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Sacrifice Chirisa Mental Health Matters
Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant found in South American countries. As a street drug, cocaine looks like a fine, white 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 and its use is even more dangerous.

Popular nicknames for cocaine include: blow,coke, crack and snow. People snort cocaine powder through the nose, or they rub it into their gums, inject it into the bloodstream. Some people inject a combination of cocaine and heroin, called a Speedball.

People who use cocaine often take it in binges, taking the drug repeatedly within a short time, at increasingly higher doses to maintain their high. Cocaine exerts its effects by increased levels of the natural chemical messenger dopamine in brain circuits controlling pleasure and movement.

Normally, the brain releases dopamine in these circuits in response to potential rewards, like the smell of good food. It then recycles back into the cell that released it, shutting off the signal between nerve cells.

Cocaine prevents dopamine from recycling, causing excessive amounts to build up between nerve cells. This flood of dopamine ultimately disrupts normal brain communication and causes cocaine’s high.

Short-term health effects of cocaine include:

• Extreme happiness and energy
• Mental alertness
• Hypersensitivity to sight, sound, and touch
• Irritability
• Paranoia—extreme and unreasonable distrust of others

Of note cocaine use leads to bizarre, unpredictable, and violent behaviour.

These effects appear almost immediately and disappear within an hour.

Other health effects of cocaine use include:

• Constricted blood vessels
• Dilated pupils
• Nausea
• Raised body temperature and blood pressure
• Faster heartbeat
• Tremors and muscle twitches
• Restlessness
• Mental illness

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.
• Needle injection: higher risk for contracting HIV, hepatitis C, and other blood borne diseases.

Cocaine users will need drug rehabilitation. This will involve psychiatric care under a psychiatrist in conjunction with psychologists and occupational therapies.

The Good news is that this is now available in Zimbabwe, where there is inpatient care at Highlands Halfway House.

In the past cocaine patients had to be referred to South Africa.

Having seen the increase of cocaine use in Zimbabwe over the past year, people experiment on harder drugs. The take home message is cocaine use is dangerous medically and psychiatrically.

• Dr Sacrifice Chirisa is a passionate mental health specialist based at Parirenyatwa Group of Hospitals; one of the country’s major referral hospitals.