Cocaine
What is cocaine?
Cocaine is a very addictive drug that is made from leaves of the coca plant found in South America. It is mostly available as an illegal drug that some people use to get high. In rare cases, it is also used as a prescription drug for for anesthesia during certain surgeries.
As a street (illegal) drug, cocaine is usually a fine, white, crystal powder. Street dealers sometimes mix it with cornstarch, talcum powder, or flour to make it look like they have more cocaine. That way they can make more money. They may also mix it with other illegal drugs. Another form of the drug is crack cocaine. Crack cocaine has been heated to make it into a rock crystal.
How do people use cocaine?People snort cocaine powder through the nose or rub it into their gums. Others dissolve the powder and inject it into the bloodstream. Some people inject a combination of cocaine and heroin, called a "speedball." Crack cocaine is smoked.
What are the short-term effects of cocaine?Cocaine is a stimulant that can make people feel like they have more energy and are extra alert. But it can also make people feel restless, irritable, anxious, and paranoid. Large amounts of cocaine can lead to bizarre, unpredictable, and violent behavior.
Cocaine's effects appear almost immediately and disappear within a few minutes to an hour. How long the effects last and how intense they are will depend on how the person used it.
In some cases, cocaine can cause very serious health problems such as a heart attack, stroke, or coma.
What are the long-term effects of cocaine?People who use cocaine over the long term may develop health problems. Which problems they have will depend on how they used the cocaine:
- Snorting it can lead to a loss of sense of smell, nosebleeds, nasal damage, and trouble swallowing.
- Smoking it can cause a cough, asthma, trouble breathing, and a higher risk of infections like pneumonia.
- Injecting it with a needle can lead to skin or soft tissue infections, as well as scarring. It can cause collapsed veins. When a vein collapses, the blood cannot flow through it. Injecting cocaine also puts a person at higher risk of getting diseases such as HIV and hepatitis C.
Other long-term effects of cocaine use may include malnutrition and movement disorders, including Parkinson's disease.
Repeated use of cocaine can lead to tolerance. This means users need more and more of the drug to have the same effect. At higher doses over time, the body becomes dependent on cocaine. If someone who is dependent on cocaine stops using it, they will have withdrawal symptoms. These symptoms can include:
- Depression
- Restlessness
- Fatigue
- Increased appetite
- Bad dreams and insomnia
- Slowed thinking
Repeated use of cocaine can also lead to cocaine use disorder, also called addiction. This is more than physical dependence. It's a chronic (long-lasting) brain disorder. When someone has it, they continue to use cocaine even though it causes problems in their life. Some examples include health problems and not being able to meet responsibilities at work, school, or home. Getting and using cocaine becomes their main purpose in life.
Can a person overdose on cocaine?It's possible to overdose on cocaine. This happens when a person uses so much cocaine that it causes a life-threatening reaction or death. Some people use cocaine along with other drugs or alcohol. This can increase the risk of an overdose.
A cocaine overdose can cause health problems such as:
- Stroke
- Seizures
- irregular heartbeat (arrhythmia)
- Heart attack
There is no specific medicine to treat an overdose. Health care providers will focus on treating the specific health problems caused by the overdose.
What are the treatments for cocaine use disorder?The treatments for cocaine use disorder are different types of behavioral therapies. There are no medicines which can treat it.
NIH: National Institute on Drug Abuse
Felter's Materia Medica on Cocaine
... Andes-Peru, Bolivia, and Chili. Dose, 60 to 240 grains. Common Name: Coca. Principal ConstituentsCocaine Preparation.Fluidextractum Coca, Fluidextract of Coca. Dose, 5 to 30 minims. Specific Indi......valescence from long illness. Action and Therapy.The action of coca depends very largely upon the cocaine it contains, therefore the physiological effects are recorded under that subject. From time ...... there is gastric pain or discomfort it is relieved by coca probably through the obtunding power of cocaine upon the nerve filaments of the stomach. As compared with cocaine this power is feeble, as i...1
The dried ripe seeds of Strophanthus Kombé, Oliver, or of Strophanthus hispidus, DeCandolle, deprived of their long awns (Nat. Ord. Apocynaceae).... / ...the cornea also produce total anesthesia, including insensibility to heat and cold (difference from cocaine), these sensations being the last to yield and the first to revive after its application. De... / ...It has been reported useful in cases of mitral regurgitation with dilatation; mitral stenosis with regurgitation; regurgitation wi1
Physician's Materia Medica on Cocaine
Chemical name Phenyldimethylpyrazolon. Antipyretic, anal gesic, locally hemostatic. Used chiefly for relief of pain of a non-in fiammatory character, as in neuralgic affections and in locomotor ataxia. It often gives relief in whooping cough, and is a valuable remedy in epilepsy. Locally it is used with advantage in acute coryza and in hemorrhoids, associated generally with cocaine. Dose. 0.2 to 0.3 Grm. (3 to 5 grs.), which may be increased if the remedy is well borne.2
The leaves of ERYTHOXYLON COCA, Lam. Stimulant and nerve tonic, local anesthetic. The active principle is Cocaine, q. v.2
Alkaloid derived from COCA LEAVES. A powerful local anesthet ic. Prescribed for relief of nausea and gastralgia, and for its local action in affections of the throat, in hay fever and in hemorrhoids. Dose, 0.008 to 0.03 Grm. (% to % gr.) or more. The Hydrochloride is the salt commonly used.2
Physician's Therapeutics Memoranda on Cocaine
For immediate relief, the smoke from mixtures of stramonium or henbane leaves with nitre and a... / ... relieve; antipyrin may give relief or inhalations of oxygen; if of nasal origin application to nasal mu cous membrane of a six per cent. solution of cocaine hydrochloride, See that all hygienic conditions are favorable. For general treatment, tonics, especially strychnine; grindelia, euphorbia pilu...2
Apply a20per cent. solution of cocaine as a local anesthetic, then cauterize with nitric acid. Dress afterwards with Iodosyl. Treat constitutionally ior syphilis.2
In a simple case, cauterize thoroughly with nitric acid, Ricord’s paste or the actual cautery (applying cocaine solution previously as an anesthetic); dress afterward with lodosyl, iodoform or acetanilid. When the ulceration is superficial, cauterization is sometimes dis pensed with am} the antiseptic dressing depended upon, but the more heroic practice is safer, and is imperative if sloughing takes place.2
Treat early stage as in acute bronchitis. The local congestion may be relieved by application of a 4 per cent. solution of cocaine, or a solution of suprarenal extract. Spray or vapor of camphor and menthol or use by inhaler of a little Phenol Camphor gives much relief. Alkal-Antiseptine with nasal douche is a useful remedy.2
Treat the indigestion causing the pain on general principles (see Indigestion). For immediate relief of pain, antacids if necessary, anodynes (codeine, chloroform, chlorodyne, hydrocyanic acid, camph orated tincture opium, cocaine, fl. ext. life everlasting), counter-irri tation; in hysterical subjects, valerianates. As tonics especially combinations of arsenic with iron.2
The bowels must be kept free (best by compound liquorice powder, Fl. Ext. Cascara Sagrada... / .... The best local applica tions (preferably in form of suppository) consist of combinations of tannin, opium and extract of stramonium; extract ergot; cocaine; distilled extract witch hazel. If the tumors (internal hemorrhoids) "come down”, they must be promptly returned and the patient should lie ...2
Solution of boric acid, 20 grs. to fl. oz., applied to nipple after nursing; glycerite of tannin; silver nitrate carefully applied; solu tion of cocaine, (4 grs. to fl. oz.) just before nursing when very painful (to be carefully washed off, of course, before the child is put to the breast); ichthyol ointment; cacao butter.2
Tetanus antitoxin should be administered at once, and convul sions combated by inhalations of chloroform or by chloral combined with potassium bromide (see Bromanodyne, Part I). Other remedies are cocaine or a combination of this with morphine and atropine, hypodermatically; Fowler’s solution; calabar bean; pilocarpine (the last to eliminate the toxin).2
For relief of pain a mixture (liquid) of camphor, 5 parts, chloral, 5 parts and cocaine hydrochloride, 1 part; Phenol Camphor; oil cloves; creosote; menthol.2
In Pulmonary Tuberculosis pure fresh air is the most important remedy. Let the patient live out of doors if possible, best in an equable climate. Cod Liver Oil... / ...form. Laryngeal Tuberculosis may be treated by insufliations of Iodosyl or iodoform, and local application of lactic acid solution (10%) Pre ceded by cocaine as an anesthetic.2
... diet and prescribe gastric antiseptics, or lavage. If from gastric irritability, sedative remedies are most effective; hydrocyanic acid, chloroform. cocaine, creosote, chloretone, bismuth; in extreme cases, aconite; it may be necessary to give the stomach complete rest, feeding the patient per rect......doses is an eficient remedy; potassium bromide, per rectum, may be given. In the vomiting of pregnancy, cerium oxalate, carbonated water; chloretone, cocaine, creosote, tincture iodine in small doses, potassium bromide and menthol are among the remedies that may give relief.2
References
2) Nelson, Baker & Co., 1904, Physician's Handy Book of Materia Medica and Therapeustics, Detroit, Michigan.