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Cocaine addiction
Cocaine is a central nervous system stimulant drug and can cause euphoria. High doses can cause panic, schizophrenic symptoms, seizures, hyperthermia, arterial hypertension, arrhythmia, stroke, aortic dissection, intestinal ischemia and myocardial infarction. Supportive therapy is used to manage toxicities, such as intravenous benzodiazepines for seizures, agitation, and hypertension and cooling techniques for hyperthermia. Withdrawal manifests itself primarily as depression, difficulty concentrating, and drowsiness (cocaine washout syndrome).
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The majority of cocaine users are occasional, or even mildly addicted to the drug. About 25% or more of adult cocaine addicts do not meet the criteria for dependence or abuse. The incidence of drug abuse among adolescents has decreased in recent years. The availability and abuse of highly psychoactive forms like cocaine has made it more difficult for people to get addicted. U.S. cocaine can be as pure as 45-60%, but it can also include a variety of weighting agents, fillers and contaminants.
Most cocaine in the U.S. is vaporized and consumed by inhalation, but it can be snorted by nose or injected intravenously. Powdered hydrochloride can be inhaled by heating it, adding sodium bicarbonate and water. The precipitate (cocaine), is then evaporated using heating (it does NOT burn) and inhaled. The effects are immediate and last for the same duration as those of high-potency, injectable cocaine. There is no tolerance to cocaine. The withdrawal symptoms after high doses of the drug include increased appetite, difficulty concentration, drowsiness, depression, and difficulty concentrating. There is an intense urge to use the drug again after a time of withdrawal.
Pathophysiology
Cocaine, an alkaloid found within the leaves of the coca plant's coca plants, increases the activity of serotonin and dopamine in the central and peripheral nervous.
The drug's desire effects are likely to be enhanced by dopamine activation, which can lead to abuse and dependence.
Noradrenaline activation causes sympathomimetic symptoms: tachycardia.
Cocaine can also block sodium channels, which can lead to its local anesthetic effects. Cocaine can cause vasoconstriction which can result in almost any type of organ damage. Other possible complications include myocardial and cerebral infarctions, cerebral ischemias and hemorhages, Aortic Dissection, intestinal and renal ischemia.
The way in which cocaine is administered will determine the moment when the effects begin.
Intranavenous injections, smoking: immediate onset, peak effect 3 to 5 minutes later, duration 15 to20 minutes
Intranasal administration - onset of effects in about 3-5 min; peak effect after 20-30min; duration approximately 45 to 90 min
Oral administration: effects start after approximately 10 minutes. Maximal effects appear after about 60 minutes. The duration is about 90 minutes.
Because cocaine is a quick-acting drug, addicts who are serious about their addiction can inject it intravenously and then smoke it multiple times a day for up to 10 minutes.
Pregnancy
Pregnancy can be affected by cocaine use.
Clinical manifestations
Acute effects
The effects of cocaine ingestion may vary depending on the mode of use. When administered intravenously or smoked, cocaine causes hyperstimulation, alertness, euphoria, feelings of increased energy, and feelings of competence and strength. The excitement and high states are similar to those obtained by injecting amphetamines. The effects are less severe and more damaging for addicts who inhale cocaine through their nose.
Addicts who smoke the drug may develop pneumothorax or pneumomediastinum, causing chest pain, shortness of breath, or both. Cocaine use can also cause chest pain ("cocaine-chest pain"), although myocardial injury from cocaine use may not be present. The mechanism behind this chest pain is still unknown. Arrhythmias and conduction abnormalities have been observed. Cardiac effects can lead to sudden death. "Marathon", which is continuous use, often for several days, can lead to exhaustion syndrome (or "exhaustion") syndrome.
Overdose and toxicity
Overdose can cause anxiety, panic and aggression, as well as paranoid delusions and impaired judgment. You may notice sweating and mydriasis, as well as an increase in heart rate and blood pressure. Myocardial infarction, arrhythmia, and death may cause your death.