Cocaine

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Contents 1 Origins and History 2 Pharmacology 3 Epidemiology 4 Street Names 5 Typical Use 6 Effects 7 Harm 8 Dependency 9 Prevention Strategies 10 Consumption Measures 11 Addiction Screening Measures 12 References

Origins and History

Cocaine naturally grows and originates from South American countries. South America supplies the correct climate and circumstance to grow in this region. "The archeological record suggests that the chewing of coca in south America dates back as far as 4000 years ago" as stated by Edward V Nunes of The New England Journal of Medicine. When Spain explored the region of South America, it sparked the use of cocaine. Cocaine, being an extremely addictive drug, left its first toll on a society in colonial Peru. As cocaine was introduced to the nations of the world through trade, the market for the drug increased. As it became more popular, it was soon a common cash crop sold by many. One of the first main distributors of this drug was a European drug company. Japan even sold this cash crop through other companies to pay for wartime funds. Japan did this while also working with the League of Nations to stop the drug trade.⁵ Most commonly, cocaine products have been grown and manufactured in South American countries with loose or corrupt governments and many guerrilla states.

Cocaine is produced in areas within South America and is distributed to other countries through drug cartels. Cocaine is notorious for being distributed by these cartels because of the ease of transportation and high value. There are a few main cartels that have distributed most of the cocaine coming out of the regions in South America. One of these leading cartels is the Medellin Cartel. This cartel, at one time, was one of the biggest cocaine operations that existed. It was put to an end by Columbian Government forces and the help of the United States military.

The United States has tried to have a very active role on the war on drugs. Although this is true, the United States anti drug policy has little effect on the overall fight against drugs. This cash crop, once produced, can be sold in other nations for extremely high weight to value ratio. The South American drug trade is normally run in 3rd world countries where U.S. policy cannot be carried out and where guerilla armies often control the regions. The cocaine industry collects such great quantities of profit that often times cartels pay for protection by these guerilla armies. When the United States war on drugs does make some progress and shuts down parts of these cartels in South America, it just leads to the "Balloon Effect". This is the idea that when one region that cocaine is being produced in is shut down; the cartel simply relocates to another South America region.⁶

The cocaine industry is such a spread out industry over 3rd world nations that if anti-drug efforts are focused on one aspect of the cocaine distribution process or on one specific cartel then it only allows the other cartels and industry participants to get stronger.⁶ Cocaine has existed in South American countries for many years; and with the current and ongoing situations of guerrilla rule and corrupt nations. the goal of anti-drug efforts are far from being fulfilled.

Pharmacology

Cocaine is a hydrochloride salt derived from the coca leaf. A non-powdered crystalline form that has not been neutralized by acid to make the hydrochloride salt is often referred to as crack. Both forms of this drug are central nervous system stimulants. The drug interferes with reabsorption of the neurotransmitter dopamine, causing it to build up. Since dopamine is associated with pleasure and movement, euphoria and hyperstimulation are often experienced. Absorption speed is related to the intensity of the high.¹ "Snorting" (inhaling the powder through the nose), injection and smoking the crack form are all highly direct ways of administering the drug, and thus the effects of cocaine are experienced quickly and intensely.

There is some evidence that the combination of alcohol and cocaine within the body can cause the liver to form the substance cocaethylene. This potentially causes both the increase in euphoric effects and the risk of sudden death.¹

Epidemiology

Among children, the Monitoring the Future study shows a steady progression of use as U.S. children go from 8th grade (2.0%) to 10th (3.7%) to 12th (5.3%).⁴ This remains far lower than the 12.7% prevelance rate among 12th graders in 1986. The National Survey on Drug Use and Health reports that within the U.S. there were 2.0 million cocaine current users in 2004, with almost a quarter of them crack users. While this figure has been stable over the past two years, daily use of cocaine appears to be on the rise, from 133,000 in 2003 to 263,000 in 2004.³ Use around the country is quite variable. Within the 21 urban centers of the Community Epidemiology Work Group (CEWG), 2004 rates of use ranged from 11.9% in Dallas and 2.3% in Detroit (lifetime use). In 19 of the 21 CEWG areas, cocaine was the most widely abused illicit stimulant.²

Street Names

Coke, Snow, Flake, Blow

Typical Use

Powdered cocaine is either snorted or mixed with water and then injected. Crack cocaine is generally smoked with a water pipe. Either form can also be ingested.

Effects

Physical effects include constricted blood vessels, dilated pupils, and an increase in body temperature, heart rate, and blood pressure. The cocaine high leads to feelings of euphoria and energy. Health hazards include addiction, heart attack, respiratory failure, stroke, and seizure.

Chronic use of cocaine can lead an increased tolerance to the high, leading the addict to use higher doses to attempt to achieve a high that was as good as first use. However, sensitivity to cocaine can also increase with increased use, often resulting in harmful health effects and death after low doses of the drug.

Increasingly high doses of cocaine can also result in cases of bizarre or violent behavior, irritability, restlessness, paranoia, and in some cases paranoid psychosis.

Long term effects of cocaine use/addiction include abnormal heart rhythm, chest pain, respiratory failure, heart attack, seizures, headaches, and gastrointestinal complications. Regular use of powdered cocaine through snorting can lead to loss of sense of smell, nose bleeds, problems with swallowing, hoarseness, and runny nose. Ingestion of cocaine can cause necrosis (cell death) in the GI tract due to reduced blood flow, this often complicated in cases of severe gangrene. Those who mix powdered cocaine with water and then inject are at risk for allergic reaction, infection, and for those who share needles several blood borne diseases, including HIV.

Harm

There are a number of primary and secondary effects of cocaine use. First, the drug's effect on the vascular system can be very harmful. It can cause constricted blood vessels, increased heart rate and blood pressure. Increases in temperature and pupil dilation are also effects. Heart attack and stroke are possible which can result in sudden death.

Crack cocaine is a huge risk factor for women who's sexual partners use crack cocaine. As with most drugs, women are commonly drawn into use through their partners. Crack is a powerfully addictive drug, often from first use, and is also very cheap. Therefore, addicted women in a cycle of binge use will often trade sex for money or drugs in order to get their fix. The more urgent the need for the drug, the more a woman will do. This is where the term "crack whores" originates. These women commonly become pregnant, often the children are born addicted to crack as well, if they survive. I have heard several first and second hand stories of crack addiction and leaving the baby to get a fix. In one situation the woman was arrested when she bought the crack, but was to afraid to tell the police about her baby because afraid they would take her child away. After 2 weeks in jail, her child was no longer alive. As far as the man's side of the crack culture: men usually serve as pimps and dealers in this culture.

Populations of crack users are at risk for many harmful side effects of the drug itself, but are also at extremely high risk for STDs, and HIV.

Dependency

Cocaine dependency has been considered a widespread epidemic. The increase use, addiction, and cocaine dependency has launched a need for a better understanding of the addictive drug. Cocaine dependency is a multifactorial disorder that, through several studies, has been stated to be partially caused by genetic and environmental factors.⁸ Cocaine can be traced back many years, but the struggle with cocaine dependency today is a much greater issue than in the past.

In 1499, the Italian explorer Amerigo Vespucci landed on the coast of Venezuela and noticed the natives chewing coca leaves.⁹ Vespucci observed their degraded state of mind after chewing these coca leaves, and soon enough cocaine was recognized in several countries. In years prior to World War II, Japan was known to sell cocaine through major corporations in order to help finance their military. While this drug trafficking was happening, Japan was cooperative with the League of Nations in efforts to reduce the amount of drug trafficking. This contradiction could be the cause of some huge uproar. The efforts to reduce cocaine dependency, both in the past and present, have been like a rollercoaster ride. In the end, the many efforts were deemed unsuccessful.

Cocaine is created from the leaves of a coca plant. This drug is used to stimulate the central nervous system to create a sense of euphoria. Even though cocaine creates a sense of euphoria, it can cause serious health risks. Depending on the dosage, cocaine can create this euphoric sense of immortality ranging from twenty minutes to several hours. Cocaine use can also increase the risk of HIV infection, neurological and psychological defects in unborn and newborn children, decreased appetite, increased crime and violence, can cause financial, medical and psychological problems, and has a high addiction rate.¹⁰ This drug is commonly used recreationally among teens and young adults. The increased use of cocaine has made it the second most popular illegal drug in the United States, behind marijuana.

There are several types of cocaine dependent subjects which are then broken down into subgroups. Some subgroups consist of "dependency because of heredity or genetics", "dependency due to environmental factors" and a mixture of both. As a result of many experiments, scientists state that it is more likely for someone to become addicted to cocaine if the addiction runs in the family. Cluster studies have been performed many times concluding that the majority of cocaine dependent individuals have been previously diagnosed with psychiatric disorders.⁸ Cluster studies are studies of a random sample of individuals in the population. These individuals are put into "natural groupings" or clusters.⁷ For example, a cluster study was used on 1393 subjects, from 660 genetically related families. Of these 600 families, 482 had at least two siblings with cocaine dependency.⁸ This experiment stated what was previously stated above, genetics play a large role in the likelihood of cocaine addiction.

The long struggles to reduce cocaine addiction have sparked many experiments to find a solution to helping people who have become cocaine dependent. Although there have been many unsuccessful attempts in the past, scientists believe there is hope in the future for great advancements. The rapid increase of cocaine use in the United States, as well as all over the world, has drawn more attention to the serious issue and hopefully one day this issue will disappear.

Prevention Strategies

For women trying to get clean from crack cocaine, it is often powerful to keep them with their children. Children become an inspiration to get and stay clean for these women. If children are taken away, often women will relapse into use.

Consumption Measures

Addiction Screening Measures

References

1. NIDA InfoFacts National Institute on Drug Abuse. www.drugabuse.gov.
2. National Institute on Drug Abuse (2005). Community Epidemiology Work Group, Epidemiologic Trends in Drug Abuse, Advance Report and Highlights/Executive Summary: Abuse of Stimulants and Other Drugs, 2005. Available online at www.drugabuse.gov/PDF/CEWG/AdvReport_Vol1_105.pdf.
3. Substance Abuse and Mental Health Services Administration (2005). Results from the 2004 National Survey on Drug and Health: National Findings. Available online at www.oas.samhsa.gov/NSDUH.htm#NSDUHinfo.
4. Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2005). Monitoring the Future national survey results on drug use, 1975-2004. Volume I: Secondary school students (NIH Publication No. 05-5727). Bethesda, MD: National Institute on Drug Abuse, 680 pp.
5. Edward V Nunes. "A BRIEF HISTORY OF COCAINE: FROM INCA MONARCHS TO CALI CARTELS: 500 YEARS OF COCAINE DEALING. " The New England Journal of Medicine 355.11 (2006): 1182.
6. Mark Peceny, Michel Durnan. "The FARC's Best Friend: U.S. Antidrug Policies and the Deepening of Colombia's Civil War in the 1990s. " Latin American Politics and Society 48.2 (2006): 95-IV.
7. Hulley, S.B., Cummings, S.R., Browner, W.S., Grady, D., Hearst, N., & Newman, T.B. (2001). Designing clinical research: An epidemiologic approach. Philadelphia, PA: Lippincott Williams & Wilkins.
8. Kranzler, H.R. (2008). The validity of cocaine dependence subtypes. Addictive Behaviors, 33, 41-53.
9. Nunes, E.V. (2006). A brief history of cocaine: From inca monarchs to cali cartels: 500 years of cocaine dealing. New England Journal of Medicine, 355, 1182.
10. Sofuoglu, M, & Kosten, T.R. (2005). Novel Approaches to the Treatment of cocaine addiction. CNS drugs, 19, 13-25.

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