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Cocaine

Type Psychoactive
Legal Status Class A
Cocaine
Derived from the Erythroxylum coca plant, cocaine is a tropane alkaloid formerly used as a local anaesthetic. Typically found in two forms: aheat stable “crack” or “freebase” form, without a hydrochloride moiety and with a lower boiling point allowing it to be smoked. The other form, “street” or “coke” contains a hydrochloride component allowing water solubility – to be delivered orally, intranasally etc. Cocaine may also be administered via the mouth through buccal absorption. Frequently, cocaine is cut with lignocaine or benzocaine, local anaesthetics of a similar appearance and with some similar effects as cocaine. Contaminated cocaine with levamisole and other adulterants is also common. Cocaine acts as a serotonin, dopamine and noradrenaline reuptake inhibitor, and has potent addictive potential following recreational use. - Be aware of the high variations in purity - Swallowing / Bombing : Stimulant drugs are caustic and can corrode soft tissues. This may result in damage to the lining of the throat, oesophagus and stomach. Ingest within a capsule/cigarette paper - Try not to inject. Snort or dab instead If you do inject – Don’t share equipment, ensure enough needles for repeat injections. - Avoid mixing with other drugs especially downers such as heroin (known as ‘speedball’) as this can cause more strain on your heart and may mask the effects of an overdose - Avoid mixing with alcohol as this creates a new drug in the body; cocaethylene which may be very toxic and could increase your risk of a heart attack or stroke - Try to ensure adequate sleep (Teens 8.5 to 9.25hrs / Adults 7 to 9hrs per 24hrs per 24hrs; www.sleepfoundation.org) - Use can cause anxiety, insomnia, paranoia and psychosis reduce or stop your use if you experience symptoms of these. - The use of stimulant drugs has become very popular; using more than one stimulant drug at a time drug can put your heart under significant stress. - Make sure you have more days where you don’t use, than days where you use. - Use in a safe environment with trusted company - Tell someone you are with what you are taking
Toxicity
1. Users with pre-existing heart, circulatory or blood pressure problems should avoid the use of cocaine, as they may be more susceptible to, and/or exacerbate cardiac toxicity. 2. Concomitant anti-depressant use increases the risk of developing a severe condition named serotonin syndrome, whereby multiple effects, including coma, seizures and a significant raise in body temperature can occur. Co-administration of cocaine with anti-depressants is therefore discouraged to decrease the risk of this occurring, as serotonin toxicity is a possibility. 3. Users with significantly worsening symptoms, particularly experiencing chest pain, elevated temperature, agitation or convulsions should attend hospital urgently for investigations. 4. Duration of action varies depending on route of administration – although inhalation, buccal, intranasal and intravenous routes of administration are the most common and tend to have rapid effects, bioavailability has been demonstrated to be higher following oral ingestion when compared to intranasal exposure.(2) 5. Co-ingestion of cocaine with ethanol produces a separate chemical named cocaethylene – it has been suggested that co-ingestion of these drugs may both enhance the risk of cardiotoxicity, and prolong cardiotoxic effects when compared to single ingestion of these drugs alone. Therefore it is discouraged that cocaine is taken in combination with alcohol. 6. Myocardial infarction, ventriculr tachycardia and fibrillation, cerebrovascular accident, pulmonary dysfunction and hepatotoxicity may occur with acute or chronic abuse.
Addiction Potential
May cause psychological dependence.
Short Term Effects
Symptoms include stimulant effects such as agitation, racing heartbeat & breathing, sweating, in addition to psychostimulant effects of dilated pupils, hallucinations and delirium. Cocaine has a significant potential to cause cardiac toxicity – elevated blood pressure, abnormal heart rhythms, chest pain, heart muscle damage, cardiorespiratory arrest and heart attack are all potential complications of cocaine use. In addition, kidney failure, hypokalaemic paralysis, acidosis and seizures are also serious symptoms that may occur with use. Hyperthermia progressing to hyperpyrexia with the potential to cause multi-organ failure is a potential complication due to cocaine being a potent serotonin reuptake inhibitor. Due to the caustic nature of the drug, damage to the nasal septum and rhinitis (“runny” nose) may occur. Via intravenous injection (which is strongly discouraged) pulmonary embolism, a potentially lethal condition can develop. Smoking also poses a risk, including pulmonary oedema (fluid build-up on the lungs).
Long Term Effects
Strong psychological dependence, psychosis.