Major insights on Nature of the drug Cocaine and Health Hazards: 6 Important Factors
Introduction
Cocaine, also known as coke is a strong stimulant and is most commonly consumed by addicts as a recreational drug. It is named after the coca plant from which it is isolated. The leaves of the coca plant have been used by Peruvians since ancient times. Cocaine was first isolated from the leaves in 1860. A recreational drug is named as such as it is consumed in recreational settings such as bars, pubs and clubs and also in any kind of public gathering. Common methods of consuming the drug include inhaling it in a powdered form as smoke, injecting it directly in the vein by dissolving it or consuming it in a liquified form. It is addictive as it creates a reward pathway in the brain. There is a high risk of dependence after use for a short period of usage. Its use also increases the risk of stroke, myocardial infarction, lung problems in those who smoke it, blood infections, and sudden cardiac death. Cocaine sold on the street is commonly mixed with local anesthetics, cornstarch, quinine, or sugar, which can result in additional toxicity. Following repeated doses, a person may have decreased ability to feel pleasure and become extremely tired.
Cocaine leads to inhibiting of the reuptake of three major neurotransmitters in the brain namely, norepinephrine, dopamine and serotonin. As a result, the concentration of these three neurotransmitters increases in the brain. It can quite easily cross the blood-brain barrier and lead to a breakdown of the barrier. Crack cocaine is said to be produced from cocaine itself after proper processing. Followed by Cannabis, cocaine is the second most illegally consumed drug across the world. Between 14 and 21 million people use the drug each year. High doses can result in very high blood pressure or body temperature. Effects begin within seconds to minutes of use and last between five and ninety minutes. Cocaine has a small number of accepted medical uses such as numbing and decreasing bleeding during nasal surgery. Mental effects may include loss of contact with reality, an intense feeling of happiness, or agitation. Physical symptoms may include a fast heart rate, sweating, and large pupils.
Production and Processing of Cocaine
Cocaine is extracted and processed from the coca plants in South America on the Andes mountains and also in lowland jungles of Colombia. Cocaine is most commonly produced in Bolivia, Peru and Colombia. These are the countries where the coca plant can be naturally grown in sufficient quantities in order to produce large quantities of cocaine drug. The coca plants grown in Colombia produce less cocaine as compared to those grown in Peru and Bolivia and so the harvest of the coca plants is more in the latter locations. Coca plants are grown, refined, and processed in local areas, often in protected sites such as native reserves, national parks, and areas along the border, which are off-limits to aerial spraying efforts to kill the crops. Cocaine, as the world knows it, is actually cocaine hydrochloride. There are 1 of 14 alkaloids that naturally occur in the coca plant. Out of over 200 plant species, there are only 2 types of coca leaves that contain enough cocaine alkaloid for cocaine production. Generally, coca leaves can be harvested 3-6 times a year. But in some areas, the coca leaf can be harvested up to 8 times a year, depending upon where the plant is grown and the specific species.
Various methods are used for cocaine production. One of the methods used is by soaking dried coca leaves with lime water or other alkaline liquids and then extracting them with kerosene in metal drums. Workers use sulfuric acid to extract the dissolved cocaine and form a liquid solution to which lime is added, leading to precipitation of coca paste.
Workers then add acid and potassium to remove impurities, followed by a bicarbonate, to cause the base to separate. The base is further dissolved in a solvent like acetone and then soaked again in acid. Finally, the cocaine paste is filtered through a cloth to separate and then dried.
Another method used for cocaine production involves dissolving the base in acetone, ether or ethyl acetate and then heating it in a bath of hot water. Methyl ethyl ketone is another solvent that workers add to the hot liquid mixture, along with hydrochloric acid, leading to cocaine hydrochloride crystallizing in the solution. Solvents are pressed out by hand, followed by a hydraulic press, then the mixture is heated in a microwave to create cocaine powder.
It takes about 450-600 kilograms of fresh Colombian coca leaves to create 1 kilogram of cocaine base. The cocaine base can then be converted into a kilogram of cocaine hydrochloride or powdered cocaine. However, this amount differs with other species of coca leaves, since one species has higher levels of cocaine alkaloid and requires fewer leaves to create cocaine base.
Common Reasons for Consumption of Cocaine
Cocaine is an addictive substance which is commonly abused not only in India or in Gujarat, but across the world in different nations and continents. There are several reasonings attached to regular usage of cocaine among addicts, which include the significant ‘high’ feeling experienced after consuming the drug which stimulates pleasurable feelings of happiness, a fantasized perception of reality, boosted confidence and a joyous feeling of excitement and thrill.
In order to constantly remain in a joyous state and distort oneself from the harsh reality of the world and relieve themselves from all sorts of stress, anxieties or pressure about their prevailing situations and responsibilities on their heads. The consumption of cocaine is considered as a temporary distortion from reality and easing of one’s grief, stress and anxiety so that they might come out stronger and positive while facing the problems. But, in the process of consuming small amounts regularly, people do not realize how easily have they become dependent on the drug and simply cannot do without a particular amount of the drug. Since the body is believed to have developed a certain tolerance level for the drug, it simply cannot function unless the desired amount is consumed.
All these factors contribute easily to drug addiction and substance abuse disorders and also lead to cases of drug overdose leading to paralysis or even death of the individual. Some other individuals who are supposed to be at risk on becoming cocaine addicts are those experiencing symptoms of depression such as excessive guilt, helplessness, loss of motivation and hope and thus they undertake the path of drug addiction. Individuals having a family history of cocaine dependency and abuse, depression, suicidal tendencies and frequent stress between family members also are highly vulnerable of cocaine addiction.
Cocaine consumption is like a habit formation, once one gets the habit of consuming it regularly, one simply cannot stop consuming it and in turn demands higher amounts day by day to get the desired effects of being ‘high’.
Health Problems related to Cocaine Consumption/Addiction
With excessive or prolonged use, cocaine abuse can cause itching, fast heart rate, hallucinations, and paranoid delusions or sensations of insects crawling on the skin. Overdoses may cause abnormally high body temperature and a marked elevation of blood pressure, which can be life-threatening, abnormal heart rhythms, and death.
Anxiety, paranoia, and restlessness can also occur, especially during the comedown. With excessive dosage, tremors, convulsions and increased body temperature are observed. Severe cardiac adverse events, particularly sudden cardiac death, become a serious risk at high doses due to cocaine’s blocking effect on cardiac sodium channels.
Physical side effects from chronic smoking of cocaine include coughing up blood, bronchospasm, itching, fever, diffuse alveolar infiltrates without effusions, pulmonary and systemic eosinophilia, chest pain, lung trauma, sore throat, asthma, hoarse voice, dyspnea (shortness of breath), and an aching, flu-like syndrome. Cocaine constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure. It can also cause headaches and gastrointestinal complications such as abdominal pain and nausea. A common but untrue belief is that the smoking of cocaine chemically breaks down tooth enamel and causes tooth decay.
Cocaine may also greatly increase the risk of developing rare autoimmune or connective tissue diseases such as lupus, Goodpasture syndrome, vasculitis, glomerulonephritis, Stevens–Johnson syndrome, and other diseases. It can also cause a wide array of kidney diseases and kidney failure. Cocaine use leads to an increased risk of hemorrhagic and ischemic strokes. Cocaine use also increases the risk of having a heart attack.
The various means of using this illicit drug can produce different adverse reactions:
- Snorting the powder can lead to loss of the sense of smell, nosebleeds, problems with swallowing, hoarseness, and a chronically runny nose.
- Ingesting it can cause severe bowel gangrene (tissue death) due to reduced blood flow.
- Injecting the drug can lead to severe allergic reactions and, as with all drug users, an increased risk for contracting HIV, viral hepatitis and other blood-borne diseases.
Myths and Facts related to Cocaine
Myth: It takes a long time to get hooked on cocaine.
Fact: All forms of the drug are highly addictive. Some people can become addicted after a short period of use.
Myth: Cocaine is a safe drug.
Fact: Cocaine, in all forms, has the potential for serious and dangerous effects on both the body and the mind.
Myth: Cocaine has no side effects.
Fact: Cocaine, particularly at high doses, can cause tremors and convulsions (seizures), infection, heart attack, stroke, psychosis, and death.
Myth: Cocaine makes you a better athlete or worker.
Fact: Chronic use of cocaine can seriously harm your body and your athletic performance. It can also cost you your job.
Myth: Cocaine makes sex better.
Fact: Cocaine can cause increased sexual activity, which can lead to high-risk sex (multiple partners, unprotected sex). Heavy use of cocaine can lead to impotence and loss of interest in sex.
Myth: Using cocaine a few times is no big deal.
Fact: Even a few uses can result in addiction, trouble with the law, or serious medical problems — even death.
Myth: It’s always safe and doesn’t cause hangovers.
Fact: This white powder is commonly thought of as pure, but little do most users realize that it is cut with hundreds of processing agents as it changes hands from supplier to dealer and so forth. You never actually know what you’re getting and because of the supply and demand, dealers are known to “stomp” it with things such as baking powder, vitamin B, cleaning products and unidentified diluting powders, thus making each use an unpredictable gamble.
The same goes for crack, the smokable form of cocaine. It is filled with just as many impurities, and whether the drug is smoked, snorted or injected, the user can never be certain what they are ingesting. No matter what, the aftermath of using cocaine causes your body and mind to crash, which actually is its unique version of a hangover.
Moreover, cocaine and crack use can lead to tremendous health complications such as heart disease, strokes, seizures and many other dangerous side effects including death.
Most people who use cocaine don’t realize that rather than it solving problems like these promising myths, it usually tends to create new ones while failing miserably to solve old ones.
Myth: Cocaine is a glamorous drug.
Fact: While television and other media tend to make cocaine seem like a drug of the rich and famous, as it is portrayed as life in the fast lane, what they don’t typically show is the devastating effects it can have on a person’s life.
The lifestyle surrounding a cocaine addict becomes very habitual. It has been known to lead to the loss of health, jobs, families and homes as it can tarnish a reputation very quickly and is an expensive habit that is hard on finances.
Data on Cocaine Addiction
The most recent statistics show that international seizures of cocaine have continued to increase and now total 756 metric tons, with the largest quantities of the drug intercepted in South America, followed by North America.
According to the European Monitoring Centre on Drugs and Drug Addiction, cocaine is also the second most commonly used illegal drug in Europe. Among young people (15 to 34 years), an estimated 7.5 million have used cocaine at least once in their life, 3.5 million in the last year and 1.5 million in the past month.
In the United States, the 2006 National Survey on Drug Use and Health reports that 35.3 million Americans aged 12 and older reported having used cocaine. Also that 8.6 million Americans aged 12 and older reported having used crack. Among those 18 to 25, 6.9% of those surveyed said they had used cocaine (including crack) within the last year. Among high-school students, 8.5% of twelfth graders had used cocaine at some point in their young lives, according to the 2006 Monitoring the Future Study by the National Institute for Drug Abuse.
In the United States, cocaine continues to be the most frequently mentioned illegal drug reported to the Drug Abuse Warning Network by hospital emergency departments. There were 448,481 emergency department visits involving cocaine reported in 2005.
The National Institute of Health (NIH) report the following statistics concerning addictive use of cocaine in the US:
- In 2014, there were an estimated 1.5 million current (past-month) cocaine users aged 12 or older (0.6 percent of the population)
- The age group most likely to abuse cocaine was adults ages 18 to 25.
- More men than women abuse cocaine.
- There were over 3,000 male overdose deaths and 1,000 female overdose deaths in 2014.
- Almost one-quarter of drug-related emergency room admissions were caused by or connected to cocaine abuse or addiction (more than 505,000 of the 1.2 million drug-related ER visits).
- Over one in three drug misuse or abuse-related emergency department visits (40 percent) that involved cocaine.
Why Cocaine shouldn’t be consumed by anyone and its harmful side effects and other uses
Common short-term psychological effects of cocaine include:
- Extreme happiness, elation
- Mental alertness
- Hypersensitivity to sight, touch, sounds
- Irritability
- Paranoia
- Talkativeness
When cocaine is smoked (in “crack” form), the effects can be stronger and quicker, but they don’t last as long. When cocaine is in its powder form and snorted, the high can last 15 to 30 minutes or longer.
Common short-term physical effects of cocaine include:
- Dilated pupils
- Fast or irregular heart beat
- Restlessness, shakiness, muscle twitches
- Nausea
- Constricted blood vessels
Common long-term health effects of cocaine use:
- Nosebleeds, loss of smell, sinus problems and problems with swallowing, especially for people who snort cocaine
- Respiratory conditions, including coughing, breathing problems, asthma, and pneumonia, especially for people who smoke cocaine
- Hepatitis C, HIV, and other blood-borne illnesses, especially for people who inject cocaine
Also, the withdrawal effects, especially depression and fatigue, from cocaine use can lead to addiction. As the high wears off, people use cocaine to counteract the symptoms. Cocaine use becomes a dangerous, vicious, and addictive cycle that is hard to stop. In order to avoid all these symptoms and the hazardous effects to harm and hinder one’s life’s well-being and state of equilibrium, one should not indulge in cocaine abuse or rather in any kind of drug abuse.
The only good thing about cocaine is that it is used for certain medical purposes such as in nasal sprays in order to reduce the amount of bleeding and it is also used for nasal and lacrimal duct surgery. The major disadvantages of this use are cocaine’s potential for cardiovascular toxicity, glaucoma, and pupil dilation. Medicinal use of cocaine has decreased as other synthetic local anesthetics such as benzocaine, proparacaine, lidocaine, and tetracaine are now used more often. If vasoconstriction is desired for a procedure (as it reduces bleeding), the anesthetic is combined with a vasoconstrictor such as phenylephrine or epinephrine. Some otolaryngology (ENT) specialists occasionally use cocaine within the practice when performing procedures such as nasal cauterization. In this scenario dissolved cocaine is soaked into a ball of cotton wool, which is placed in the nostril for the 10–15 minutes immediately before the procedure, thus performing the dual role of both numbing the area to be cauterized, and vasoconstriction. Even when used this way, some of the used cocaine may be absorbed through oral or nasal mucosa and give systemic effects. An alternative method of administration for ENT surgery is mixed with adrenaline and sodium bicarbonate, as Moffett’s solution.
Cocaine hydrochloride (Goprelto), an ester local anesthetic, was approved for medical use in the United States in December 2017, and is indicated for the introduction of local anesthesia of the mucous membranes for diagnostic procedures and surgeries on or through the nasal cavities of adults. Cocaine hydrochloride (Numbrino) was approved for medical use in the United States in January 2020.
The most common adverse reactions in people treated with Goprelto are headache and epistaxis. The most common adverse reactions in people treated with Numbrino are hypertension, tachycardia, and sinus tachycardia.
