Source & Forms
Cocaine is a natural alkaloid. It is extracted from leaves of an Andean shrub, Erythroxylon coca. Cocaine is free base, which is white to light brown in color depending on impurities, and as cocaine hydrochloride salt, which is a white powder. Cocaine hydrochloride is water-soluble.
- Origin/Early Use
The leaves were used by the native population to get rid of fatigue due to being in high levels of altitude. It wasn’t until 1884 when Europeans implicated it for its medicinal purposes. It was said to cure depression and alcohol dependence.
Drug Use in U.S.
Cocaine is currently the primary non-alcoholic drug of abuse. Smoking has increased over the years throughout cities in the U.S. Cocaine consumption in North America rose rapidly; by the late 1980s, 30 million people were cocaine users and 6 million were cocaine addicts. Estimates in the 1990s suggested that 30-40 million Americans have some experience with cocaine and that 1 of every 2 persons aged 25-30 years has used the drug. More than 5 million Americans use cocaine regularly via insufflation (snorting/sniffing), inhalation (smoking), and injection today.
- Current Use
It’s used in ophthalmic and spinal anesthetic. Cocaine can be snorted or injected subcutaneously (under the skin) or intramuscularly (into the muscle). Injection is rarely used because it slows absorption that then will not have the end result in a rush.
Crystalline free-base form of cocaine is soluble in water then volatilized and smoked. Smoking results in an instantaneous high due to swift penetration to the brain.
Pharmacology and Effects
- Routes of administration
Three main routes of administration are smoking, intranasal, and injection.
- Drug’s effect in the synapse, physiological effects
Cocaine stipulates the user with euphoria by blocking dopamine with the presynaptic neuron. This results in a higher dopamine concentration in the synapses and more postsynaptic firing.
Heart– Cocaine increases heart rate and blood pressure while compressing the arteries supplying blood to the heart. Heart attack is a common result. Cocaine can also lead to arrhythmia, a deadly abnormal heart rhythm.
Brain– Cocaine can compress blood vessels in the brain resulting in strokes, seizures, and can lead to violent behavior.
Lungs & Respiratory System- Snorting cocaine can result in nose and sinus damage and can cause perforations in the nostril. Smoking cocaine can irritate the lungs and can result in permanent lung damage.
Stomach- Cocaine compresses blood vessels that supply to the gut. As a result, the oxygen deprivation a cause stomach ulcers and perforations in the stomach and/or intestines.
Kidneys- Rhabdomyolysis is a process in which the kidneys fail as a result from cocaine use. Cocaine will accelerate long- term kidney damage resulting in high blood pressure.
Sexual Function- Chronic cocaine can impair sexual function in men and women.
- Psychological effects
- Dependence and depression
- Feelings of restlessness, irritability, mood swings, paranoia, sleeplessness, and weight loss
- Emotional problems and isolation from family and friends
- Psychosis, paranoia, depression, anxiety disorders, and delusions
Causes for Concern
- Acute toxicity
Cocaine can lead to severe issues in the heart, brain, lungs, stomach, and in muscles. The severity will be directly related to the amount and how long the drug has been used.
- Chronic toxicity
Cocaine has the ability to accelerate heart, brain, lungs, stomach, and/or muscle issues. For example, if you suffer from high blood pressure, cocaine makes it harder for the heart to pump blood. Death is common among acute and chronic cocaine users.
- Dependence potential
Cocaine dependence is a psychological desire. The amount of dopamine in the central nervous system and activates the brain’s reward circuit. While users report feelings of supremacy and euphoria, cocaine is a highly dangerous drug, regardless of frequency of use
- Social issues
Cocaine users typically experience paranoia, hallucinations, and/or extremely aggressive behavior. It can also lead to depression. Antidepressants are typically used in cocaine treatment to counteract the depression.
Current beneficial uses
Today cocaine is mainly used in the medical field by otorhinolaryngologists (ears, nose, & throat) and for vasoconstrictive properties (blood vessels). Procedures involving cocaine and adrenaline in the right dosages are safe however; patients that have had previous heart issues or have a history of cocaine use should take precautions.
Health Impact Assessment
Overall, cocaine is a highly addictive drug and is hard to discontinue. The only medicine is offered to help addicts are antidepressants which only help with being depressed. Hospitals get more cases of cocaine overdoses than any other drug related issues. Today in the medical field cocaine can be used in anesthesia and to help study blood vessel properties. Cocaine can be a benefit when monitored and in the hands of the right people.
Approaches to Prevention/ Mitigation
A Relapse Prevention Plan consists of emotional, mental, and physical abstinence and noticing symptoms early. Some prevention techniques involves telling someone when you have a sudden urge to use, distracting yourself, waiting for 30 minutes, doing recovery one day at a time, and taking time for relaxation every day.
- Relevant Regulations & Laws
Cocaine is a Schedule II drug under the Controlled Substances Act. It has a high potential for abuse. Congress distinguished crack cocaine in the Anti-Drug Abuse Act of 1988 by creating a mandatory minimum penalty for possession. This is the only federal mandatory minimum for a first offense of possession of a controlled substance. Under law, possession of more than five grams of crack cocaine is punishable by a minimum five years in prison. Simple possession (without the intent to distribute) of any quantity of powder cocaine by first-time offenders is a misdemeanor punishable by no more than one year in prison.
Overall, cocaine is a highly addictive drug. Most overdoses hospitals encounter entail people suffering from cocaine abuse. Due to this fact I would definitely recommend special education to teens in high school. Education at an earlier age has the potential to prevent a person from becoming an abuser at a later age. Knowing the effects and the origin of any drug is important because it might affect you differently than another individual.
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