Cocaine
Cocaine produces effects similar to those of amphetamines but is a much more powerful stimulant. It may be taken by mouth, inhaled as a powder through the nose (snorted), or injected, usually directly into a vein (mainlining). When boiled with sodium bicarbonate, cocaine is converted into a freebase form called crack cocaine, which can then be smoked. Crack cocaine acts almost as fast as cocaine injected intravenously.
Symptoms and Complications
Cocaine produces a sense of extreme alertness, euphoria, and great power when injected intravenously or inhaled. Because cocaine's effects may last only about 30 minutes, the user takes repeated doses. Cocaine also increases blood pressure and heart rate and narrows (constricts) blood vessels. These effects can cause a heart attack, even in healthy young athletes. Other effects include constipation; intestinal damage; extreme nervousness; the feeling that something is moving under the skin (cocaine bugs), which is a sign of possible nerve damage; seizures; hallucinations; insomnia; paranoid delusions; and violent behavior. Long-term users may damage the tissue separating the two halves of the nose (septum), causing sores (ulcerations) that may require surgery.
Women who become pregnant while addicted to cocaine are more likely than nonaddicts to miscarry. If the woman does not miscarry, the fetus may be damaged by the cocaine, which easily travels into its bloodstream from the mother's blood. A baby born to an addicted mother may have abnormal sleep patterns and poor coordination (see Section 22, Chapter 259). Crawling, walking, and speech development may be delayed, although this may be the result of nutritional deficiencies, poor prenatal care, and maternal abuse of other drugs as well.
Withdrawal reactions include extreme fatigue and depression--the opposite of the drug's effects. Suicidal urges emerge when the addict stops taking the drug. After several days, when mental and physical strength have returned, the addict may attempt suicide.
Treatment
Emergency Treatment: Cocaine is a very short-acting drug, so treatment of uncomfortable reactions usually are not necessary. Emergency medical staff watch the person closely to see if the life-threatening effects subside. Drugs such as beta-blockers may be given to lower blood pressure or heart rate. Other drugs may be given to stop seizures. A very high fever may also need to be treated.
Detoxification and Rehabilitation: Withdrawing from long-term cocaine use may require close supervision because the person can become depressed and suicidal. Entering a hospital or a drug treatment center may be necessary. The most effective method of treating cocaine addiction is psychotherapy. Sometimes the mental health disorders common to cocaine addicts, such as depression, are treated with appropriate drugs.
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