Crack and Cocaine

So much has been written about the negative effects of cocaine and the dangers of taking it that the following are just a few short and abridged excerpts from information available on the internet. They have been chosen because people who have experienced crack or cocaine addiction can identify with them and because they talk about the real potential risk that people who are addicted to these drugs can face.

As you read it though, it is important to remember that there is a way out of this addiction. You can stop these negative effects from happening by admitting you have a problem and then seeking help.

At StreetScene we have many years of experience in working with people with crack and cocaine addictions, many of our staff have experienced the condition first hand and recovered and gone on to lead lives more enjoyable than they ever thought possible. Many of our graduate clients are still in touch and send us word as their lives go from strength to strength, doing things they never dreamed were possible whilst they were in the grip of their problems

With this in mind, please read on…

How Does Cocaine and Crack Affect the Brain?

Cocaine is a strong central nervous system stimulant that increases levels of dopamine in the brain’s reward circuit. It is this excess of dopamine that is responsible for cocaine’s euphoric effects. With repeated use, cocaine can cause long-term changes in the brain’s reward system and in other brain systems as well, which may eventually lead to addiction. With repeated use, tolerance to the cocaine high also often develops. Many cocaine abusers report that they seek but fail to achieve as much pleasure as they did from their first use. Some users will increase their dose in an attempt to intensify and prolong the euphoria, but this can also increase the risk of adverse psychological or physiological effects.

What Adverse Effects Does Cocaine and Crack Have on Health?

Abusing cocaine has a variety of adverse effects on the body. For example, cocaine constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure. It can also cause headaches and gastrointestinal complications such as abdominal pain and nausea. Because cocaine tends to decrease appetite, chronic users can become malnourished as well.

Different methods of taking cocaine can produce different adverse effects. Regular snorting can lead to loss of the sense of smell; nosebleeds; problems with swallowing; hoarseness; and a chronically runny nose. Swallowing cocaine can cause severe bowel gangrene as a result of reduced blood flow. Injecting cocaine can bring about severe allergic reactions and increased risk for contracting HIV/AIDS and other blood-borne diseases. Binge-patterned cocaine use may lead to irritability, restlessness, and anxiety. Cocaine users can also experience severe paranoia — a temporary state of full-blown paranoid psychosis — in which they lose touch with reality and experience auditory hallucinations.

All cocaine and crack users can experience acute cardiovascular or cerebrovascular emergencies, such as a heart attack or stroke, which may cause sudden death. Cocaine-related deaths are often a result of cardiac arrest or seizure followed by respiratory arrest.

Added Danger: Cocaethylene

When people consume two or more psychoactive drugs together, such as cocaine and alcohol, they compound the danger each drug poses. Researchers have found that the human liver combines cocaine and alcohol to produce a third substance, cocaethylene, which intensifies cocaine’s euphoric effects. Cocaethylene is associated with a greater risk of sudden death than cocaine alone. (NIDA)

A common myth is that cocaine is not addictive because it lacks the physical withdrawal symptoms seen in alcohol or heroin addiction. Cocaine has powerful psychological addictive properties. As more than one user has reflected: "If it is not addictive, then why can't I stop?" (webmd)

Cocaine and Crack abuse symptoms

The effects of cocaine can be divided into three areas; what goes on in the central nervous system, in the brain, and in the rest of the body. The effects of the drug vary greatly, depending on both physical and psychological circumstances. Because cocaine affects every organ system, from the brain to the skin, the following discussion will cover signs and symptoms for major organ systems.

Central nervous system and psychiatric effects: Users who have pleasurable experiences report varying degrees of euphoria; increased energy, excitement, and sociability; less hunger and fatigue; a marked feeling of increased physical and mental strength; and decreased sensation of pain. Some will feel a great sense of power and competence that may be associated with the delusion or false sense of grandeur, known as cocainomania. There can be talkativeness, good humour, and laughing.

However there are also dilated pupils, nausea, vomiting, headache, or vertigo (the sensation of your surroundings or yourself moving or spinning). With or even without increased amounts of coke, these can progress to excitement, flightiness, emotional instability, restlessness, irritability, apprehension, inability to sit still, teeth grinding, cold sweats, tremors, twitching of small muscles (especially of face, fingers, feet), muscle jerks, hallucinations of all sorts, and cocaine psychosis. Cocaine psychosis resembles paranoid schizophrenia and can bring on paranoia, mania, and psychosis.

Major effects that usually cause a cocaine abuser to go or be taken to an accident and emergency department are severe headache, seizures, loss of consciousness that can be caused by not breathing or bleeding in the brain, stroke, hyperthermia (increased body temperature), coma and loss of vital support functions (such as low blood pressure, slow heart rate, slow respirations, and death).

Brain effects: The use of cocaine or crack causes the alteration of responsiveness of the brain to various chemicals. These alterations are responsible for most of the complications of cocaine. Infants of cocaine and crack smoking parents have been brought to an accident and emergency department because of seizures induced by second-hand cocaine smoking. One study of people who sought care in an accident and emergency department reported that 22% complained of anxiety, 13% dizziness, 10% headache, 9% nausea, 9% psychosis, and 9% confusion.

The rest of the body:

Ear nose and throat: Because the majority of cocaine users sniff or snort cocaine through their nose, there are a variety of nasal and sinus diseases. Many users complain of nasal irritation, nasal crusting, recurrent nosebleeds, nasal stuffiness, facial pain caused by sinusitis, and hoarseness.The mucous membrane of both sides of the septum (the cartilage that separates the nostrils) can be damaged by decreased blood supply, along with drying, crusting, and nose picking. This results in a perforation or hole in the septum with more crusting, foul secretions, nosebleeds, and whistling with nasal breathing, the so-called coke nose.
 Because nasal obstruction is a common complaint, many users self-treat with over-the-counter nasal decongestants. This adds to the problem because it also closes or narrows the blood vessels.

Lung effects: The direct effects of smoking crack are responsible for most lung and breathing complications. The large surface area of the lungs and its great blood supply cause rapid and profound brain stimulation known as a head rush.

The residue from the tars, matches, cocaine contaminants, and additives, such as marijuana, often cause chronic bronchitis, chronic coughing, and coughing up black, non-bloody phlegm. These conditions can cause shortness of breath and chest pain.

Using deep inhalation and breath holding to maximise the amount of cocaine inhaled and absorbed can cause the lung to collapse. These cocaine users will complain of sharp chest pain, often worse with deep breathing, neck pain, difficult or painful swallowing, and air under the skin in the neck that feels like small bumps under the skin when touched.

In one study of the cocaine abusers who came to an accident emergency department, 40% complained of chest pain - the most common complaint - and 22% complained of shortness of breath or were unable to breathe.

Cardiovascular (heart, blood vessels): The major effect of cocaine is to stimulate the sympathetic nervous system. This system is responsible for the "fight or flight response" and is controlled primarily by adrenaline or epinephrine. The effects include increased heart rate, blood vessel narrowing, and high blood pressure. Angina or the chest pain that is felt with decreased blood supply to the heart and heart attack have accounted for more reports in medical journals than any other complication of cocaine intoxication.

Other cardiovascular complications include abnormal heart rhythms or rapid heart rate, cardiomyopathy or disease of the heart muscle, or aortic rupture or dissection where there is weakening of the walls of the aorta. The acute use, despite the amount or route, causes narrowing of the arteries to the heart and vasospasm resulting in decreased blood flow to the heart. This causes angina, which can lead to a heart attack that means death of heart tissue. Chronic use of cocaine, regardless of the route, leads to accelerated hardening and subsequent narrowing of the coronary arteries. Therefore, angina and heart attacks and cardiac deaths have been found in young users from 19-44 years old.

The overstimulation of the sympathetic system with the rapid heart rate, high blood pressure, and vasospasm also cause the abnormal rhythms. Those rhythms may be ventricular tachycardia and ventricular fibrillation and may cause sudden death. In a US study, chest pain was the most common complaint to accident and emergency departments, with up to 40% of people complaining of chest pain and 21% complaining of palpitations or the sensation that their hearts were racing or going fast. (WEBMD)