Cocaine is a powerful central nervous system stimulant with effects similar to those of amphetamines. Cocaine abuse is not new to mankind. Cocaine hydrochloride which is the pure chemical of the product has been abused for more than a 100 years and coca leaves, which is the source of cocaine has been ingested for a thousand years.
There are two basic chemical forms of cocaine:
1- The hydrochloride salt - is a powdered form that dissolves in water and can be taken intravenously or intra-nasally (through the nose).
2- The freebase - is not a neutralised form and can be smoked.
Coke, C, snow, blow, or flake is common street terms used to call the white, crystalline powder form of cocaine. It is common to find cocaine mixed with other white, nonreactive substances such as cornstarch, talcum powder, or other stimulants such as amphetamines. Crack is a freebase form of cocaine that has been processed with ammonia or baking soda to remove the hydrochloride compound of cocaine hydrochloride. When the crack is smoked, the user experiences a high in less than 10 seconds, which made it very popular in the mid-1980s.
Cocaine can be chewed, snorted, injected, smoked, and mainlined. It is important to note that none of these methods are safe, and all of them can lead to overdoses and toxicity.
How Cocaine Affects your Body
Cocaine is capable of producing a feeling of pleasure and euphoria. Cocaine is also one of the most addictive drugs known to man. Cocaine blocks the reuptake of dopamine in nerve terminals. This increases dopamine levels in the nucleus accumbens, which is one of the main pleasure centers in the brain. The pleasure associated with food, water, sex, and drugs of abuse cause increased activity in the nucleus accumbens. When cocaine is used, a pleasurable feeling is felt by direct stimulation of the nucleus accumbens.
With continued use, tolerance develops. Higher and higher doses of cocaine are required to achieve the same level of pleasure experienced previously.
3. Obstetric complications such as miscarriage, placental abruption, and premature labor.
Addiction to Cocaine
Cocaine’s ability to stimulate the reward centers of the brain makes it one of the most addictive drugs. Some of the effects of cocaine addiction are given below.
Crash Symptoms - experienced when cocaine effects remove - These symptoms usually resolve in 24 hours:
• Dysphoria - abnormal depression
• Anhedonia - the inability to feel pleasure
• Anxiety, irritation, fatigue, and hypersomnolence (increased sleepiness)
After prolonged use the symptoms are more severe:
• Intense craving
• Severe suicidal tendencies
Treating Cocaine Abuse
Cocaine addiction is one of the most difficult to treat due to intense cravings. Relapses and urges to use can occur after months or years when exposed to social cues.
Medical practitioners focus on treating the addiction with a holistic approach and treating the medical complications one by one. Acute intoxications require sedation and, in some cases, antipsychotic agents. Seizures and hypertension should be managed as well.
The treatment of cocaine dependence starts with psychological and social support including motivation, awareness programs, and counseling. Heavy users with stronger dependence require a rehabilitation center or a separate residential setting.
1- Harrison, P. Shorter Oxford textbook of psychiatry (6th ed., pp. 478-479)
2- Www1.nyc.gov. 2020. Cocaine Abuse & Addiction. [online] Available at: <https://www1.nyc.gov/site/doh/health/health-topics/cocaine-abuse-and-addiction.page> [Accessed 3 October 2020].
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