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Free advice, from a clinician in the field on all aspects of cocaine addiction, detox, withdrawal, rehab, admission, therapy, counselling and outpatients.


Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. Although healthcare providers can use it for valid medical purposes, such as local anesthesia for some surgeries, recreational cocaine use is illegal. As a street drug, cocaine looks like a fine, white, crystal powder. Street dealers often mix it with things like cornstarch, talcum powder, or flour to increase profits. They may also mix it with other drugs such as the stimulant amphetamine, or synthetic opioids, including fentanyl. Adding synthetic opioids to cocaine is especially risky when people using cocaine don’t realize it contains this dangerous additive. Increasing numbers of overdose deaths among cocaine users might be related to this tampered cocaine.

Cocaine is a very powerful and extremely addictive drug derived from the leaves of cocoa plants, native to South America. While it can have valid uses in medical practice (local anesthesia) it's possession by those not engaged in medical practice is illegal and, like possession of other illegal drugs could lead to a criminal record, fine, and even imprisonment: aside from the damage it does to someone's health.  

To increase their profits , dealers will "cut" the drug (increase the volume by adding in other substances). Ordinarily, Cocaine is a fine , crystal like, white powder. It can be cut with, amongst other things, cooking flour, talcum powder, corn-starch but can also be cut with other illegal drugs such as opioids and amphetamines.  When it is mixed with opioids, usually Fentanyl, this exponentially increases the risk as the user will not be aware and can lead to overdose. Indeed, there is a worrying increase in deaths from Cocaine use where it has been cut with opioids. 

How do people use cocaine?

While some people will rub Cocaine into their gums, most people will snort it through the nose.  Some users will dissolve the powder and inject it, directly, into their bloodstream. When cocaine is injected with heroin, this is known as Speedballing.  When Cocaine is produced in a rock crystal (freebase Cocaine) users will heat it up and smoke it: This is known as Crack as the name is derived from the cracking sound produced when the rock is heated. Crack can also be broken up and mixed with Cannabis or tobacco and smoked in a cigarette. 

It is not uncommon for people who use Cocaine to use large amounts in very short periods of time. This is known as binge use. When this occurs it is common for the user to take in large amounts to maintain their "high". 

How does cocaine affect the brain?

There is a naturally occurring chemical messenger in the human brain called Dopamine. By using cocaine, Dopamine levels are increased. Without Cocaine, Dopamine will recycle back into the cell that released it and thus the signal between the two nerve cells is shut off. Cocaine has the effect of preventing the Dopamine from being recycled and thus a large build up occurs which, in turn, stops cellular communication. This flood of Dopamine within the reward centre of the brain which thus reinforces further drug use.  

When sufficient amounts are used over a period of time the reward circuit can be adapted with a reduced reaction to Cocaine. Thus someone has to take more to have the same effect. 

When someone uses Cocaine, there will be some effects in the short term: 

* Very high levels of energy and extreme bouts of elevated mood

*  Significant heightened state of mental alertness

* Hypersensitivity to touch, sound and sight

* Extreme irritability

* Unreasonable distrust of others and extreme paranoia.

 When some people use Cocaine they find it helps them to undertake rudimentary tasks, both mentally and physically. However, some people report the opposite and will tell you that Cocaine slows them down.  When large amounts are taken it can lead to very bizarre and seriously dangerous violent behaviour. The effects are, almost, instantaneous, but disappear very quickly and will be almost gone within an hour. As to how long the effects last depend on how it was taken.  When it is 

Some people find that cocaine helps them perform simple physical and mental tasks more quickly, although others experience the opposite effect. Large amounts of cocaine can lead to bizarre, unpredictable, and violent behaviour. 

When cocaine is injected or smoked, the effect is stronger and quicker but will wear off more quickly. When snorted the high can last from fifteen minutes to half an hour. For those who smoke Cocaine, the high may only last for five to ten minutes. 

What are the other health effects of cocaine use?

Cocaine can serious damage your health. In some circumstances, use can be fatal. Some of the common health related issues are: 

  • Blood vessels become constricted ( Vasoconstriction) this can lead to heart attacks and Gangrene. 

  • Mydriasis (dilated pupils) 

  • Feeling sick (nausea) 

  • Hyperthermia and hypertension (raised blood pressure and body temperature) 

  • Tachycardia and arrhythmia (Fast heat beat and irregular heart beat) 

  • Twitching of the muscles and shaking (tremor) 

  • Not being able to stand still (restlessness) 

Some long-term health effects of cocaine depend on the method of use and include the following:

  • snorting: olfaction (no sense of smell) , epistaxis (nosebleeds) , rhinorrhoea (nosebleeds)   , and problems with swallowing

  • smoking: . Persistent coughing, respiratory distress, asthma and higher risk of infection. 

  • consuming by mouth: severe bowel decay from reduced blood flow

  • needle injection: higher risk for contracting HIV, hepatitis C, and other bloodborne diseases, skin or soft tissue infections, as well as scarring or collapsed veins

While more cocaine users smoke or snort than inject, that is not to say that non-injectors do not also expose themselves to risky sexual behaviour with infected partners.  There have been studies to show that Cocaine can speed up HIV infection and that it also impairs immune cell function while promoting reproduction of the HIV virus. There is also a body of evidence that Cocaine makes people more susceptible to Hepatitis C. 

Chronic use can also lead to poor appetite which is why some people use it: Precisely for that effect. It can also induce movement disorders such as Parkinson's after many years of use.  There is also the risk of sustained paranoia. 

Can a person overdose on cocaine?

Absolutely, YES!  An overdose can lead to life threatening symptoms or even death. It can occur on the first occasion someone uses it or after many years of use. It can be deliberate or accidential. It is not uncommon for those using cocaine to also use alcohol and other drugs which are often mixed with substances that the user is unaware of.  The potential medical emergencies can include, amongst others: 

* seizures

* Irregular heart rhythm 

* heart attack 

* Stroke 

Can a cocaine overdose be treated?

Unlike opioids where Naloxone can be used, there is no reversal agent or antidote for Cocaine. Medical professionals will treat the condition caused to manage the situation. 

How does cocaine use lead to addiction?

Continued use can lead to long term changes in a persons brain reward system which can lead to addiction. This is because the brain eventually adapts to the extra dopamine caused by the drug and becomes steadily less sensitive to it. As a result users will take more of it , more frequently to feel the same effects as when they first started to use it. Should someone stop using it they are likely to feel: 

* depressed in mood

* very tired

* Increasingly hungry 

*Not be able to sleep with some nightmares

* A slowdown in their thinking. 

How can people get treatment for cocaine addiction?

 As above, there is no medical detox for cocaine: It is a very short acting drug. Centres may offer Cocaine users a short course of Benzodiazepines and/or Beta Blockers, if it is clinically appropriate to do so.  The mainstay of recovery from Cocaine is a 12 step or SMART based group therapy approach, augmented with abstinence. As with all addictions, the most effective way to get into recovery is in a residential treatment centre. Outpatient services are also available. 

Call Paul to discuss and achieve the abstinence you deserve.


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