Cocaine and derivatives

Sign up as a user (no pun intended) and receive emails with new articles (Click Here).

General

Cocaine is a powerful stimulant - it is not an opiate. It is used almost solely as a drug of abuse; it is seldom used for the few medical purposes it serves.

Cocaine is made from the leaves of the coca plant native to South America. It is the most powerful central nervous system stimulant found in nature. Three countries: Colombia, Peru, and Bolivia account for all the coca production in the world.

 The coca plant

As a street drug, cocaine looks like a fine, white, crystal powder.

People who use cocaine often take it in binges—taking the drug repeatedly within a short time and at increasingly higher doses—to maintain their high.

Robin Williams said that: "Cocaine is God's way of saying that you're making too much money." However, due to its expense - often more than $1,000 a day - many wealthy people have been left penniless by cocaine addiction.

After marijuana, cocaine is the second most commonly used illicit drug in the United States, and the second most trafficked drug in the world.

According to one study, trace amounts of cocaine can be found on four out of every five dollar bills in circulation.

More than 400,000 babies are born addicted to cocaine each year in the U.S.

---

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

---

Want to get the whole story?

See the author's book, for a guided tour through the brain changes, genetics, and psychology that cause addiction... and how to use this information to beat addiction.

This successful book enables addicts and alcoholics to understand why addictive substances hold such power over them, and it allows non-addicts to understand addiction and all the behaviors that go along with it. Loved ones, teachers, clergy, supervisors, healthcare professionals... anyone who encounters addiction will find this book an eye-opener.

The book is presented in everyday language with a sense of humor that makes it a fun read.

This important book is available in e-book and paperback versions, and for download of free samples at amazon.com Click Here

---

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

---

 

The direct effects of the drug itself causes only one third of the deaths associated with cocaine use. The vast majority of deaths related to cocaine are caused by homicide, suicide, and motor vehicle collisions as a result of the drug’s mind-altering properties.

Cocaine in history

Back as far as 3000 BC, cocaine was used by the ancient Incas in the Andes as a way to speed up their breathing and heart rate to counter the effects of exertion at high altitudes.

In Peru as late as the 1500s, cocaine was used during religious ceremonies. The Native Peruvians would chew the leaves of the coca plant during religious ceremonies to produce a stimulant effect that often included hallucinations, both auditory and visual.


Cocaine was given to slaves by their "owners" in efforts to make them work harder, and because it was believed that it made the slaves easier to control.

The drug was not formally isolated from the coca leaves until 1859, when German chemist Albert Niemann first extracted cocaine from coca leaves.

In the 19th century it was added to wine in France (coca wine).

It was used in the U.S. in the 19th century as an anesthetic for eye, nose and throat surgeries. It was also the active ingredient in many "tonics" used for just about any illness.

 Cocaine was viewed as a cure-all.

The maker of Coca-Cola, John Pemberton, actually used coca leaves as an ingredient in his cola drink in the 1880’s. Coca-Cola then became widely known as a cola that would produce euphoric effects and increased energy. Coca-Cola originally contained about 9 mg of cocaine per serving. Cocaine was removed from the drink’s ingredients in 1903, but a cocaine-free version of the coca leaf is still used as a flavor additive in Coke even today.


Unfortunately, it took many years before cocaine abuse was finally considered dangerous and potentially lethal to the user. By the early 1900s, cocaine use was a very widespread problem. During this time, the US Government reported as many as 5,000 cocaine-related deaths each year. By 1922 cocaine was no longer legal, and use of the drug would gradually taper off.



Cocaine use saw a resurgence, beginning in the 1960s. By the 1970s, cocaine would start to emerge once again as a fun, fashionable way to get high and stay “awake and alert.” The drug was widely used by entertainers, business professionals and elites in a forlorn effort to increase focus, increase energy and provide a stimulant effect. Widespread use escalated heavily through the 80s (especially with the introduction of crack cocaine) and to the present day.

Forms of cocaine

(Note: no photos of the drugs are provided, so as to avoid triggers for those who suffer addiction).

Cocaine is most often seen in its powder form, which is snorted through the nose, or rubbed into the gums. The powder can be dissolved in water and injected into a vein. Some users' ears ring after an injection, a condition known as a “bell ringer.”

There is also an injectable combination of cocaine and heroin, called a Speedball.

Another popular method of use is to smoke cocaine that has been processed to make a rock crystal (also called "freebase cocaine"). The crystal is heated to produce vapors that are inhaled into the lungs. This form of cocaine is called Crack, which refers to the crackling sound of the rock as it's heated. Crack is the most addictive form of cocaine.

All of the cocaine coming into the United States arrives as powder cocaine and some is modified and made into crack in the country.

 You never know how your cocaine got here! This is not how you make crack cocaine (sorry).

The slowest onset of cocaine’s effects occurs when it is snorted, and this can take up to 20 minutes. The effects last up to 60 minutes. When injected, cocaine reaches the brain within one minute and the effects last for up to 30 minutes. Smoked cocaine (only crack cocaine can be smoked) takes about 20 seconds to reach the brain, and its effects last for about 30 minutes.

Oddly, cocaine and crack cocaine differ in that the criminal punishments associated to their use and possession are very different. For example, on average, possessing 500 grams of powder cocaine carries the same penalty as possessing 28 grams of crack.

There is a particularly deadly trend that is becoming epidemic: cutting cocaine with Fentanyl or Carfentanil. This is done to rip off users, who still get high off cheap and easy to import Fentanyl, often with little or no actual cocaine present in the powder. However, it is a deadly practice, and has been found responsible for multiple accidental cocaine deaths. Unlike cocaine, which is a stimulant, Fentanyl and its cousin Carfentanil are opiates, which cause a person to stop breathing very easily. Because Naloxone doesn't work for cocaine, many cocaine users are not familiar with the life-saving drug, nor do they have access to it, because they're not even aware they are using Fentanyl.

How does cocaine affect the brain?

Cocaine increases levels of the natural chemical messenger (neurotransmitter) dopamine in brain. This is the "feel-good" reward chemical that the brain releases to reward us when we accomplish something. (See "The Brain in Addiction and Alcoholism" Click Here.) This is the same brain chemical that all drugs of addiction, including alcohol, target to have their pleasurable effects, although many of them do it in different ways.

Cocaine not only causes increased release of dopamine, it also prevents dopamine from recycling, causing excessive amounts to build up. This flood of dopamine ultimately disrupts normal brain communication and causes cocaine’s high. When the drug wears off dopamine levels crash to below-normal, and we feel depressed, sluggish, fatigued. This is part of what makes us crave more of the drug, to get that dopamine back up.


The high from cocaine is characterized by extreme happiness and energy, mental alertness, and hypersensitivity to sight, sound, and touch. 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 depend on the method of use. Injecting or smoking cocaine produces a quicker and stronger but shorter-lasting high than snorting. The high from snorting cocaine may last 15 to 30 minutes. The high from smoking may last 5 to 10 minutes.

High levels of dopamine are also the cause of psychosis, such as in the disease schizophrenia, so along with the high comes paranoia (extreme), irritability, and bizarre, unpredictable and violent behavior. Many people have ended up in prison for violence they committed while high on cocaine.

Cocaine overdose

An overdose occurs when the person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death. An overdose can be intentional or unintentional. Death from overdose can occur on the first use of cocaine or unexpectedly thereafter. Many people who use cocaine also drink alcohol at the same time, which is particularly risky and can lead to overdose. Others mix cocaine with heroin, another dangerous—and deadly—combination.


Ingesting cocaine and alcohol together causes more deaths than any other drug combination. The effects of cocaine and alcohol combined cause the liver to produce a substance known as cocaethylene. Cocaethylene enables users to consume more alcohol than usual when ingesting cocaine at the same time. This increases a person’s tolerance to alcohol, leading to highly toxic levels in the blood. Over time, cocaethylene accumulates inside the liver causing long-term heart problems and increased risk of overdose with each successive use.

Unfortunately, there is a rapidly rising threat of cocaine overdose, as the trend among dealers to add the powerful Fentanyl and ultra-powerful Carfentanil to cocaine is rapidly rising. The risk of unintentional overdose is very high. The overdose from these opiates is much different from that of cocaine (see "Fentanyl / Opiates Overdose Click Here).

Some of the most frequent and severe health consequences leading to overdose involve the heart and blood vessels, including irregular heart rhythm and heart attacks, and the nerves, including seizures and strokes. During my time as an ER doctor I treated many young people for heart attack and stroke from cocaine use. Not good.

Cocaine-induced stroke. Obviously, this person did not survive the stroke.

There is no specific treatment for cocaine overdose. Treatment consists of addressing the specific symptoms: heart attack, stroke, seizure, injuries, etc. and providing life support.

Derivatives of cocaine

Cocaine is very expensive to buy at street level, and very difficult to import into a country where it is not grown. So, naturally, people are trying to find ways to synthesize cocaine. Only two cocaine derivatives - made by either changing the chemical structure of real cocaine, or by trying to synthesize something similar from scratch - have been found in recreational cocaine. These are pFBT (short for 3-(p-fluorobenzoyloxy)tropane), and dimethocaine. It is uncertain if these have much of a psychoactive effect - giving a high - so they are not commonly seen as recreational drugs.

Another way in which cocaine's limited amounts is addressed is by dealers tainting it with impurities as a way of increasing its amount. Apparently, everybody who touches the real cocaine "cuts" it before in turn selling it, so they can increase their profits at the expense of their customers. By the time it reaches the users, there may not be very much real cocaine left in what they are purchasing. Unfortunately, most of the substances used to dilute cocaine are themselves very toxic when snorted, injected, or smoked. These are known to include: cornstarch, talcum powder, laundry detergent, boric acid, laxatives, and flour.

Dealers may also mix it with other drugs such as other stimulants or with opiates, especially the most deadly of them all: Fentanyl and Carfentanil (see "Fentanyl / Opiates Click Here).

The other way that people are skirting the high price of cocaine is by selling other stimulants as cocaine, or as cocaine substitutes. Chief among these is "Bath Salts," a synthetic stimulant derived from the Khat plant (click here to learn more about "Bath Salts" and the Khat plant: Click Here).

Long-Term Effects

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

• • snorting: loss of sense of smell, nosebleeds, frequent runny nose, and problems with swallowing.

 

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

 Sorry about the graphic picture, but this is bowel that has died from lack of blood flow, as seen with chronic cocaine use. The bowel on the far right is healthy, the bowel on the left is dead or dying. This is your bowel on drugs.

 

• needle injection: higher risk for contracting HIV, hepatitis C, and other blood-borne diseases. However, even people involved with non-needle cocaine use place themselves at a risk for HIV because cocaine impairs judgment, which can lead to risky sexual behavior with infected partners.

Cocaine has been described as the “perfect heart attack drug” because it increases blood pressure, constricts arteries, and thickens heart muscle walls. These abnormalities persist long after the effects of cocaine have worn off, even in recreational users.

 The perfect heart attack drug.

Other long-term effects of cocaine use include being malnourished, because cocaine decreases appetite, and movement disorders, including Parkinson’s disease, which may occur after many years of use. In addition, people report irritability and restlessness resulting from cocaine binges, and some also experience severe paranoia, in which they lose touch with reality and have auditory hallucinations—hearing noises that aren't real.

Cocaine causes significant tooth decay because it dehydrates the mouth and causes bruxism - involuntary teeth grinding.

Chronic cocaine use can destroy the nasal septum - the cartilage separating the nostrils inside the nose.

Nasal septum destruction from snorting cocaine.

Cocaine, HIV, and Hepatitis

Studies have shown that cocaine use speeds up HIV infection. According to research, cocaine impairs immune cell function and promotes reproduction of the HIV virus. Research also suggests that people who are infected with HIV and use cocaine may also be at increased their risk for co-infection with hepatitis C, a virus that affects the liver, even if they do not inject drugs.

Treatment for cocaine addiction

There are no approved medications for treating cocaine addiction: Methadone, Suboxone, etc do not address stimulants such as cocaine.

Treatment consists of a recovery program, such as attending a detox facility, a rehab facility, and/or an outpatient rehab program. Crucial is on-going support with a recovery program that addresses the reasons behind the addiction, and provides a supportive infrastructure of recovery on an on-going basis. Chief among these are the Twelve Step programs (Click Here) and SMART Recovery (Click Here).

There are millions of people who have recovered from cocaine addiction and experienced a return to a rich and full life. It is possible for anyone. Please feel free to review some of the articles on this website about recovery for more information.



References:

cocaine.org

European Monitoring Centre for Drugs and Drug Addiction. (2015, Jan 8). Synthetic cocaine derivatives drug profile. Retrieved from http://www.emcdda.europa.eu/publications/drug-profiles/synthetic-cocaine-derivatives

Platt, Jerome. Cocaine addiction: Theory, research, and treatment. Cambridge, MA: Harvard University Press, 1997.

United States National Institute for Drug Addiction. (2016, June 6). Cocaine. Retrieved from https://www.drugabuse.gov/publications/drugfacts/cocaine on 2017, December 11