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Coca

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


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Felter's Materia Medica on Coca

CAFFEA
   The seeds of Caffea arabica, Linné (Nat. Ord. Rubiaceae). Native of Arabia-Felix and Ethiopia; and extensively cultivated in Asia and America between the north and south latitudes of 56°. Common Name: Coffee. Principal Constituents.-The chief constituents are caffeine (C8H10N4O2. H2O); a volatile aromatic oil; caffeol is also present in minute quantity and upon it depends the aroma of coffee; and caffeo-tannic acid. Preparations.—1. Infusum Caffeæ, Infusion of Coffee. Dose, 2 to 8 fluidounces. 2. Specific Medicine Coffeæ. Dose, 1 to 60 drops. Specific Indications.—Feeble circulation, with threatened heartfailure; sense of exhaustion; headache, with cerebral hyperemia or congestion. Action.—Coffee is a decided cerebral stimulant and energizer. It also increases reflex activity of the spinal cord. Used moderately it is a mild bitter stomachic, stimulating the appetite and facilitating digestion. There is reason to believe that it increases hepatic activity and it promotes peristalsis, thereby favoring a free action of the bowels. Coffee slightly accelerates the circulation. Under its use the intellect is quickened to an extraordinary degree, thinking is facilitated, ideas flow freely, the reasoning faculty is sharpened, and an enormous amount of mental and physical work may be accomplished. The action of hot coffee upon the cerebrospinal system is especially evident when a person is exhausted by mental strain or physical exertion. Coffee removes drowsiness after a heavy meal, and may produce wakefulness that will last for several hours. If coffee be withheld from one who is accustomed to its stimulus, physical and mental exhaustion become so severe as to interfere with intellectual pursuits or bodily endurance under exertion, and a profound headache may be experienced. Coffee probably retards tissue waste, and is, therefore, a conservator of force. The excessive use of coffee causes irritability, dejection of spirits, muscular weakness and trembling, watchfulness, dizziness, headache, and ringing noises in the ears; and flatulence, sour stomach with heartburn and eructations, and disordered action of the bowels. Probably the hepatogastric symptoms— “coffee biliousness” —is due largely to the empyreumatic oil present in coffee; the nervous symptoms chiefly to the caffeine it contains. Therefore preparations from which the latter has been removed are just as likely to produce stomach disorders as regular coffee. The stimulating effects of coffee are most largely due to caffeine. This alkaloid is one of the most rapidly acting cerebro-spinal stimulants and probably the nearest of any drug to a physiologic energizer of the intellectual brain. It sharpens the intellect wonderfully, and increases particularly the reasoning faculties rather than the imaginative. It operates without after-fatigue and renders the person capable of great mental achievement and physical endurance. Workmen do more work under coffee, and soldiers stand long marches under the stimulus of the caffeine it contains. Large doses produce excitation of the spinal cord, and if carried to full action exaggerate the reflexes, making the person exceedingly nervous. No harm, however, is done to any organ by coffee or by caffeine, and no after-fatigue or exhaustion follows, provided neither be given to the extent of interfering with the taking of food nor of preventing rest or sleep. Caffeine excites muscular contractility, and powerfully stimulates respiration. Upon the circulation it heightens blood pressure and quickens the contraction of the heart. These are accomplished through its action upon the vasomotor control and upon the heart muscle itself, its effects upon the latter taking origin at the veno-auricular junction, and extending from thence to the auricle and the ventricle. Caffeine increases the output of both the solids and the fluids of the urine, by dilating the renal bloodvessels and by direct action upon the renal epithelia. The tissuewaste of the body is thought to be restrained by caffeine, thus making it a conservator of force and energy. Caffeine is believed to be oxidized and destroyed in the body. The common non-alcoholic beverages of mankind (except coca)—coffee, tea, cocoa, kola, maté and guarana— owe their grateful stimulus to caffeine or related alkaloids. The theine of tea is practically caffeine. All of them relieve fatigue, increase mental acuity, endurance and the capacity for exertion without being followed by fatigue or exhaustion. Therapy.—Coffee in strong infusion is given both by stomach and rectum in opium poisoning. It should be made fresh and as strong as possible. The warmth adds to its efficiency. A cup of strong, hot coffee is often an effectual sobering draught in acute alcoholism. and small and repeated amounts will sometimes ward off an attack of delirium tremens. Coffee is a gratefully refreshing agent for headache due to cerebral hyperaemia or congestion, as shown by red face and injected eyes, but will be likely to aggravate a neuralgic headache when the face is pale. Strong coffee sometimes cuts short an attack of asthma, and checks hiccough. It is the most refreshing stimulant that can be used in the exhaustion of low fevers of a typhoid type and in the debility following other acute disorders, particularly if the patient was previously accustomed to its use as a beverage. In fact, coffee should never be wholly withheld in acute disorders when it has been a factor in the patient's daily dietary. For its stimulating effect in fatigue and nervous exhaustion and calming action in nervous excitation of debility, coffee should be freshly prepared and drunk hot, preferably without sugar or cream; for use in narcotic poisoning very strong, “black coffee” may be given freely, both by mouth and per rectum.1

COCAERYTH5
   The dried leaves of Erythroxylon Coca, Lamarck, and its varieties. (Nat. Ord. Erythroxylaceae.) South American Andes-Peru, Bolivia, and Chili. Dose, 60 to 240 grains. Common Name: Coca. Principal Constituents—Cocaine Preparation.—Fluidextractum Coca, Fluidextract of Coca. Dose, 5 to 30 minims. Specific Indications.—Defective innervation, with dizziness; impaired digestion; pain in back of the head, and fatigue; gastric pain; inordinate hunger and thirst; exhaustion during convalescence 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 immemorial the people of the Andes, particularly in Peru, Bolivia, and Chili, have used coca leaves as other nations use stimulating table beverages; and when undergoing long journeys and hard work the natives are accustomed to chew the leaves with lime or some other alkaline substance, in order to endure hunger and fatigue, which it enables them to do with remarkable certainty. These uses of the plant led to its adoption into medicine as a remedy for neurasthenia and other disorders, with nervous weakness and muscular debility. Coca is a remedy to be used temporarily only for defective innervation. Though the appetite is apparently normal, digestion is imperfect, and there is an associated occipital and post-cervical pain, dizziness, and inability to stand for any great length of time. The mental faculties are sluggish and tired-brain fag-and thinking is difficult and despondency a common condition. If 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 is coca in all its effects, still there is sufficient of the alkaloidal influence exerted to make coca a remedy to be used with great circumspection. In nervous debility it may be carefully employed for a brief period, especially in convalescence from exhausting fevers and other diseases in which a persistent nervous depression follows. While of some value in chorea and repeated attacks of hysteria, it should not be used when any other agent can be made to serve the purpose. In fact, there is no more wisdom or justification in employing coca preparations for simple functional maladies because of mere nervous discomfort than there would be in prescribing opium for similar purposes. Both lead to pernicious habits, with a train of miseries to which the victim finally succumbs. An occasional dose of 10 to 15 drops of the fluidextract will sometimes overcome insomnia caused by gloom and worry, and very rarely it helps one over an attack of asthma. It may be used for any length of time desired in gastric carcinoma to relieve the irritability and pain. Its chief use, if employed at all, will be for very temporary exhibition in the debility following fevers, or for a more prolonged use in advanced phthisis, to give rest, quiet gastric irritability, and aid breathing. For all prolonged states of mental depression, as neurasthenia, hypochondria, melancholia, depressive insanity, etc., its administration should not be encouraged, and as a remedy for the opium and other drug habits it has no place in medicine on account of the habit-forming dangers of coca itself. To sum up some of the beneficial results of temporary coca medication would be to include its influence as a circulatory and respiratory stimulant, a restorative of strength after exhaustive acute diseases or operations, in-sudden nervous exhaustion and insomnia, in painful indigestion, headache from exhaustion, and in migraine. In all of these it should be used for but short periods, and any symptoms of cocainism should be a warning to cease its administration. The fluid medicines may be used in moderate doses. The habit of using coca wines is but a mild form of cocaino-alcoholic tippling.1

STROPHANTHUSSTROP4
   The dried ripe seeds of Strophanthus Kombé, Oliver, or of Strophanthus hispidus, DeCandolle, deprived of their long awns (Nat. Ord. Apocynaceae). West and east coast of tropical Africa. Dose, 1 to 2 grains. Principal Constituents.—Strophanthin (C31H48O12—8 to 10 per cent), a bitter glucoside yielding glucose and strophanthidin (see below), kombic acid, inert alkaloid ineine and tanginin. Preparation.—Tinctura Strophanthi, Tincture of Strophanthus. Dose, 1 to 10 drops. Derivative.—Strophanthinum, Strophanthin. Commercial strophanthin is a glucoside or mixture of glucosides occurring as a permanent white or yellowish powder, readily soluble in water and diluted alcohol; less soluble in absolute alcohol; and almost insoluble in ether and chloroform. It should not be tasted except in very dilute solution. Average Dose, 1/60 grain (by mouth); 1/80 grain (intravenously). Specific Indications.—Weak heart, due to muscular debility; muscular insufficiency; rapid pulse, with low blood pressure; cardiac pain, with dyspnea. Action.—Externally applied, strophanthus preparations appear to exert no special effects unless mixed with hydrous wool fat, when the action of the drug is said to be apparent. The seeds, however, applied to the cornea produce prolonged anesthesia (Steinbach). Three or four drops of a solution of strophanthin (1 to 1000) applied to 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 Schweinitz and Hare found that ocular anesthesia occurs only in dogs, not in man. A disagreeable irritation of the conjunctiva has been produced by this use of strophanthin; it has no effect on intraocular pressure or upon vision - accommodation. Strophanthus is a muscle poison. When taken internally it acts primarily upon the voluntary muscles, increasing their contractility, and if the dose be poisonous it causes tetanic paralysis, the muscles being unable to regain their former normal flexibility. Under its toxic influence the muscles first become enfeebled, then somewhat rigid, fibrillary twitchings, which are spontaneous, non-rhythmical and increasing contractions, somewhat similar to those of chorea, are observed, and finally the muscles become pallid, non-contractile and hard. It is these effects that render strophanthus an efficient arrowpoison, the muscular paralysis produced rendering the animal an easy prey to its pursuer. When the muscles are in extreme paralysis, lactic acid has been observed to replace the normal alkaline condition. Strophanthus muscular paralysis consists chiefly in diminishing the ability of the muscles to relax, and then in destroying this capability, producing a condition difficult to distinguish from rigor mortis. Strophanthus does not appear to affect either the spinal cord or to act upon its nerve trunks. Its specific action upon the heart is due to direct contact (through the blood) with the muscular fibres of that organ, and not to any effect upon the cardiac nerves. A large dose so increases contractility that a more perfect, energetic, and prolonged systole is the result, and the capability of the muscle to relax is lost, or so diminished that diastole can not take place; after death the ventricle is so completely contracted as to almost efface the cavity, the heart passing from life directly into rigor mortis. According to some it may cease either in systole or diastole. The caliber of the blood vessels is but little influenced by strophanthus, it having no effect upon the vasomotor control. It is strongly diuretic in so far as lack of secretion depends upon low blood pressure, i. e., it increases diuresis in so far as increased blood pressure produces an increased urinary product. It is also thought by some to act especially upon the renal secreting structures. When one is in good physiological condition it is said to have little or no diuretic action; but in diseased conditions, with low blood pressure, it is asserted to excel digitalis in diuretic power. If strophanthus be given in large doses it produces gastro-intestinal irritation with vomiting and diarrhoea. Small doses, however, act as a bitter tonic, improve the appetite, augment gastric action, and promote digestion. In proper doses it strengthens the heart-muscle, slows cardiac action, increases the interval between beats, reduces the pulse-rate, and powerfully increases arterial tension (but less so than digitalis), not by any effect (to any extent at least) upon the vessels, but by strengthening the heart-muscle, giving increased power. Whether or not the drug is cumulative is still an unsettled question, though it probably is not unless given too freely in overlapping doses. The action of a good strophanthus upon the heart is probably greater than that of any other drug, and its active principle, when pure, is of far greater potency than the digitalis derivatives. Therapy.—Strophanthus is a remedy for weak heart from debility of the cardiac muscle, with lack of proper contractile power, as shown by a rapid, weak pulse, and very low blood pressure. The disordered action of the heart is due to lack of tonicity and not from weak walls due to deposition of fat, in which case the drug must be used with extreme circumspection, though in small doses it has been recommended by some as a remedy for cardiac fatty degeneration, as it has also in atheroma of the arteries in the aged. It is also a remedy for praecordial pain and for cardiac dyspnea. It has been strongly endorsed in heart affections with disorders of compensation. Strophanthus is useful in valvular heart disease only so far as there is muscular insufficiency, where the compensatory increase of muscular action is not sufficient to offset the valvular insufficiency. “It has been reported useful in cases of mitral regurgitation with dilatation; mitral stenosis with regurgitation; regurgitation wi1


References

1) Felter, Harvey Wickes, 1922, The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio.