults abusing cocaine has dropped significantly. However, in Hollywood, the use and abuse of the illicit drug continues unabated.
In fact, snorting cocaine can be as commonplace as sipping a glass of champagne. After a night out in the clubs, the party typically goes back to an oversized mansion somewhere in the Hollywood Hills. There’s music, a pool table, more alcohol and a bunch of pretty people doing a line or two.
Dennis Quaid described a similar scene, telling Newsweek that his "greatest mistake" in life was the cocaine addiction he developed in the 1970s and 1980s when he first encountered show business' pressures – and payoffs.
"It was very casual at first. That's what people were doing when they were at parties. Cocaine was even in the budgets of movies, thinly disguised," Quaid said. "It was petty cash, you know? It was supplied, basically, on movie sets because everyone was doing it. People would make deals. Instead of having a cocktail, you'd have a line."
And in a town founded on fame, cocaine is often synonymous with stardom.
Last year Paris Hilton hit headlines after pleading guilty on two misdemeanor counts in a Las Vegas court of cocaine possession. Charlie Sheen was hospitalized in January following a porn-star fueled party complete with a reported "briefcase full of cocaine." In her recent memoir, Belinda Carlisle opened up about her battle with a three-decade coke addiction. And then there is the late Amy Winehouse, who’s own father was quoted three years ago saying the Grammy-winning songstress would die if she continued to smoke crack.
"In general, with cocaine abuse, or cocaine dependence, the numbers are dropping. They are not peaking or elevating. But in Hollywood, it’s still going strong," Dr. Reef Karim, a leading addiction specialist at The Control Center in Los Angeles told FOX411's Pop Tarts column. "You still see coke everywhere in Hollywood. It is still considered to be a party drug."
So what is it about cocaine that has so many Hollywood types hooked?
"Cocaine is unique in how it stimulates the brain’s reward center. The chemical signal for pleasure in the brain is the release of dopamine in the nucleus accumbens in the midbrain," explained Dr. David Sack, CEO of the star-saturated Malibu rehab center Promises. "Cocaine strongly and selectively increases dopamine in this region, causing the ‘rush’ and euphoria."
FOX411 recently explored the use of cocaine as a popular weight loss drug and appetite suppressant in the image-fueled industry. But it also serves another critical function: sudden and abundant energy.
"It keeps you awake. And for a lot of people it makes them more hyper or more sociable, so, you’ve got people that want to party all night that don’t want to gain a lot of weight, that want to be able to talk to other people that they aren’t that interested in to start with, and want to have a good time in a pleasurable way," Reef explained. “Cocaine seems to make sense for them."
According to Dr. Eric Braverman, addiction specialist and author of “Younger You,” a big ego and money to burn also pave the way for cocaine addiction.
"[Celebrities tend to be] narcissistic, so cocaine gives them a sense of authority and power. Also, many rely on cocaine to fill voids in their lives," he said, adding that celebrities with the addiction may drop upwards of $1,000 per day on the stuff.
But anything that takes you too far up, can also take you too far down.
"It affects the brain. When you’re trying to talk to somebody on coke, it’s like someone injected ADHD into their brain and you’re trying to have a conversation with them while they’re talking about 10 different conversations, at a mile a minute, that make no sense," Reem continued. "From a body standpoint, there are definitive adverse affects. Coke constricts your blood vessels, which is why there is potentially all of these heart issues associated with taking cocaine. It can also leave you malnourished."
Karim recently treated "a Hollywood starlet type" with a cocaine abuse problem that left her shockingly thin.
"She wasn’t anorexic, but she was on her way. When I looked at her levels of vitamins and electrolytes, they were all off, because she wasn’t really eating. And she wasn’t really eating because she was doing coke every time she went out, which was like four or five times per week," he said. "So, it can have rapid effects like heart attacks and stroke, mental effects, and effects that involve your entire body system. It’s usually not a good end result."
While any form of cocaine can be addicting, Sacks said crack cocaine, which produces an immediate high, is the one most abusers get dangerously attached too.
"When cocaine is smoked, it is absorbed very quickly through the lungs and into the blood stream where it travels to brain," he said. "The addicting properties of crack cocaine and intravenous cocaine are similar, but with crack cocaine, the user repeats the dosing over and over again at very short intervals."
Unlike the stories from the days of Studio 54 of cocaine-snorting production lines, today its consumption is a little more discreet.
"If you go to a typical Hollywood house party and it’s after midnight, there’s going to be coke there, it’s just a matter of which bathroom it’s in and who’s got it.," Karim said, while Sack added that most celebrities easily get their fix via "friends" or direct through a dealer in an affluent community that can deliver straight to one's front door. Nightclub owners have even been known to dispense cocaine to celebrities as a "payment" or incentive for them come to a the club.
But those with a cocaine problem lose more than just money, weight and years off their lives. Like all addictions, sufferers also lose their sense of self.
"When someone is truly addicted to a substance or a behavior, their brain is hijacked by that substance or behavior, so you’re not thinking or acting as you, but the drugs or behaviors are talking," Karim said. "The sex addiction is talking. The gambling addiction is talking. The cocaine addiction is talking."
But in Hollywood, many don't seek the professional help they need or even acknowledge that there is a problem.
"The entertainment industry generally has a broader tolerance for recreational drug use than other fields. Illicit drug use is tolerated so long as it doesn’t interfere with production. Some of this probably comes in the spirit of tolerance and supporting personal liberty, particularly in artists, but it is misguided," Sack added. "Higher social use of drugs leads to higher rates of problem use and drug dependency. Individuals whose drug use has become problematic or who have become addicted have trouble recognizing how their drug behavior is different from others who appear to be able to use socially. They will point to friends or colleagues or appear to use larger quantities, more often and use this to rationalize their own behavior. They don’t realize that individuals differ markedly in how they respond to and metabolize drugs."