Cocaine has been the drug of choice for the
wealthy and the artistic elite. It is a highly toxic substance that can
cause heart failure and death, even when taken in small doses. It also
regularly causes users to experience psychotic delusions.
Cocaine is a powerfully addictive drug that is
snorted, sniffed, injected, or smoked. Crack is cocaine that has been
processed from cocaine hydrochloride to a free base for smoking. Its
street names include coke, snow, flake, blow, and many others.
Cocaine is a stimulant drug. The powdered,
hydrochloride salt form of cocaine can be snorted or dissolved in water
and injected. Crack is cocaine that has not been neutralized by an acid
to make the hydrochloride salt. This form of cocaine comes in a rock
crystal that can be heated and its vapors smoked. The term "crack"
refers to the crackling sound heard when it is heated.
Regardless of how cocaine is used or how
frequently, a user can experience acute cardiovascular or
cerebrovascular emergencies, such as a heart attack or stroke, which
could result in sudden death. Cocaine-related deaths are often a result
of cardiac arrest or seizure followed by respiratory arrest.
Cocaine is a strong central nervous system
stimulant that interferes with the re-absorption process of dopamine, a
chemical messenger associated with pleasure and movement. The buildup
of dopamine causes continuous stimulation of receiving neurons, which
is associated with the euphoria commonly reported by cocaine abusers.
Physical effects of cocaine use include constricted blood vessels,
dilated pupils, and increased temperature, heart rate, and blood
pressure. The duration of cocaine's immediate euphoric effects, which
include hyper-stimulation, reduced fatigue, and mental alertness,
depends on the route of administration.
The faster the absorption of the drug, the more
intense the high. On the other hand, the faster the absorption, the
shorter the duration of action. The high from snorting might last 15 to
30 minutes, while that from smoking may last 5 to 10 minutes. Increased
use can reduce the period of time a user feels high and increases the
risk of addiction. Some users of cocaine report feelings of
restlessness, irritability, and anxiety. A tolerance to the "high" may
develop - many addicts report that they seek but fail to achieve as
much pleasure as they did from their first exposure.
Some users will increase their doses to intensify
and prolong the euphoric effects. While tolerance to the high can
occur, users can also become more sensitive to cocaine's anesthetic and
convulsive 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, may lead to a state
of increasing irritability, restlessness, and paranoia. This can result
in a period of full-blown paranoid psychosis, in which the user loses
touch with reality and experiences auditory hallucinations.
Other complications associated with cocaine use
include disturbances in heart rhythm and heart attacks, chest pain and
respiratory failure, strokes, seizures and headaches, and
gastrointestinal complications such as abdominal pain and nausea.
Because cocaine has a tendency to decrease appetite, many chronic users
can become malnourished. Different means of taking cocaine can produce
different adverse effects. Regularly snorting cocaine, for example, can
lead to loss of the sense of smell, nosebleeds, problems with
swallowing, hoarseness, and a chronically runny nose.
Ingesting cocaine can cause severe bowel gangrene
due to reduced blood flow. People who inject cocaine can experience
severe allergic reactions and, as with all injecting drug users, are at
increased risk for contracting HIV and other blood-borne diseases.
When people mix cocaine and alcohol, they are
compounding the danger each drug poses and are unknowingly forming a
complex chemical experiment within their bodies. NIDA-funded
researchers have found that the human liver combines cocaine and
alcohol and manufactures a third substance, cocaethylene that
intensifies cocaine's euphoric effects, while potentially increasing
the risk of sudden death.
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