Infamous as the worst

Cocaine is commonly comprehended to be the ‘most addictive’ and ‘most dangerous’ of all substance of abuse. Variously referred to as coke, snow, girl, lady; cocaine is a crystalline powder, which can be topically applied, ingested, inhaled or injected. Cocaine is derived from Erythoxylon coca, a shrub native to South America. It gives it its psychoactive qualities.

Many faces

Powder form is frequently rubbed along the gums and absorbed orally. The coca leaf is chewed like betel nut for its effect. The base form known as ‘freebase’ as well as a cheaper adulterated form called ‘crack’ is vaporized and then smoked. Insufflation is better termed as snorting or sniffling among drug users, where the fine powder is inhaled through the nose directly. Injection gives the quickest rush; when combined with heroin (known s speedball) it is highly lethal. Practice of anal and vaginal insertions (plugging) have also been reported.

The culprit’s act

Cocaine exerts its effects on the brain through the mesolimbic pathway where it stimulates the release of dopamine, the chief neurotransmitter responsible for experiencing reward. Cocaine also increases other neurochemicals noradrenaline and serotonin. It offers a sense of euphoria, physical vigor and amplified energy. The subjective proficiency and self-esteem get significantly raised too. However, in higher doses it leads to agitation, irritability, impaired judgment, impulsive and dangerous sexual behavior, and extremes of aggression.

Intense craving

The behavioral effects of cocaine appear almost immediately and usually last for a short time (20 to 40 minutes). The user needs to take frequent and larger doses in order to continue experiencing these euphoric effects. Oral use takes the longest to act, injectable, the least. Cocaine produces such euphoria that the brain can develop dependence with one use.

Severe withdrawal

Following the ‘high’ of cocaine intoxication, the crash of depression is 
associated with irritability, anxiety, sadness, fatigue, lack of
 drive and excessive sleeping. Usually all these symptoms subside 
in 14 to 18 hours but with heavy use this can last for weeks. 
Sometimes the depression may progress to suicidal intent. Unpleasant dreams are quite common along with slowing of thought. People who take cocaine truly know the intensity and severity of the withdrawal. They tend to medicate themselves with alcohol and sleeping pills but this only complicates the condition and then makes it poly-substance dependence.

MINDFRAMES: Reframing dependence

Cocaine users do not come voluntarily for treatment. Well known as the ‘rich man’s drug’ and used by the elite, cocaine is getting more popular as affordability and accessibility is increasing. The exaltation experience with cocaine is too positive, and the negative effects though troublesome, seem too minimal to warrant a search for treatment. Medications help control the withdrawal. On a broader treatment perspective, the family and friends circle; all need to get involved in the management to restore a drug free life. Hospitalization, with pharmacotherapy and psychotherapy can assist detoxification and help attain abstinence. Substance dependence is an illness. People with diabetes, cancer and cardiac conditions get sympathy and understanding from their loved ones; sadly this is not the case with a drug like cocaine. Here the best and foremost person who can help oneself is oneself. It makes sense to do it sooner than later.

Frequently Asked Questions

What are the physical effects of cocaine?
A single use of cocaine can send the consumer in hypertensive crisis. Coughing up of blood, inability to breathe, fever, allergic reactions, chest pain, palpitations are all common. Long term inhaling can lead to a breakdown of the nasal cartilage. Chronic use facilitates heart attacks and paralytic strokes. Cocaine has highly significant and dangerous physical effects; but users seldom take cognizance.

Frequently Asked Questions

Is nicotine’s action on the brain similar to cocaine?
Nicotine and cocaine both act on the same areas of the brain in a similar manner but both differ significantly in the intensity of the reaction. The ‘minirush’ and the ‘minicrash’ in the brain seen with nicotine addiction, is quite in keeping with the massive ‘rush’ and ‘crash’ seen with cocaine use. They are not considered to be similar drugs though and treatments differ.

Frequently Asked Questions

Is cocaine ever used as medication?
Cocaine is known (and used) for its anesthetic properties. Long ago, cocaine found medical use in the management of oral cancers to block its intense pain. Even today, many of its derivatives are used as local anesthetics. However, cocaine is a drug of abuse and is not to be considered as a real medicine when used in its potent crack and free base form by drug abusers.