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What are the medical complications
of cocaine abuse?
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 and
nausea.
Cocaine 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
and coma.
Different 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.
Research 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. 
Source: National Institute on Drug Abuse
Research Report Series 1999
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