Jun 6, 2019 in Research

Consequences of Cocaine Usage

Introduction 

Cocaine is a strong stimulant, which has local anesthetic and psychoactive effects. Due to these effects, cocaine is frequently used as a drug. The leaves of the plant, which is called coca, have long been famous for their tonic and narcotic effects. Aborigines of South Africa were the first who started using those leaves and producing a substance made of them. Pure cocaine extracted from the leaves of coca spread to Europe and the United States in the middle of the XIX century. Initially, it was widely used for medicinal purposes, but at the beginning of the XX century, cocaine was replaced by more advanced drugs and is no longer used in medicine. 

Cocaine is considered to be the second in the list of “problem drugs” (narcotic substances abuse, which represents a significant social and economic problems). Due to geographical proximity of areas of coca bush cultivation and production of chemically pure cocaine, the use of the substance is mainly spread in North and South America. According to Pomara et al., in 2012, 70% of global cocaine consumption was concentrated in North and South America; 22% - in Western Europe (5648). 

The effects of cocaine usage can be divided into two parts: central and peripheral. This division is based upon the parts of the nervous system affected by the drug. Effects on the central nervous system include cheerfulness, euphoria, bursts of energy, increased mental activity, decreased need for sleep, little appetite, and enlarged physical endurance. Peripheral effects are tachycardia, shortness of breath, increased blood pressure and body temperature, sweating, and dilated pupils. 

Adverse effects of cocaine consumption result from repeated use when drug addiction causes serious changes in the nervous system and the organism is unable to function normally without cocaine. Cocaine has a powerful deathless to users because it affects heart, brain, emotions, increases blood pleasure, provokes violent physical behavior, causes problems with work performance, and has many other negative effects. This essay will describe adverse consequences of cocaine usage. 

Cocaine and Cardio-vascular Diseases 

Cocaine seriously affects the cardio-vascular system. Ghodse wrote about these effects: “In the cardio-vascular system there is a temporary increase in pulse rate and blood pressure, palpitations, and flushing of the face” (92). Flushing of the face is a result of vascular spasms, which leads to the broken thermoregulation. As a result, body temperature increases, which negatively affects cardio-vascular system. Such condition is a serious challenge for the human heart. It can lead to heart attack, arrhythmia or stroke. The heart of a drug addicted person is always in a very bad state regardless of the name of the drug. If a cocaine addicted person does not die of overdose, after some period of drug usage, the state of his/her heart will be similar to the one of an 80-year old person. 

According to the fact sheet published by the National Institute of Drug Abuse, various cardio-vascular problems caused by repeated cocaine intake can lead to sudden death: “Cocaine-related deaths are often a result of the heart stopping (cardiac arrest) followed by an arrest of breathing”.  Nowadays, cardiologists agree that drug addiction is one of the main factors that rapidly and significantly increase the risk of having cardio-vascular diseases. 

Cocaine users often complain about having heart pain. This pain is usually not associated with physical activity but in some cases can be quite severe. According to Pomara, in the United States, doctors treat more than 64 thousand patients who use cocaine and have such symptoms per year (5650). They are examined in connection with suspected acute myocardial ischemia; 57% of them are hospitalized. Cardiograms and other methods of heart investigation often show that cocaine users have such heart diseases and disorders as hypertension, bradycardia, myocardial ischemia, and tachycardia. Myocardial ischemia results from the coronary arteries constriction. Cocaine users who smoke tobacco make this effect even more severe. Cocaine also causes numerous changes in the coagulation system. Cocaine usage increases significantly the risk of blood clots formation because cocaine damages the platelets directly and indirectly. Due to cocaine addiction, increased thrombus formation frequently occurs in persons who were considered to be healthy, and this happens suddenly, i.e. without prior cardiovascular diseases. Cocaine also facilitates the progression of atherosclerosis and accelerates the formation of atherosclerotic plaques in the coronary and cerebral arteries, even in young adults. According to the “Practice guideline for the treatment of patients with substance use disorders: alcohol, cocaine, opioids”, 31% of cocaine users who complained about the heart pain had a heart attack. In addition, when a cocaine-addicted person stops taking the drug, it may also cause the attack of myocardial ischemia.  

Along with that, according to Bradley et al., cocaine usage is associated with increased risk of an aneurysm. According to scientists, aneurysm is a ballooning-out of the wall of an artery. Additionally, according to Moore and Richardson, “Cocaine and crack cocaine cause stroke and hemorrhage and have, occasionally, been associated with a vasculitis (17). 

 

Cocaine and its Effect on Brain and Central Nervous System

Cocaine seriously affects brain and central nervous system. According to Sommers, cocaine usage alters brain both functionally and structurally. Sommers states: “Cocaine goes straight to your head, literally, and messes with your brain’s nerve cells, throwing your body and mind out of whack” (13). He proves these facts by the results of the PET (position-emission tomography), which shows that the metabolism of a nonuser’s brain is much higher than that of a cocaine-addict’s brain.  

Cocaine addiction develops very quickly because the substance reaches immediately the human brain and causes a relatively powerful effect, a feeling of extreme pleasure - euphoria. Scientists, for example, Sommers, state that cocaine affects the same parts of brain as stress does. At the same time, cocaine usage affects the organism on genetic level. The drug inhibits the gene responsible for depression by forming special neurons, which protect the organism from it but only in the state of narcotic intoxication. The rest of time, a cocaine-addicted person experiences severe depression and can overcome it only by taking a new dose of the drug. In addition, cocaine provokes various neurological diseases and mental disorders, for example convulsions. 

Cocaine overdose can lead to psychotic disorders with fear, anxiety, and confusion, occasional auditory, visual and tactile hallucinations. The patient believes that others are planning something against him/her and want to kill him/her. Tactile hallucinations are the most frequent: patients feel some crawling insects on and under their skin, and scratch their skin. The acute cocaine intoxication leads to many other somatic and neurological symptoms, such as sweating, dry mouth, tremor, burning eyes, headaches, frequent urination, increased tendon reflexes, muscle twitching, insomnia, nausea, and diarrhea. Addictive behavior is also one of the examples of cocaine effects on the brain and the central nervous system. O’Leary and Hancox wrote: “Cocaine is a highly active stimulant that alters dopamine metabolism in the central nervous system resulting in a feeling of euphoria that with time can lead to addictive behaviors”.

Cocaine and Addictive Behavior 

Addictive behavior caused by cocaine usage significantly influences the emotions of an addicted person. According to Lowinson, “Cocaine produces an alternative sequence of positive (euphoria) and negative (craving) reinforces that tend to perpetuate the addictive behavior” (203). 

Cocaine causes changes in the person’s behavior and life style: for example, a cocaine-addicted person can experience mood swings appearing for no reason except the drug usage. After taking the drug, a person feels joyful and energetic, but when the drug is temporarily unavailable, this person becomes irritable, unhappy, depressed, and sometimes aggressive. A cocaine-addicted person does not need to sleep while experiences the consequences of drug usage, but when its effect is not felt any more, a user sleeps for quite long periods of time. In fact, cocaine addicted people do not want to eat after taking drugs. Nevertheless, the loss of appetite is not the reason why addicted people lose appetite; cocaine also affects metabolism in human bodies. They often cannot sleep well because of having muscle pain and pain in the nose. Addictive behavior also includes such symptoms as emotional instability, anxiety, and paranoids, depression, panic and psychosis. 

Cocaine is a highly addictive substance. Freye wrote: “Laboratory research has shown that given an option, animals prefer cocaine to water, food, and even sex” (64). He stated that those animals continued to take the drug and ended up dying of overdosing. Freye believes that the same is true about people. 

Addiction to cocaine can cause two kinds of behavior. The typical symptoms of the first kind are depression, apathy and suicidal tendencies. The drug user feels so depressed that he/she does not want to live any longer. According to Morton, cocaine was associated with 18% to 22% of suicide episodes (109). A cocaine user abandons all affairs and relationships. An addicted person often experiences various fears, phobias, and mental disorders. Psychological disorders caused by cocaine usage are very similar to the symptoms of Schizophrenia. Cocaine users experience various hallucinations; they can talk to themselves. The second type includes aggressiveness and paranoiac. Morton states that paranoia is experienced by 68% to 84% of addicted people (109). A cocaine user has the fear of people, but it leads to aggressiveness and violent behavior. Unmotivated violence is a frequent issue associated with cocaine usage. An addicted person can attack a stranger and cause him serious injuries without any motivation. According to Morton, “Cocaine-related violent behaviors occur in as many as 55% of patients with cocaine-induced psychiatric symptoms” (109). The drug is also associated with homicide in 31% of cases. 

Other Adverse Outcomes of Cocaine Usage 

Cocaine usage affects not only cardio-vascular system, brain, and central nervous system but also many other organs and systems of the human organism. Among them, there are lungs, kidneys, liver, immune system, skin, and others. 

Basically, lungs are affected the most seriously when cocaine is smoked. The drug causes a harmful effect on the alveolar apparatus of the lungs. In addition, it should be noted that smokers of cocaine and crack suffer from acute respiratory problems including coughing, wheezing, asthma and severe chest pain with pulmonary bleeding. Large doses of cocaine can lead to the death from the lung failure. 

Kidneys play a significant role in the process of cocaine clearance from the body. Karch and Drummer wrote: “In human studies of radioactive cocaine uptake, kidney uptake is greater than that of the heart” (72). F. J. van der Woude states that the research on cocaine and its effect on kidneys has been started only recently and there is still not enough evidence to make conclusions about it. Nevertheless, in his article “Cocaine use and kidney damage”, he explains some findings made in the course of research. The scientists come to the following conclusion: “Renal abnormalities are part of the spectrum of acute and chronic cocaine toxicity” (299). He states that regular cocaine usage damages the kidneys not only during the prenatal development but also later in life. According to the scientists, rhabdomyolysis and hypertension are the risk factors associated with the cocaine abuse. These factors lead to renal malfunctions. In addition, cocaine can cause a sudden, overwhelming renal failure due to the process called rhabdomyolysis. Regular cocaine usage may also speed up the long-term damage to the kidneys because cocaine abuse increases the blood pressure. Rhabdomyolysis is the impairment of muscle fibers, which leads to the kidneys’ damage. According to scientists, for example, J. van der Woude, the process needs to be carefully investigated. Scientists suggest that rhabdomyolysis is caused by the toxic effect of cocaine, which destroys endothelium (the inner lining) of blood vessels causing thrombus in the blood vessels and capillaries and imparing microcirculation; in turn, this leads to the necrosis of muscle tissue. Along with that, rhabdomyolysis may occur due to hyperthermia and seizures which are frequently caused by the cocaine abuse. Another type of kidney damage is an acute tubular necrosis. It is also associated with the direct toxic effects of cocaine in the nephron. 

In the organism of a cocaine-addicted person, liver performs functions similar to the function of kidneys. For this reason, it is also negatively affected by the drug even though it still requires research and investigation. Cocaine metabolism takes place in the liver and blood plasma. Liver diseases frequently result from the cocaine usage combined with the alcohol consumption. Additionally, such diseases often develop in cocaine users who suffer from viral hepatitis. According to Ries et al., “Liver abnormalities reported in case series of cocaine users can be accounted for by viral hepatitis from injection drug use, alcoholic liver disease, or other consequences of a drug-using lifestyle” (145). The scientist states that there is no direct evidence that supports the idea that cocaine is hepatotoxic in human even though it is in rodents. 

Cocaine also affects the immune system although the connection between drug abuse and immunity is poorly investigated. According to the article published by the National Institute on Drug Abuse, “These finding suggest that cocaine and other drugs that stimulate sigma receptors may promote tumor growth by increasing the production of immunosuppressive chemical messengers”. This means that cocaine not only inhibits the immune system but might also cause cancer. According to the scientists, further research is needed to prove this statement. Ries et. al claim that cocaine impairs inborn immune mechanisms. 

Cocaine abuse also leads to perforated septum, changes of smell, nosebleeds, erosion of tooth enamel, and even throat cancer. According to Ries, the development of these symptoms depends upon the route of administration. Those users who prefer the intranasal route of administration often suffer from nasal collapse and perforated septum, chronic rhinitis, ulcers, and sinusitis resulting from vessel constriction. Furthermore, cocaine abuse can result in sores and perforation of the nasal septum. The chronic difficulty in nasal breathing may affect the intranasal distribution of powder, which further exacerbates the problem and contributes to a perforation of the nasal septum. As a result of cocaine usage, the narrowing of blood vessels leads to an infectious inflammation, chondrites and perforation of the nasal septum with the development of chronic rhinitis. The oral route of administration results in dental erosion and gingival ulceration. The acid, which is a component of cocaine, leads to the development of dental erosion; the acid destroys the tooth enamel. Sores and ulcers on the gums appear due to the same mechanism as the perforation of the nasal septum. Cocaine smoking can lead to corneal ulceration. In addition, cocaine abuse can result in gastric ulcer. 

Cocaine usage also leads to the changes in the reproductive and sexual systems. Lakoski, Galloway and White wrote about “decreased reproductive ability reported in many abusers of cocaine” (347). Ries et. al state that in a case of a single usage, cocaine may perform the functions of an aphrodisiac, but regular usage impairs sexual function. According to the authors, men who use cocaine regularly may develop erectile dysfunction and delayed or inhibited ejaculation; women may face such problem as irregular menstruation.

Cocaine affects fetus in the same way as the mother causing a spasm of blood vessels, increased blood pressure and tachycardia. The drug impairs uterine circulation and may cause placental insufficiency. Cocaine usage, especially combined with the usage of other drugs, increases the risk of such complications as spontaneous abortion, premature birth, premature rupture of membranes, intrauterine hypoxia, the decreased circumference of the head, the length and weight of the fetus, the death of the fetus, drug intoxication of a newborn child (in case of breastfeeding), and impaired physical and mental development of the child. Cocaine also provokes other diseases. Selected toxicological examinations have shown that cocaine usage increases the risk of premature detachment of the placenta, but the mass toxicological examinations have not confirmed this. At the same time, it was reported that 15% of children whose mothers used cocaine during pregnancy developed sudden infant death syndrome. Nevertheless, this assumption needs more evidence. In addition, cocaine usage by a pregnant woman increases the risk of congenital malformations in the fetus (mainly gastrointestinal abnormalities, kidney and urinary tract impairments). Babies whose mothers took big doses of cocaine for three days before the birth had an ischemic stroke, but this problem also needs further investigation.  

Cocaine and Problems with Work Performance 

Cocaine has long been known as a way to increase productivity, efficiency, and physical endurance. The drug was also considered to be a mental stimulant. According to Spillane, “Physicians, of course, had employed cocaine as a mental stimulant; in the words of a Boston physician, it “renews the vigor the intellect and relieves mental exhaustion, rendering the flow of thought more easy and the reasoning power more vigorous” (91). This caused the popularity of cocaine in Europe and the US in the nineteenth century. Various scientists of that time including Freud promoted the positive effects of cocaine and were convinced that its usage was absolutely safe and did not cause addiction. Workers in Western Europe, the US, and in South America used cocaine very frequently. They were encouraged to use it by the planters who wanted their workers and slaves to be more productive. 

Nevertheless, increased mental activity and physical endurance are the short-term effects. The long-term consequences of cocaine usage connected with the work performance are negative. Cocaine has a significant negative effect on memory and concentration. Depression and the feeling of frustration caused by the cocaine usage also inhibit the human ability to work and participate in the social life. Along with that, a cocaine-addicted person quickly loses the interest to work, hobbies, and previous life in general. A person becomes completely unproductive, and the only thing, which remains important, is how to get a new dose of the drug. Even if an addicted person stops using cocaine, the cognitive and intellectual potential of this person is lower than the average. People who experience the effects of cocaine often assume that they are very smart and the ideas expressed by them are really exceptional. However, in fact, the speech of a cocaine user is often chaotic and meaningless. 

Conclusions 

Cocaine is a stimulating substance that is frequently used as a drug due to its effects. Cocaine is extracted from the leaves of a plant, which is called coca. It was originally grown and produced in South America, and then, cocaine spread to the Western Europe and the US. It was widely used for medical purposes but later was replaced with more advanced drugs. Cocaine affects both central and peripheral nervous systems. In addition, cocaine is a highly addictive substance. The drug affects all the major systems of the human organism including cardio-vascular, nervous system, digestion system, reproductive system, and others. The cardio-vascular system is the one, which faces the most serious and life-threatening effects of cocaine usage. The drug-addicted people often experience such problems as temporary increase in pulse rate and blood pressure, palpitations, and thermoregulation problems resulting from the vessel constriction. Along with that, cocaine usage can lead to sudden death from a heart attack or stroke. The drug addiction also facilitates the formation of thrombus. 

Cocaine also has serious negative effects on human brain. It is affected by the drug both structurally and functionally. Cocaine deals with the same brain structures as stress does. Thus, cocaine intake protects the organism from stress but only when the drug is used. For this reason, cocaine quickly develops addiction in people. When an addicted person is deprived of the possibility to take a new dose of the drug, such person becomes extremely depressed. Other cocaine effects connected with brain include hallucinations, convulsions, and many others. The drug also leads to the addictive behavior when a person experiences a sequence of euphoria and severe depression, loss of appetite, anxiety, aggressiveness, and suicidal tendencies. Very often, an addicted person is not interested in anything except the drug taking and end up dying of overdose. Unmotivated violence is also often a result of cocaine usage, which leads to the connection between cocaine addiction and criminality. 

Cocaine smoking influences lungs resulting in serious lung diseases. Kidneys are also affected by the usage of the drug even though the results of cocaine usage connected with kidneys needs more research to be done. Cocaine usage has also adverse effects on liver even though no direct evidence of cocaine being hepatotoxic in humans was found. Cocaine influence on the immune system is also very alarming. The research has shown the connection between the cocaine usage and the increased risk of having cancer, but further research needs to be conducted to prove these findings. In addition, cocaine usage causes such adverse symptoms as an infectious inflammation, chondrites and perforation of the nasal septum with the development of chronic rhinitis, nasal collapse and perforated septum, chronic rhinitis, ulcers, and sinusitis resulting from vessel constriction. Other consequences of cocaine usage are nose and mouth ulcers, dental erosion, and gastric ulcer. 

Furthermore, cocaine affects the sexual and reproductive human abilities. Cocaine usage by a pregnant woman leads to multiple fetus malfunctions and may even lead to the death of fetus. The drug significantly increases the risk of spontaneous abortion, premature birth, premature rupture of membranes, intrauterine hypoxia, the decreased circumference of the head, the length and weight of the fetus, the death of the fetus, drug intoxication of a newborn child (in case of breastfeeding), impaired physical and mental development of the child, and many other problems. 

Cocaine was traditionally believed to increase the productivity of work and stimulate the brain. The drug was considered to be a mental stimulant for quite a long time, which causes its popularity in the Western Europe and the US. Nevertheless, regular usage of the drug leads to the decline in career and social life. A person loses interest to his/her job and hobbies. The cognitive ability and intellectual potential of a cocaine-addicted person are lower than the average.

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