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Cocaine is
a powerfully addictive drug of abuse. Once having tried cocaine,
an individual cannot predict or control the extent to which he or
she will continue to use the drug.
The major routes of administration of cocaine are sniffing or snorting,
injecting, and smoking (including free-base and crack cocaine).
Snorting is the process of inhaling cocaine powder through the nose
where it is absorbed into the bloodstream through the nasal tissues.
Injecting is the act of using a needle to release the drug directly
into the bloodstream. Smoking involves inhaling cocaine vapor or
smoke into the lungs where absorption into the bloodstream is as
rapid as by injection.
"Crack" is the street name given to cocaine that has
been processed from cocaine hydrochloride to a free base for smoking.
Rather than requiring the more volatile method of processing cocaine
using ether, crack cocaine is processed with ammonia or sodium bicarbonate
(baking soda) and water and heated to remove the hydrochloride,
thus producing a form of cocaine that can be smoked. The term "crack"
refers to the crackling sound heard when the mixture is smoked (heated),
presumably from the sodium bicarbonate.
There is great risk whether cocaine is ingested by inhalation (snorting),
injection, or smoking. It appears that compulsive cocaine use may
develop even more rapidly if the substance is smoked rather than
snorted. Smoking allows extremely high doses of cocaine to reach
the brain very quickly and brings an intense and immediate high.
The injecting drug user is at risk for transmitting or acquiring
HIV infection/ AIDS if needles or other injection equipment are
shared.
Short-term effects
of cocaine
Increased energy
Decreased appetite
Mental alertness
Increased heart rate
Increased blood pressure
Constricted blood vessels
Increased temperature
Dilated pupils
Long-term effects
of cocaine Addiction
Irritability
Mood disturbances
Restlessness
Paranoia
Auditory hallucinations
Health Hazards
Cocaine is a strong central nervous system stimulant that interferes
with the reabsorption process of dopamine, a chemical messenger
associated with pleasure and movement. Dopamine is released as part
of the brain's reward system and is involved in the high that characterizes
cocaine consumption.
Physical effects of cocaine use include constricted peripheral
blood vessels, dilated pupils, and increased temperature, heart
rate, and blood pressure. The duration of cocaine's immediate euphoric
effects, which include hyperstimulation, reduced fatigue, and mental
clarity, depends on the route of administration. The faster the
absorption, the more intense the high. On the other hand, the faster
the absorption, the shorter the duration of action. The high from
snorting may last 15 to 30 minutes, while that from smoking may
last 5 to 10 minutes. Increased use can reduce the period of stimulation.
Some users of cocaine report feelings of restlessness, irritability,
and anxiety. An appreciable tolerance to the high may be developed,
and many addicts report that they seek but fail to achieve as much
pleasure as they did from their first exposure. Scientific evidence
suggests that the powerful neuropsychologic reinforcing property
of cocaine is responsible for an individual's continued use, despite
harmful physical and social consequences. In rare instances, sudden
death can occur on the first use of cocaine or unexpectedly thereafter.
However, there is no way to determine who is prone to sudden death.
High doses of cocaine and/or prolonged use can trigger paranoia.
Smoking crack cocaine can produce a particularly aggressive paranoid
behavior in users. When addicted individuals stop using cocaine,
they often become depressed. This also may lead to further cocaine
use to alleviate depression. Prolonged cocaine snorting can result
in ulceration of the mucous membrane of the nose and can damage
the nasal septum enough to cause it to collapse. Cocaine-related
deaths are often a result of cardiac arrest or seizures followed
by respiratory arrest.
Medical consequences
of cocaine abuse Cardiovascular effects
disturbances in heart
rhythm heart attacks
Respiratory effects
chest pain
respiratory failure
Neurological effects
strokes
seizures
headaches
Gastrointestinal effects
abdominal pain
nausea
Source: National Institute on Drug Abuse
Research Report Series 1999
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