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Cocaine

• What is Cocaine
• How is Cocaine Used?
• How does cocaine produce its effects?
• What are the short-term effects of cocaine use?
• What are the long-term effects of cocaine use?
• What are the medical complications of cocaine abuse?
• History of Cocaine

What is Cocaine?

Cocaine is a powerfully addictive stimulant that directly affects the brain. Cocaine has been labelled the drug of the 1980s and '90s, because of its extensive popularity and use during this period. However, cocaine is not a new drug. In fact, it is one of the oldest known drugs. The pure chemical, cocaine hydrochloride, has been an abused substance for more than 100 years, and coca leaves, the source of cocaine, have been ingested for thousands of years.

Pure cocaine was first extracted from the leaf of the Erythroxylon coca bush, which grows primarily in Peru and Bolivia, in the mid-19th century. In the early 1900s, it became the main stimulant drug used in most of the tonics/elixirs that were developed to treat a wide variety of illnesses. Today, cocaine is a Schedule II drug, meaning that it has high potential for abuse, but can be administered by a doctor for legitimate medical uses, such as a local anaesthetic for some eye, ear, and throat surgeries.

There are basically two chemical forms of cocaine: the hydrochloride salt and the "freebase." The hydrochloride salt, or powdered form of cocaine, dissolves in water and, when abused, can be taken intravenously (by vein) or intranasally (in the nose). Freebase refers to a compound that has not been neutralized by an acid to make the hydrochloride salt. The freebase form of cocaine is smokable.

Cocaine is generally sold on the street as a fine, white, crystalline powder, known as "coke," "C," "snow," "flake," or "blow." Street dealers generally dilute it with such inert substances as cornstarch, talcum powder, and/or sugar, or with such active drugs as procaine (a chemically-related local anaesthetic) or with such other stimulants as amphetamines.

How is Cocaine Used?

The principal routes of cocaine administration are oral, intranasal, intravenous, and inhalation. The slang terms for these routes are, respectively, "chewing," "snorting," "mainlining," "injecting," and "smoking" (including freebase and crack cocaine). Snorting is the process of inhaling cocaine powder through the nostrils, where it is absorbed into the bloodstream through the nasal tissues. Injecting releases the drug directly into the bloodstream, and heightens the intensity of its effects.

Smoking involves the inhalation of cocaine vapour or smoke into the lungs, where absorption into the bloodstream is as rapid as by injection. The drug can also be rubbed onto mucous tissues. Some users combine cocaine powder or crack with heroin in a "speedball."

Cocaine use ranges from occasional use to repeated or compulsive use, with a variety of patterns between these extremes. There is no safe way to use cocaine. Any route of administration can lead to absorption of toxic amounts of cocaine, leading to acute cardiovascular or cerebrovascular emergencies that could result in sudden death. Repeated cocaine use by any route of administration can produce addiction and other adverse health consequences.

How does cocaine produce its effects?

A great amount of research has been devoted to understanding the way cocaine produces its pleasurable effects, and the reasons it is so addictive. One mechanism is through its effects on structures deep in the brain. Scientists have discovered regions within the brain that, when stimulated, produce feelings of pleasure. One neural system that appears to be most affected by cocaine originates in a region, located deep within the brain, called the ventral tegmental area (VTA). Nerve cells originating in the VTA extend to the region of the brain known as the nucleus accumbens, one of the brain's key pleasure centres. In studies using animals, for example, all types of pleasurable stimuli, such as food, water, sex, and many drugs of abuse, cause increased activity in the nucleus accumbens.

Researchers have discovered that, when a pleasurable event is occurring, it is accompanied by a large increase in the amounts of dopamine released in the nucleus accumbens by neurons originating in the VTA. In the normal communication process, dopamine is released by a neuron into the synapse (the small gap between two neurons), where it binds with specialized proteins (called dopamine receptors) on the neighbouring neuron, thereby sending a signal to that neuron. Drugs of abuse are able to interfere with this normal communication process.

For example, scientists have discovered that cocaine blocks the removal of dopamine from the synapse, resulting in an accumulation of dopamine. This build-up of dopamine causes continuous stimulation of receiving neurons, probably resulting in the euphoria commonly reported by cocaine abusers.

As cocaine abuse continues, tolerance often develops. This means that higher doses and more frequent use of cocaine are required for the brain to register the same level of pleasure experienced during initial use. Recent studies have shown that, during periods of abstinence from cocaine use, the memory of the euphoria associated with cocaine use, or mere exposure to cues associated with drug use, can trigger tremendous craving and relapse to drug use, even after long periods of abstinence.

What are the short-term effects of cocaine use?

Cocaine's effects appear almost immediately after a single dose, and disappear within a few minutes or hours. Taken in small amounts (up to 100 mg), cocaine usually makes the user feel euphoric, energetic, talkative, and mentally alert, especially to the sensations of sight, sound, and touch. It can also temporarily decrease the need for food and sleep. Some users find that the drug helps them to perform simple physical and intellectual tasks more quickly, while others can experience the opposite effect.

• Increased energy
• Decreased appetite
• Mental alertness
• Increased heart rate
• Increased blood pressure
• Constricted blood vessel
• Increased temperature
• Dilated pupils

The duration of cocaine's immediate euphoric effects depends upon the route of administration. The faster the absorption, the more intense the high; also, the faster the absorption, the shorter the duration of action. The high from snorting is relatively slow in onset, and may last 15 to 30 minutes, while that from smoking may last 5 to 10 minutes.

The short-term physiological effects of cocaine include constricted blood vessels; dilated pupils; and increased temperature, heart rate, and blood pressure. Large amounts (several hundred milligrams or more) intensify the user's high, but may also lead to bizarre, erratic, and violent behaviour.

These users may experience tremors, vertigo, muscle twitches, paranoia, or, with repeated doses, a toxic reaction closely resembling amphetamine poisoning. Some users of cocaine report feelings of restlessness, irritability, and anxiety. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest.

What are the long-term effects of cocaine use?

Cocaine is a powerfully addictive drug. Once having tried cocaine, an individual may have difficulty predicting or controlling the extent to which he or she will continue to use the drug. Cocaine's stimulant and addictive effects are thought to be primarily a result of its ability to inhibit the reabsorption of dopamine by nerve cells. Dopamine is released as part of the brain's reward system, and is either directly or indirectly involved in the addictive properties of every major drug of abuse.

• Irritability
• Mood disturbances
• Restlessness
• Paranoia
• Auditory hallucinations

An appreciable tolerance to cocaine's high may develop, with many addicts reporting that they seek but fail to achieve as much pleasure as they did from their first experience. Some users will frequently increase their doses to intensify and prolong the euphoric effects. While tolerance to the high can occur, users can also become more sensitive (sensitization) to cocaine's anaesthetic and convulsant effects, without increasing the dose taken. This increased sensitivity may explain some deaths occurring after apparently low doses of cocaine.

Use of cocaine in a binge, during which the drug is taken repeatedly and at increasingly high doses, leads to a state of increasing irritability, restlessness, and paranoia. This may result in a full-blown paranoid psychosis, in which the individual loses touch with reality and experiences auditory hallucinations.

What are the medical complications of cocaine abuse?

There are enormous medical complications associated with cocaine use. Some of the most frequent complications are cardiovascular effects, including disturbances in heart rhythm and heart attacks; such respiratory effects as chest pain and respiratory failure; neurological effects, including strokes, seizure, and headaches; and gastrointestinal complications, including abdominal pain and nausea.

Cardiovascular Effects:

• Disturbances in heart
• Rhythm heart attacks

Respiratory effects:

• Chest Pain
• Respiratory failure

Neurological Effects:

• Strokes
• Seizures
• Headaches

Gastrointestinal Effects:

• Abdominal pain
• Nausea

Cocaine use has been linked to many types of heart disease. Cocaine has been found to trigger chaotic heart rhythms, called ventricular fibrillation; accelerate heartbeat and breathing; and increase blood pressure and body temperature. Physical symptoms may include chest pain, nausea, blurred vision, fever, muscle spasms, convulsions and coma.

Different routes of cocaine administration can produce different adverse effects. Regularly snorting cocaine, for example, can lead to loss of sense of smell, nosebleeds, problems with swallowing, hoarseness, and an overall irritation of the nasal septum, which can lead to a chronically inflamed, runny nose. Ingested cocaine can cause severe bowel gangrene, due to reduced blood flow. And, persons who inject cocaine have puncture marks and "tracks," most commonly in their forearms.

Intravenous cocaine users may also experience an allergic reaction, either to the drug, or to some additive in street cocaine, which can result, in severe cases, in death. Because cocaine has a tendency to decrease food intake, many chronic cocaine users lose their appetites and can experience significant weight loss and malnourishment.

Research has revealed a potentially dangerous interaction between cocaine and alcohol. Taken in combination, the two drugs are converted by the body to cocaethylene. Cocaethylene has a longer duration of action in the brain and is more toxic than either drug alone. While more research needs to be done, it is noteworthy that the mixture of cocaine and alcohol is the most common two-drug combination that results in drug-related death.

History of Cocaine

Cocaine in its various forms is derived from the coca plant which is native to the high mountain ranges of South America. The coca leaves were used by natives of this region and acted upon the user as a stimulant. The stimulating effects of the drug increase breathing which increases oxygen intake.

This afforded native labourers of the region the stamina to perform their duties in the thin air at high altitudes. In time science figured out how to maximize the strength and effect of the drug contained in the coca leaves.

Through chemically synthesizing the coca leaves the white crystal powder we have come to know as cocaine was created. As time passed newer methods to magnify the euphoric effects of the drug were invented which has led us to the most potent and addictive form of the drug, crack.

Crack cocaine is the most popularly used version of cocaine today. Smoking cocaine rocks began in the late 1970's. Rocking-up cocaine powder and smoking it was originally the method developed so distributors of cocaine could test the purity of the drug before it was purchased from the manufacturers. Crack has destroyed millions of lives since it was first introduced to the streets of America. Crack is a relatively new drug on the scene compared to drugs like opium or heroin; nonetheless, it has been part of our history and culture for nearly 150 years.

Cocaine was first synthesized in 1855. It was not until 1880, however, that its effects were recognized by the medical world.

The first recognized authority and advocate for this drug was world famous psychologist, Sigmund Freud. Early in his career, Freud broadly promoted cocaine as a safe and useful tonic that could cure depression and sexual impotence. Cocaine got a further boost in acceptability when in 1886 John Pemberton included cocaine as the main ingredient in his new soft drink, Coca Cola. It was cocaine's euphoric and energizing effects on the consumer that was mostly responsible for skyrocketing Coca Cola into its place as the most popular soft drink in history.

From the 1850's to the early 1900's, cocaine and opium laced elixirs, tonics and wines were broadly used by people of all social classes. This is a fact that is for the most part hidden in American history. The truth is that at this time there was a large drug culture affecting a broad sector of American society. Other famous people that promoted the "miraculous" effects of cocaine elixirs were Thomas Edison and actress Sarah Bernhart. Because there were no restrictions placed on acquiring these drugs in the early 1900's, narcotics was an acceptable way of life for a large number of people, many of whom were people of stature. Cocaine was a main stay in the silent film industry. The pro-drug messages coming out of Hollywood at this time were receiving international attention which influenced the attitudes of millions of people about cocaine.

As a rule, famous people are role models that can and do influence the masses. Star power has proven time and again to be the most potent form of advertising. Think about it: The world’s most famous psychologist; the man that invented the light bulb; a stable of Hollywood silent film stars; and the inventor or the most popular soft drink in history - all on the pro-cocaine band wagon. All promoting the drug's positive effects. Some did it through personal testimonials that ran in printed pages across the nation. Others (in particular the silent film stars) promoted cocaine's acceptability through the examples they set by their well publicized life styles.

In the same way as other narcotics like opium and heroin during this time, cocaine also began to be used as an active ingredient in a variety of "cure all" tonics and beverages. In many of the tonics that drug companies were producing at this time, cocaine would be mixed with opiates and administered freely to old and young alike. It wasn't until some years later that the dangers of these drugs became apparent.

In fact, it was the negative side effects of habitual cocaine use that was responsible for coining the phrase, "dope fiend". This terminology came about because of the behaviour of a person abusing cocaine for prolonged periods of time. Because cocaine is such a powerful stimulant, prolonged daily use of the drug creates severe sleep deprivation and loss of appetite. A person might go days or sometimes weeks without sleeping or eating properly. The user often experiences psychotic behaviour.

They hallucinate and become delusional. Coming down from the drug causes a severe state of depression for the person in withdrawal. This person can then become so desperate for more of the drug that they will do just about anything to get more of it, including murder. If the drug is not readily available, the depression one experiences in withdrawal can become so great the user will sometimes become suicidal. It is because of this heinous effect on the user that the word "fiend" became associated with cocaine addiction.

Over the course of the next several years the American majority became more and more aware of the dangers of cocaine. As the severity of this problem became more and more apparent, concern mounted to an eventual public outcry to ban the social use of cocaine. This public pressure forced Pemberton to remove cocaine from Coca Cola in 1903. Eventually the public pressure became so great as to place a national prohibition on cocaine.

The country's legislators took notice, and in 1920 cocaine was added to the list of narcotics to be outlawed by the passing of The Dangerous Drug Act of 1920. Unfortunately, as with the opiates like heroin, the dangers of cocaine abuse were recognized by law makers after the fact. The market for cocaine had already been established and was deeply entrenched into American history and culture and is with us today.

References

• http://www.narconon.org/drug-information/cocaine-coke.html
• http://www.narconon.org/drug-information/cocaine-history.html
• http://www.narconon.org/drug-information/cocaine-timeline.html

History of Cocaine Use & Abuse

 

 

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SCRC's approach is aimed at facilitating change from the culture of addiction to the culture of recovery.

This process will yield limited success when approached outside of a residential treatment facility particularly when detoxification is required. It is imperative that individuals entering treatment are given as much training and education as possible.

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