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addiction is one of society's greatest problems today. Individuals
addicted to cocaine will do almost anything to get the drug.
It has penetrated all levels of our society, rich, poor,
and everyone in between. Family members connected to cocaine
addicts live in chaos and confusion. Not understanding the
underlying mechanics of cocaine addiction.
What is Cocaine?
A) Cocaine is derived from the leaves of the coca bush, which
grows in South America. Cocaine has been used for centuries
by Indians to combat the effects of hunger, hard work, and thin
air, in the mid 1800s its effects were praised by Freud, among
others. Until 1906, this substance was a chief ingredient of
Coca-Cola and was also used as an anesthetic. Widespread use
and addiction led to government efforts against cocaine in the
early 1900s. The danger associated with cocaine was ignored
in the 1970s and early 1980s, and cocaine was proclaimed by
many to be safe. With the accumulating medical evidence of cocaine's
deleterious effects and the introduction and widespread use
of cocaine, the public and government have become alarmed again
about its growing use. To many Americans, especially health
care and social workers who deal with cocaine users and have
witnessed the personal and societal devastation it produces,
cocaine addiction is, by far, the most serious drug problem
in the United States.
How is cocaine used?
There are four primary methods of ingesting cocaine. These are:
"Snorting" - absorbing cocaine through the mucous
membranes of the nose.
Injecting - users mix cocaine powder with water and use a syringe
to inject the solution intravenously.
Freebasing - Cocaine hydrochloride is converted to a "freebase"
which can then be smoked.
Crack Cocaine - Cocaine hydrochloride is mixed with ammonia
or sodium bicarbonate (baking soda) and other ingredients, causing
it to solidify into pellets or "rocks". The crack
is then smoked in glass pipes.
How widespread is cocaine addiction?
1997, an estimated 1.5 million Americans (0.7 percent of those
age 12 and older) were current cocaine users, according to the
1997 National Household Survey on Drug Abuse (NHSDA). This number
has not changed significantly since 1992, although it is a dramatic
decrease from the 1985 peak of 5.7 million cocaine users(3 percent
of the population). Based upon additional data sources that
take into account users underrepresented in the NHSDA, the Office
of National Drug Control Policy estimates the number of chronic
cocaine users at 3.6 million.
18 to 25 years old have a higher rate of current cocaine use
than those in any other age group. Overall, men have a higher
rate of current cocaine use than do women. Also, according to
the 1997 NHSDA, rates of current cocaine use were 1.4 percent
for African Americans, 0.8 percent for Hispanics, and 0.6 percent
Cocaine remains a serious problem in the United States. The
NHSDA estimated the number of current cocaine users to be about
604,000 in 1997, which does not reflect any significant change
1998 Monitoring the Future Survey, which annually surveys teen
attitudes and recent drug use, reports that lifetime and past-year
use of cocaine increased among eighth graders to its highest levels
since 1991, the first year data were available for this grade.
The percentage of eighth graders reporting cocaine use at least
once in their lives increased from 2.7 percent in 1997 to 3.2
percent in 1998. Past-year use of cocaine also rose slightly among
this group, although no changes were found for other grades.
from the Drug Abuse Warning Network (DAWN) showed that cocaine-related
emergency room visits, after increasing 78 percent between 1990
and 1994, remained level between 1994 and 1996, with 152,433
cocaine-related episodes reported in 1996.
Why would anyone become addicted to cocaine?
The effects of cocaine are immediate, extremely pleasurable,
and brief. Cocaine produce intense but short-lived euphoria
and can make users feel more energetic. Like caffeine, cocaine
produces wakefulness and reduces hunger. Psychological effects
include feelings of well-being and a grandiose sense of power
and ability mixed with anxiety and restlessness. As the drug
wears off, these temporary sensations of mastery are replaced
by an intense depression, and the drug abuser will then "crash",
becoming lethargic and typically sleeping for several days.
What are the physical effects of cocaine addiction?
Even though the public is often regaled with highly publicized
accounts of deaths from cocaine, many still mistakenly believe
the drug, especially when sniffed, to be nonaddictive and not
as harmful as other illicit drugs. Cocaine's immediate physical
effects include raised breathing rate, raised blood pressure
and body temperature, and dilated pupils.
causing the coronary arteries to constrict, blood pressure rises
and the blood supply to the heart diminishes. This can cause
heart attacks or convulsions within a hour after use. Chronic
users and those with hypertension, epilepsy, and cardiovascular
disease are at particular risk. Studies show that even those
with no previous heart problems risk cardiac complications from
cocaine. Increased use may sensitize the brain to the drug's
effects so that less of the substance is needed to induce a
seizure. Those who inject the drug are at high risk for AIDS
and hepatitis when they share needles. Allergic reactions to
cocaine or other substances mixed in with the drug may also
What are the short term effects of cocaine?
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. Short-term effects of cocaine
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
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 behavior. 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?
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. Long-term effects of cocaine Addiction
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
anesthetic and convulsant effects, without increasing the dose
taken. This increased sensitivity may explain some deaths occurring
after apparently low doses of cocaine.
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 use?
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
consequences of cocaine abuse:
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
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.
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.
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 centers. 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.
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 neighboring 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 buildup of dopamine
causes continuous stimulation of receiving neurons, probably
resulting in the euphoria commonly reported by cocaine abusers.
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.
Are there any other problems that can occur from cocaine addiction?
Cocaine can cause feelings of anxiety and depression, which
may last for weeks. Attempts to stop using the drugs can fail
simply because the resulting depression can be overwhelming,
causing the addict to use more cocaine in an attempt to overcome
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