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February 2019: Cocaine Addiction

Cocaine Withdrawal

Cocaine is a strong central nervous system stimulant which interferes with the re-absorption of dopamine to create a “high” from the surplus of positive chemicals in the brain. Normally dopamine is self-regulated in the brain and is recycled back into the cells that released it. When that re-absorption is disrupted by Cocaine, the flood of positive “feel-good” chemicals reinforces drug-taking behaviors

Cocaine withdrawal can be challenging and draining. Although there are no visible physical symptoms, such as vomiting and shaking that accompany withdrawal from heroin or alcohol, there are withdrawal symptoms that vary in severity. The cessation of Cocaine use is followed by an immediate “crash” with symptoms that include:

  • fatigue & sleepiness
  • agitation
  • lack of joy or pleasure
  • suicidal thoughts
  • cravings
  • In some cases paranoia 

These typically subside after about seven to ten days, although cravings for Cocaine may last years and recur suddenly. There are no FDA-approved drugs approved to treat Cocaine withdrawal although there are medications that can assist with mood stabilization. 

Affects of Chronic Cocaine Use

Cocaine carries serious health risks, both short and long-term. The initial high is short-lived and depends on the method of drug delivery. Snorting cocaine has a longer effect, generally thirty minutes or less but is less intense than smoking. A high from smoking may last only five to ten minutes but the drug is absorbed faster into the bloodstream for greater intensity. Users of cocaine may experience the following with their high:

  • Restlessness & irritability
  • Anxiety & paranoia
  • Psychosis & hallucinations
  • Unpredictable violent or aggressive behavior

Long-term Cocaine use can cause cardiovascular, respiratory, brain, and other physical damage. It’s important to get help immediately in overcoming an addiction to cocaine to minimize long lasting bodily harm and complications. 

Cardiovascular Damage

Cocaine is referred as the “perfect heart-attack drug” as users have been shown to have higher rates of aortic stiffening,  increased systolic blood pressure, and increased thickness of heart’s left ventricle wall – all factors associated with higher risks of heart attack and stroke. Additional risks include changes in body temperatureheart rate, arrhythmias, atherosclerosis, and microvascular disease – a condition where the small arteries in the heart are damaged causing the signs and symptoms of heart disease. 

Respiratory Damage

The smoking of cocaine or “crack”, as opposed to snorting cocaine (which can lead to spontaneous perforation of the nasal septum), is more likely to lead to serious respiratory damage. Studies have found that repeated direct exposure of the lungs to Cocaine can cause: “interstitial pneumonitis, fibrosis, pulmonary hypertension, alveolar hemorrhage, asthma exacerbation, barotrauma, thermal airway injury, hilar lymphadenopathies, and bullous emphysema”. 

Chronic users may also develop “crack lung” a way to describe one of the respiratory complications that can arise from smoking crack cocaine. The capillaries in the lungs hemorrhage leading to severe coughs or trigger respiratory failure. It usually presents within 48 hours after Cocaine inhalation and is a potentially fatal. 

Quick Facts on Cocaine

2017 reported Cocaine use in the past month (0.8%), and lifetime use (14.9%) in the U.S. both increased compared to 2016 data. (SAMHSA)

There were 13,942 overdoses involving Cocaine in 2017, more than double the 6,512 overdoses in 2007. (NIDA)

The 2018 Monitoring the Future Study reported 3.9% of twelfth grade students had used cocaine in their lifetime, 2.3% in the last year, and 1.1% in the last month. (NIDA)

In 2017, an estimated 2.2 million people aged 12 or older were current users of cocaine. (SAMHSA)

Almost 15% of people ages 12 and older have tried Cocaine in their lifetime according to the National Survey on Drug Use and Health in 2017. 

Signs of Cocaine Use

Cocaine is a strong central nervous system stimulant which interferes with the re-absorption of dopamine to create a “high” from the surplus of positive chemicals in the brain. Normally dopamine is self-regulated in the brain and is recycled back into the cells that released it. When that re-absorption is disrupted by Cocaine, the flood of positive “feel-good” chemicals reinforces drug-taking behaviors

There are numerous studies and articles that talk about how Cocaine is highly addictive. Some may have read about the study where rats chose cocaine over food.  While it’s true that Cocaine produces an immediate euphoria, the drug affects other parts of the brain in ways that imprint the euphoria into memory. Cocaine affects the limbic system, which includes the area of the brain that acts as memory centers. Studies have shown, “when someone experiences a cocaine high, these regions imprint memories of the intense pleasure as well as the people, places, and things associated with the drug. From then on, returning to a place where one has taken cocaine or merely seeing images of cocaine-related paraphernalia triggers emotionally loaded memories and desire to repeat the experience.” 

Long-Term Brain Damage

Long-term Cocaine use has been linked to accelerated age-related decreases in grey matter in the brain – essentially accelerating the natural deterioration that occurs over time. 

Cocaine users may risk brain hemorrhage 20 years earlier than non-drug users. 

Abusing Cocaine may increase the risk of developing Parkinson’s Disease

NIDA supported researchers completed a study which found that Cocaine abuse resulted in long-term impaired mental and physical functioning including delayed memory, reaction time, and calculation ability. 

Frequently Asked Questions

What is Cocaine?

Cocaine refers to a drug derived from the coca plant native to South America. For thousands of years native people in South America would chew the coca leaves for their therapeutic stimulant properties. In the 1900’s Cocaine was used and developed as a painkiller. Today, Cocaine is a Schedule II drug which the DEA describes as highly addictive with use potentially leading to severe psychological or physical dependence. Schedule II drugs are considered dangerous and are highly regulated, used only for legitimate medical purposes. 

Either in powder or crystal form, Cocaine is often mixed with additives (some of which can be incredibly dangerous). It has become a common illegal drug with various street names including: blow, coke, crack, flake, icing, nose clams, snow, snow white, tardust, and white powder. “Crack” is the crystal form of Cocaine, which is normally a white powder. It is heated then smoked and received its street name from the crackling sound heard when heated. The differences between crack and cocaine are minor, although crack is generally viewed as more potent as it impacts the bloodstream more quickly resulting in a more potent although shorter lived high. This difference is due to how the drug enters the body, as opposed to chemical composition. 

How does Cocaine affect the brain?

Cocaine is a strong central nervous system stimulant which interferes with the re-absorption of dopamine to create a “high” from the surplus of positive chemicals in the brain. Normally dopamine is self-regulated in the brain and is recycled back into the cells that released it. When that re-absorption is disrupted by Cocaine, the flood of positive “feel-good” chemicals reinforces drug-taking behaviors

Long-term cocaine use has significant negative impacts on the brain including accelerated grey matter degradation, greater risk of brain hemorrhage, risk of developing Parkinson’s disease, and long-term mental and physical deficits. 

How addictive is Cocaine?

The Center for Substance Abuse Research very clearly states that when it comes to smoking crack cocaine, a person can become addicted after his or her first time trying the drug. While there are no shortage of articles about how cocaine is addictive, it primarily has this affect because of how the drug affects the limbic system in the brain. The limbic system contains the parts of our brian that hold the memory centers, and the euphoria experienced during the high is imprinted in the mind. Thereafter, returning to a place or even seeing images of cocaine can trigger memories and cravings

How is Cocaine addiction treated?

The majority of individuals seeking addiction treatment for cocaine are polydrug users meaning they use cocaine and additional drugs. While there are not currently any FDA approved drugs to treat cocaine addiction, therapy and clinical interventions can be effective. It’s also important to understand that frequent cocaine use has the affect of altering the mind and body, in some cases permanently. Specialized addiction treatment centers can help address individual, family, and social components, and provide treatment in a safe and sober environment which may be helpful for individuals who have tried to get clean on their own unsuccessfully in the past. Comprehensive addiction treatment centers also have the capability to address any co-occurring mental health disorder that may be contributing to drug use. 

Cocaine Use On The Rise

Cocaine use in the United States has seen a recent resurgence that broke records in 2015 and has continued to rise. The greatest contribution to Cocaine’s increase in use and popularity may in fact simply be its availability. In terms of Cocaine’s use, the 2015 NSDUH survey estimated a 26% increase in people aged 12 and older who tried Cocaine for the first time compared with 2014, and a 61% increase compared with 2013. In 2015, just under one million people in the United States (0.4% of the population) tried Cocaine.

Over the same period, Columbia’s Cocaine crop yield doubled between 2013 and 2015 to a total almost twice as much as the second and third largest producers. The production has since continued to break records annually. In 2017, there was enough cultivation to produce 1,520 tons of Cocaine which was a 31% increase compared to 2016.

The increase in Cocaine use has also resulted in an increase in Cocaine overdoses over the last five and ten years. In 2017 there were 13,942 overdoses involving Cocaine use compared to only 6,512 in 2007, a more than 100% increase over the decade. Cocaine addiction is dangerous and has lasting negative effects on the body. It’s important if you have a cocaine addiction to receive treatment quickly to avoid the long-term negative effects Cocaine has on the lungs, heart, and brain.

Risks of Cut Cocaine

Cocaine is one of the most expensive illicit drugs. It can be altered or “cut” with other drugs or substances. The additive allows the seller to increase their profit and this can occur at any and all stages of the drug supply. The average purity of English Cocaine is reported to be no more than 20% to 30%

While some additives can be seen as diluents, others are adulterants which themselves have an effect and cause a mental or physical bodily reaction. Some of these adulterants can be incredibly harmful and have caused deathsOne of more dangerous and common adulterants is Levamisole, a drug used by farmers to deworm livestock. The drug underwent clinical trials for treating cancer and autoimmune disorders and approximately 10% of patients patients in the trial developed agranulocytosis – a condition which has an effect similar to AIDS where the immune system is crashed catastrophically. A simple infection can become life-threatening without an effective immune system.  

In 2011, U.S. Drug Enforcement Administration (DEA) estimated that 82% of seized cocaine contained levamisole, an increase from 1.9% in 2005.

Other additivies include: acetaminophen, amphetamine or methamphetamine, caffeine, corn starch, fentanyl, lead, lidocaine, phenacetin, sodium bicarbonate, and sugar.

 

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