Dr Sacrifice Chirisa Mental Health Matters
Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. In the street, cocaine looks like a fine, white, crystal 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, or synthetic opioids, including fentanyl.
Adding synthetic opioids to cocaine is especially risky when people using cocaine don’t realise it contains this dangerous additive. Increasing numbers of overdose deaths among cocaine users might be related to this tampered cocaine. Popular nicknames for cocaine include:
Cocaine is used in different ways, below are some of the ways it is used:
People snort cocaine powder through the nose, or they rub it into their gums.
Others dissolve the powder and inject it into the bloodstream. If it combines with heroin, it is called speedball.
Another popular method of use is to smoke cocaine that has been processed to make a rock crystal, the crystal is heated to produce vapours that are inhaled into the lungs. This form of cocaine is called crack, which refers to the crackling sound of the rock as it is heated. Some people also smoke crack by sprinkling it on marijuana or tobacco, and smoke it like a cigarette.
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.
So this is how cocaine affects the brain in terms of the neurobiological action. Cocaine increases levels of the natural chemical messenger dopamine in brain circuits related to the control of movement and reward. Normally, dopamine recycles back into the cell that released it, shutting off the signal between nerve cells.
However, cocaine prevents dopamine from being recycled, causing large amounts to build up in the space between two nerve cells, stopping their normal communication.
This flood of dopamine in the brain’s reward circuit strongly reinforces drug-taking behaviours, because the reward circuit eventually adapts to the excess of dopamine caused by cocaine, and becomes less sensitive to it. As a result, people take stronger and more frequent doses in an attempt to feel the same high, and to obtain relief from withdrawal.
Short-term health effects of cocaine use include, but not limited to:
Hypersensitivity to sight, sound, and touch
Paranoia; extreme and unreasonable distrust of others
Large amounts of cocaine can lead to bizarre, unpredictable, and violent behaviour.
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 depends 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.
Some long-term health effects of cocaine depend on the method of use and include the following:
Snorting: loss of smell, nosebleeds, frequent runny nose, and problems with swallowing
Smoking: cough, asthma, respiratory distress, and higher risk of infections like pneumonia
Consuming by mouth: severe bowel decay from reduced blood flow
Needle injection: higher risk for contracting HIV, hepatitis C, and other blood borne diseases, skin or soft tissue infections, as well as scarring or collapsed veins. However, even people involved with non-needle cocaine use place themselves at a risk of HIV because cocaine impairs judgment, which can lead to risky sexual behaviour with infected partners.
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 from cocaine binges, and some also experience severe paranoia and psychosis in which they lose touch with reality and have auditory hallucinations; hearing noises that aren’t real.
As with other drugs, repeated use of cocaine can cause long-term changes in the brain’s reward circuit and other brain systems, which may lead to addiction. That is difficult to treat. The reward circuit eventually adapts to the extra dopamine caused by the drug, becoming steadily less sensitive to it.
As a result, people take stronger and more frequent doses to feel the same high they did initially and to obtain relief from withdrawal.
When one stops using cocaine one will withdrawal and have the following symptoms that include:
Unpleasant dreams and insomnia
Treating cocaine addiction is a difficult process, but doable. Due to the changes that would have happened to the reward neural systems of the brain it takes much longer than most drugs and much harder to treat. Behavioural therapy is usually used to treat cocaine addiction. This will include a combination of the following therapies:
Contingency management or motivational incentives; providing rewards to patients who remain substance free
Therapeutic communities and Drug rehab facilities
The take home message is cocaine is bad news, and its addiction is difficult to treat. The best is to avoid it at all costs as one single use can get many hooked for life. For help in Zimbabwe contact Highlands Halfway House or Borrowdale Halfway House in Harare as they have developed expertise to help patients with addictions.