Drug Abuse: Cocaine

“I was making frequent use of cocaine at that time … I had been the first to recommend the use of cocaine, in 1885, and this recommendation had brought serious reproaches down on me.”    ― Sigmund Freud.

The worldwide famous love affair between S. Freud and Cocaine was a rare incident of no dependence. More commonly this love affair consumes the person and destroys their life. Cocaine has been around for thousands of years, it’s derived from small leaves of the cocoa shrub in rainforests in South America. The culture of chewing cocaine leaves, which contains 2% cocaine, goes back to the Inca civilization. Even to this day, chewing cocoa leaves is part of the culture in that region, though due to the low cocaine content there’s very few instances of toxicity or abuse.

These cocaine leaves were originally brought to Europe in the 1500’s, but they didn’t gain any popularity and were put away for three hundred years. In 1859, a German Chemist Alfred Niemann, isolated the active ingredient of the cocoa plant after observing its anesthetic effect on his tongue.

Brief History of Coca Cola:

In 1863 a Corsican Chemist and Businessman, Angelo Mariani, mixed coca and wine. Mixing cocaine with alcohol increases its half-life, giving it a more elongated and intoxicating effect. Soon enough “Vin Mariani” became a worldwide sensation. Celebrities all over the world started promoting this drink, even the sculptor of The Statue of Liberty, Frederic Bartholdi, said that if he was drinking Vin Mariani The Statue of Liberty would have been three times taller. In the USA John Pemberton, an Atlanta pharmacist, was promoting a similar drink called French Wine Cola. In 1885 he substituted wine with soda water, added syrup of the African Kola nut containing about 2% caffeine. Thus Coca-Cola was born. In around 1903 coca leaves were switched with decocainized coca leaves, which retained the coca flavor but took out the harmful ingredient, the same soda we drink today.

Though effects of cocaine depend on the person’s expectations, the purity of the substance, and the route of administration, there are some features that remain the same. If cocaine is injected via the vein, the energy rush is felt within seconds, peaking in four minutes and wearing off in thirty to forty minutes. If snorted through the nose, the effect is felt in about three minutes, peaking in twenty minutes, and wearing off in sixty to ninety minutes. The users experience a general sense of well-being and euphoria, but sometimes cocaine could trigger a panic attack. When cocaine starts to wear off, the mood of of the user changes drastically, becoming irritable, despondent, and depressed. This kind of aftermath is what creates a craving for another dose. This type of depression could lead to suicide, because of which cocaine, especially if mixed with alcohol, has become recognized as a significant risk factor for suicide attempts. “The research team looked at nearly 900 suicidal men and women admitted to emergency departments between 2010 and 2012. After controlling for confounding variables, they found that the combination of cocaine and alcohol use led to an increased risk of patients attempting suicide again in the following year.”

Cocaine produces a quick elevation in the sympathetic branch of the autonomic nervous system. Heart rate and respiration are increased, and appetite is diminished. Blood vessels compress, pupils in the eyes dilate, and blood pressure rises. The powerful sympathetic changes may lead to a cerebral hemorrhage or heart failure. In extreme cases cocaine may also inhibit the parasympathetic system, adversely affecting behavior. In car accidents where drivers were under the influence, they exhibited over confidence in their abilities.

Chronic use of cocaine produces undesirable mood changes, making users irritable, depressed, and paranoid. It can produce hallucinatory sensations, such as “cocaine bugs” where people often scratch the skin into open sores or even pierce themselves with knives to cut out the imaginary creatures. These hallucinations combined with paranoia and anxiety make up a serious mental disorder called cocaine psychosis.

Medical uses of cocaine are limited to rubbing it on the skin, blocking the transmission of nerve impulses, deadening all sensations in the area. But there’s potential dangers. If cocaine enters the bloodstream then it might lead to cocaine abuse, and cocaine doesn’t act as an anesthetic for a long time.

Cocaine greatly enhances the activity of dopamine, and also norepinephrine to a lesser extent. This effect blocks the reuptake process at the synapse, so the neurotransmitters stimulate the postsynaptic receptors to a greater degree. This causes the feeling of euphoria, since dopamine increases in the area of the brain which is responsible of pleasure and reinforcement. Chronic abuse of cocaine leads to the loss of about 20% of dopamine receptors over time. Resulting in decline in pleasure from any source, which might cause a relapse of drug use.

One feature of cocaine that makes it so different from other drugs is that chronic users develop a pattern of sensitization, or heightened responsiveness with respect to motor behavior and brain excitation. This phenomenon is called the kindling effect, making cocaine especially dangerous since it might set of brain seizures. As as result of the kindling effect, deaths from cocaine overdose may occur from relatively low dose levels.

How is cocaine made?

During the initial stages, coca leaves are soaked in various chemicals to extract cocaine from the plant. Then leaves are crushed and alcohol is percolated through them to remove extraneous matter. After some more treatments, the result is cocaine that is about 60% pure. This is coca paste, which can be applied to a cigarette and smoked.

An additional step to make this paste into a more popular type of cocaine, often called the “champagne of drugs”, is to oxidize it with acids and make it a water soluble drug. The result is a while powder, called cocaine hydrochloride, which is 99% pure cocaine and classified chemically as salt. This way, it can be either injected via a vein or snorted through the nose.

In the 1980’s new types of cocaine were introduced, free-base cocaine and crack cocaine. In free-base, the hydrochloride is removed from the salt of cocaine, waking it smokable. This way it enters the brain faster and produces a more intense effect. It’s very hard to get free-base since it need to be cleaned well not to leave any ether in, making it flammable.

Crack cocaine results in the same type of drug, though much cheaper. Cocaine is treated with baking soda, turning it into small rocks. When smoked, they produce a cracking noise while burning hence the name: crack.

Smoking cocaine is without question worse than snorting it, or even taking it through the vein. Inhaling high potency cocaine into the lungs, almost immediately goes to the brain setting a psychological and physiological dependence. People under the influence forget everything around them, and often in cravings neglect their basic instincts. While crack abuse remains a problem, the number of new crack users has decreased substantially, linked to the idea of being a “crack head” which is equated with being a loser.

Coming off cocaine is one of the hardest things to do. As said by one of the treatment experts: “Coming off cocaine is one of the most anguished, depressing experiences. I’ve watched people talk about coming off freebase and one of the things I notices was the nonverbal maneuvers they sue to describe it. It looks like they’re describing a heart attack. They have fists clenched to the chest. You can see that it hurts. THey can re-create that hurt for you because it’s a devastating event. They’ll do almost anything from crashing on cocaine. And on top of that they’ll do just about anything to keep their supply coming. Postcocaine anguish is a strong inducement to use again – to keep the pain away.”

The initial stage is detoxification and total abstinence: the cocaine user aims to achieve total withdrawal with the least physical and psychological discomfort. In the first 24-48 hours the withdrawal symptoms start to arise, causing severe depression, headaches, and irritability. It’s not easy for the abuser to go through this alone, because of which a lot of support is required. Whether its from a family member, friend, or a doctor, it’s recommended not to go through this experience alone. The chances of relapse are high, and little details can set it off. Seeing baby powder or flour might induce the cravings, since it will remind the user of the drug.

Cocaine is tremendously dangerous, and is recommended to be avoided at any cost. If you are addicted to the drug, or think you might be developing it, get in touch with others. It’s no shame in admitting that you have a problem, a shame would be to ruin your life because of this drug. You have a chance to live a normal life, so reach out to a professional, or someone you trust, and get back on the right road in life. I urge everyone to stay away from this drug, and help the ones in need.

****
Graphs and Works Cited:

“Studies Show Mixing Cocaine and Alcohol May Increase Suicide Risk.” The Treatment Center, 21 Sept. 2017, http://www.thetreatmentcenter.com/blog/mixing-cocaine-and-alcohol-may-increase-suicide-risk/.

Levinthal, Charles F. Drugs, Society, and Criminal Justice. Pearson, 2016.

Goode, Erich (2005). Drugs in American Society. New York: McGraw-Hill College.

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