The Interesting History of Cocaine
Of all the stimulant drugs, cocaine remains the most well known – and in certain circles has maintained a level of social acceptability. Although its users come from different ages, races and professions, cocaine is still perceived as the drug of choice for the more outwardly successful trend-setters.
Cocaine first became known in western society when the ‘conquistadors’ of Spain invaded high-lying areas of Peru. The natives of the area were observed chewing the coca leaves endemic to the area, and the influence it seemed to have on their behaviour was easily identified. This included higher states of arousal, increased activity and heightened confidence.
For these reasons alone, the Spanish invaders soon outlawed its consumption among the natives, deeming it the “work of the devil”. However, in consideration of the native’s increased productivity when consuming the substance, the Spanish soon legalized and taxed it.
Coca leaves were sent back to Europe for analysis and sampling, and it has been conjectured that a primary reason for its initial failure to catch on in polite society was because it didn’t travel as well as coffee beans, and had minimal effect after its time at sea.
In the mid 1800s, scientists began isolating the active ingredients of the coca leaf, and its potential as an anaesthetic and a general tonic were soon being marketed to the medical profession and the public. It’s popularization was then rapid, and cocaine was soon to be found in general tonics, cigarettes and even alcoholic preparations. One such preparation – Mariani Wine – was heartily endorsed by the Vatican!
The Dangers of Cocaine Abuse
It is estimated that more than 90% of hospital admissions for serious cardiac events, including arrhythmias and heart attacks, in people under the age of 30, are as a direct result of cocaine use. This does not apply only to serious cocaine abusers, but also to first time users and occasional users.
Different methods of taking the drug can produce different adverse cocaine effects. Regular snorting of cocaine, for example, can lead to loss of the sense of smell; nosebleeds; problems with swallowing; hoarseness; and a chronically runny nose.
Long term cocaine abusers sometimes have to have their nasal cavities / septum’s rebuilt by specialists ENT’s (Ear, Nose and Throat surgeons). Ingesting cocaine orally can cause severe bowel gangrene as a result of reduced blood flow and injecting cocaine can bring about severe allergic reactions and increased risk for contracting HIV and other blood-borne diseases.
Binge-patterned cocaine use may lead to irritability, restlessness, and anxiety.
All cocaine abusers 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.
It is extremely difficult to determine a standard “safe” dosage of cocaine. This differs from individual to individual and is further complicated by the fact that cocaine is usually “cut” (mixed) with one or more other substances, including caffeine, baking soda and even rat poison. These two factors combine to produce an almost “Russian Roulette” risk profile every time the substance is ingested.
Toxic doses can lead to respiratory failure, stroke and heart failure.
The Difference Between Cocaine Abuse & Cocaine Addiction
For regular users, cocaine addiction (dependence) is a serious risk, and more often than not, full-blown addiction. A ‘social user’ crosses the line from cocaine abuse to cocaine addition when ever increasing tolerance results in the user needing more of the substance, more frequently, to achieve the desired results.
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.
Cocaine abuse 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.
The high from using cocaine may last 15 to 30 minutes. In order to sustain the high, a cocaine abuser has to administer the drug again. For this reason, cocaine is sometimes abused in binges—taken repeatedly within a relatively short period of time, at increasingly higher doses.
Cocaine addiction affects all areas of the users life, including physiological, emotional, mental, financial and family life.
It is not difficult for a cocaine addicted person to bankrupt him or herself in a relatively short space of time. Emotionally, cocaine typically gives its users a sense of invincibility and inflated self-worth, often very at odds with their reality.
The mental obsession is characterised by a sense of panic when the drug runs out, and an almost unstoppable desire to do whatever it takes to acquire the next hit.
Other dangers include prolonged loss of appetite, malnutrition and complications of the digestive system.
Cocaine dependence often leads to severe paranoia — a temporary state of full-blown paranoid psychosis — in which they lose touch with reality and experience auditory hallucinations and need to be admitted to a quality cocaine addiction treatment centre.
Cocaine’s effect on brain chemistry is profound, as it raises the presence of dopamine and serotonin in the brain. These two neural transmitters are responsible for normal feelings of pleasure and satisfaction, and the sustained effect of cocaine renders the user profoundly dependent on the substance just to feel normal.
Hallmarks of cocaine craving include mental obsession, irritability, inability to focus on anything else and irrationality.
Loss of Control
Cocaine addicts never feel more in control of their lives than when intoxicated. The feelings of grandeur and power are at serious odds with their real life situation. It can seem extremely paradoxical to the observer. The addict’s house may be falling apart, they may be facing financial ruin, they may have lost their job and their partner – all quite clearly consequential to their cocaine addiction.
Yet to the cocaine addict, this reality and their attendant anxieties can only be solved by the next hit. This loss of control is in direct opposition to standard human behaviour; whereas as a healthy person seeks to minimise drug intake and maximise financial security, the cocaine addict who has lost control literally pursues the opposite.
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 exposure. 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.
The Importance of Cocaine Detox
You may have heard the cocaine addiction does not produce the sort chronic physical dependence as some other drugs. While there is sometruth to this, it is not the whole picture. Unlike alcohol or heroine, for example, abruptly stopping the use of cocaine does not, strictly speaking, produce what is called ‘withdrawal syndrome’ – in which the individual experiences distinct symptoms, including intense muscular pain, sweating and even seizures.
However, the cocaine addict trying to come off the drug experiences severe and often intolerable cravings for the substance. In more advanced cases, paranoia and dissociation are also present.
The severity of these cravings is a direct result of the effect cocaine has on brain chemistry. The cocaine addict has become dependant on the substance for the effects the drug has on serotonin and dopamine – the brains normal feel-good transmitters. With prolonged use, the cocaine addict starts to need the drug simply to feel normal. Attempting to go without the drug is more often than not impossible for a cocaine addict.
To safely get through cocaine detoxification, cocaine addicts need specialized support from addictions specialists, as well as medical supervision. It is essential that they are assessed for depression during this phase, and receive medical support. Many cocaine addicts suffer from co-occurring psychiatric problems which must also be addressed to ensure their best chances of recovery.
Cocaine Addiction Treatment and Rehabilitation
In addition to successfully getting off cocaine for a meaningful amount of time, cocaine addicts need comprehensive drug rehabilitation treatment to increase their chances of sustaining a drug-free lifestyle.
It is critical that cocaine addicts learn about the disease of addiction to better understand why they ended up in this fragile position, where many of their peers did not.
Above all, cocaine addicts need to break through their wall of denial that so often prevents them seeing how their life-problems are directly linked to their addiction. This is extremely tough for addicts, as beneath their denial hides immense shame. Helping them to get honest about their disease brings this shame out into the open, and only skilled clinicians should be trusted to facilitate this process without adding to the burden of shame.
Recovery from cocaine addiction is not only possible; it is probable when handled correctly. A good treatment centre will have qualified staff across all needed disciplines, including counsellors, doctors, nurses and mentors.
The debate as to whether drug addiction and alcoholism meet the rigid classification to be determined a ‘disease’ will rage on. What’s more important is how practically useful the disease concept can be in people’s lives.
It may be convenient for people to regard addiction as analogous to a disease if it helps them to structure their lives around the problem. This is most important when treating co-morbidity.
Defining a sustainable treatment strategy that includes comprehensive assessment and treatment of dual-diagnosis is paramount to patient’s success. I believe wholeheartedly that drug rehabs help treat mood disorders too, and have seen many patients with mood disorders and addiction receive effective treatment that resulted in an overall improved quality of life.
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