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Cocaine: Old Attitudes New Dangers

Alcoholism is the primary chemical causing addictive disease in our country. It is responsible for thousands of fatalities each year, but there is another drug that is having a profound effect both on how we think about chemical dependency and on addictions medicine. In the 1980’s and early 1990’s it became the “in thing” in certain social circles in North Carolina for lawyers to use this drug. The drug is cocaine.

Cocaine was first isolated from the South American cocoa leaf, as its most active alkaloid, in the 1880’s by Albert Niemann. From the beginning cocaine has been a controversial drug. Coca-Cola’s original Coke was marketed as a patent medicine and contained cocaine. Coca-Cola abandoned the use of cocaine in its syrup in 1903 but many respected health professionals, not to mention President William McKinley, praised cocaine as a medical wonder drug. Cocaine was first regulated in the United States in 1914 and continues to be used medically as a local anesthesia for certain operations. But after it was initially lauded as a medical breakthrough and given fashionable credibility by Sherlock Holmes’ use in the literary world, cocaine generally disappeared from the scene in the 1920’s and 1930’s and was considered a drug of great depravity used only in the roughest urban ghettos.

This changed in the late 1960’s and early 1970’s when cocaine emerged from the ghetto and again obtained a degree of respectability in certain circles. At this time, many health professionals and substance abuse treatment centers sent mixed messages to the public about cocaine. Some viewed cocaine as not threatening because its use did not seem to have all of the classic medical symptoms of other addictive drugs. For example cocaine use did not promote tolerance to a great degree and withdrawal from cocaine did not appear to be nearly as dangerous as drugs like heroin or alcohol. During this time users of cocaine inhaled it in a powder form into their nostrils where it was carried into the bloodstream through the tiny blood vessels in the nose’s mucous membrane.

Then the practice of free-basing began. This involved inhaling a highly concentrated form of cocaine vapor directly into the lungs. This form of use brought death and other tragedies. Professional opinion altered dramatically and cocaine rapidly came to be viewed as a very dangerous drug. At the same time, cocaine became a prestigious drug with an elite reputation and its market began to expand rapidly as cocaine became both much cheaper and much stronger. This increased usage also brought a dramatic increase in cocaine-related medical emergencies and fatalities. It was estimated in 1984 that one out of every ten or about 22 million Americans had tried cocaine.

Then, in 1985 an even more ominous event: a new form of free-base cocaine called “crack” appeared on the east coast and began spreading across the country. Crack is a form of cocaine hydrochloride that is processed into a resulting powder or crystals known as rocks. It is thought that the name crack comes from a crackling sound when it is smoked. The crystals are white and are about the size of a pencil eraser. Crack became available on the street corner in ready-to-smoke form at a price of $5 to $10 a rock. The development of crack was a marketing coup on the same scale as the sliced loaf of bread or the Bic pen. It made the drug ready for immediate use, available at prices that the youth market could afford and allowed for its ingestion, i.e., smoking, in a matter that was readily acceptable.

Cocaine, in any form, affects the electrical signals sent between the brain and the heart and can cause potentially fatal seizures. The world was soon to learn about the tragic death of nationally known sports stars who succumbed to the effect cocaine can have on even the healthiest person. Although it is now demonstratively clear that cocaine use is a potentially fatal activity, many users continue to see what they are doing through the attitudes of preceding decades where substantial uncertainty existed not only in public opinion but among health professionals about the risk of cocaine use.

What do you need to know about crack? First, it is important to understand why crack is so highly addictive. When crack is smoked, it reaches the brain almost instantaneously, providing a very quick “high.” The crack “high” does not last long, however, and is usually followed by a profound “low” that leaves the user depressed and agitated and therefore, craving the drug to eliminate the symptoms of the low. Because the crack high is so intense and pleasurable but also so short and because the low that follows is equally profound, crack users take the drug again and again. As a result, the addictive process with crack seems to accelerate in the body. The person who is a relatively short-time crack user may experience the same level of addictive disease that affects an alcoholic who has drunk hard for twenty years. Many crack addicts who have sought to recover express the belief that their addiction started with just one-time use. Brain chemistry research indicates that cocaine, in any form, has a “catch-22” affect on human neuroreception. That is, it increases the release of pleasure inducing components while at the same time it reduces the brain’s ability to reprocess these components. The inevitable result is the familiar downward spiral of addiction.

Medically, we now know much more about the affects of cocaine than have been known in the past. Cocaine increases the blood pressure markedly, causing often fatal brain hemorrhaging as the blood accelerates through arteries at a much greater pace. Another source of cocaine fatalities comes from the changes that occur in the heartbeat as the electrical signal between the brain and the heart becomes distorted. Heartbeat speeds up 30% or more above its normal rate with marked irregularities so that the heart will skip beats and then double up on contractions.

Cocaine can have an affect on skin coloration, causing the skin to have a yellow or grayish cast probably because of damage to the liver. It also stimulates the oil glands in the skin often causing pimples and acne.

Cocaine users are often sufferers of bronchitis and coughing. Cocaine affects the membranes of the openings to the lungs causing mucous to form and inflammation. Another symptom of cocaine use is its affects on the muscles of the body. Like its overstimulation of the heart muscle, it also overstimulates other muscle fibers causing involuntary contractions. This may result in cocaine users having facial ticks or involuntary jerks of the bodies caused by faulty signals going to muscle fibers. The electrical misfiring caused by cocaine has resulted in convulsions.

Emotionally, cocaine users ride a roller coaster of extreme highs in which they feel powerful and in control and extreme lows in which they feel irritable, suspicious and depressed. The emotional affects of cocaine are likely to be seen most readily in the disruption of the family system or in a lawyer becoming increasingly conflictual with other partners or associates. Because of the cost of sustaining a cocaine habit, financial problems are another sign that a person’s life is being put into havoc by the drug.

The evidence is absolutely clear that cocaine, which was once viewed as a wonderful medical discovery, with effects so beneficial that it could be an ingredient in a popular soft drink, is now a dangerous and vicious drug. The difficulty is that we may be viewing cocaine through the eyes of an earlier generation and through the ambivalence of medical and treatment professionals 10 to 20 years ago. We do not need to be re-educated the hard way. Cocaine hooks its users faster than almost any other drug and significantly alters brain chemistry. Cocaine addiction does not go away by ignoring it. Usually cocaine is used with alcohol where its use will accelerate the onset of brain chemistry changes that make a person dependent upon alcohol. In fact, cross-addiction with alcohol, although usually most recognizable at first is almost always inevitable. Cocaine addiction only gets worse. Because cocaine is so destructive, the addict should immediately seek help. If you think you have a problem with cocaine, or any other chemical, or are concerned about someone who does, confidentially contact the PALS Program at 1-800-720-7257.

– by Don Carroll

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