COCAINE is the main active chemical in the leaves of Erythroxylon coca, a shrub that grows in South America and southeast Asia. The drug has significant physical and psychological effects.
The psychological effects mean that regular users of high doses of cocaine develop bouts of uncontrolled and impulsive behaviour as well as exhibiting impaired judgment.
The initial attraction of the drug is the pleasant feelings of euphoria it induces, leading to a huge rush of energy and optimism. Increased self-esteem and sex drive are other immediate effects.
New users often try cocaine to help them to increase their productivity at work and in other areas of their lives, so that they can work harder for longer.
However, as David (above) says, “It lasts half an hour – up to an hour if it’s really good coke – then you start losing it, so you have another line. But the second is never as good as the first. You spend the night chasing the first buzz.”
These mostly pleasant feelings diminish with successive doses. Users of the drug need progressively larger doses to achieve the same degree of euphoria.
High doses bring toxic side effects including paranoia and hallucinations. Regular users experience disordered thought patterns, by which they lose insight and may become violent.
Cocaine’s physical effects are equally toxic. When the powder is snorted into the nostrils, it causes blood vessels in the lining of the nasal passages to shrink. Repeated doses lead to a loss of blood supply to the septum, the wall dividing the nostrils.
Eventually, this wall begins to disintegrate and a hole appears between the two nasal passages.
A telltale sign of repeated cocaine use is a red, running, stuffed-up nose, due to a reflex widening of the blood vessels following initial constriction.
Once it gets into the body, cocaine releases large amounts of the stress hormone noradrenaline, which causes blood vessels to narrow. This leads to a sudden and significant rise in blood pressure, as well as a narrowing of the coronary arteries, putting users at risk of heart attack or stroke. Many cocaine deaths are due to these cardiovascular events.
The body’s main blood vessel, the aorta, becomes damaged by long-term use of cocaine. A surge in blood pressure forces the blood between the inner and outer linings of the aorta. This false passage can burst (an aortic dissection), leading to a tearing pain in the chest or back.
Research has found that more than one-third of patients with the potentially fatal condition had been using cocaine. Cocaine and alcohol are synergistic. Drinking makes the cocaine last longer because of the way the two drugs interact in the liver.
Researchers have found that the human liver combines cocaine and alcohol to manufacture a third substance, cocaethylene, which intensifies cocaine’s euphoric effects. The risk of sudden death is about 18 times greater than when cocaine is used on its own.
Liver damage is also more common when alcohol and cocaine are used together. Other life-threatening effects associated with heavy use include brain seizures, respiratory failure and kidney failure. Cocaine causes appetite suppression, which accounts for some of its popularity in the fashion industry. It increases body temperature and causes skin pallor.
“Snow bugs” is a term used to describe the unpleasant crawling feelings under the skin sometimes felt during withdrawal from the drug. Other withdrawal signs include pain, sleeplessness and occasionally life-threatening convulsions.
As cocaine assumes a greater role in a person’s life, behaviours such as lying, missing work and denying cocaine use to loved ones may develop.
Cocaine was once used as a local anaesthetic in eye surgery and a related product, lignocaine is still used in medicine and dentistry today.