cocaine addiction durham
cocaine addiction

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Cocaine

Cocaine is an extremely addictive stimulant that creates a sense of euphoria and increased energy in people who use it. A cocaine high tends to be short-lived so it is often used in a binge pattern, meaning it’s used repeatedly and in increasingly larger doses over a short period of time. Cocaine raises the risk of serious heart problems and even of sudden death in people who use it because of its range of cardiovascular effects, which include sharp increases in heart rate and narrowing (constriction) of blood vessels.

Each method of cocaine use poses its own risks. Common methods of administration are injecting (“shooting”) the drug into the bloodstream, smoking the cocaine in the form of crack, or inhaling cocaine through the nostrils – also called “snorting” cocaine.

The high from snorting cocaine tends to last relatively longer than some other methods – approximately 15 to 30 minutes compared to five to 10 minutes from shooting the drug. Even an occasional episode of snorting cocaine can lead to the loss of the sense of smell as well as nosebleeds and trouble swallowing.

Long-term cocaine use can cause changes in the brain and over time it changes the drug effects that an individual may experience while under the influence. After long-term cocaine use, including binge dosing, the areas of the brain relating to reward and pleasure undergo a change because receptors in these areas become desensitized to the persistently elevated amounts of dopamine that cocaine can result in. These gradual changes in dopamine receptor sensitivity can result in a failure to send adequate signals of pleasure and reward compared to before cocaine abuse.

A person’s experience of the cocaine high may also start to change. Many long-term users find that they experience more of cocaine’s negative effects as they progress in their abuse.

Effects of Cocaine on the Brain

  • Accelerated brain aging: There is now evidence which suggests that cocaine may cause the brain to age at a quicker rate than average pace. In part this is due to pronounced losses in the density of grey matter in crucial areas of the brain, but also due to other functional deficits in various brain regions. Long-term cocaine use can cause significant deleterious  effects on the brain, increasing speed of neurodegeneration.
  • Blood vessel damage: Research suggests that cocaine usage can contribute to blood vessel damage within the brain. Such constriction of blood vessels can lead to increased susceptibility to experiencing a stroke. A significant drop in the overall speed of blood flow throughout the brain with increased cocaine usage comes with prolonged usage
  • Cognitive deficits: The experience of long-term cognitive impairment resulting from heavy cocaine is experienced by many users. This is caused by dopamine levels dropping and activity in the prefrontal cortex decreasing. Optimal cognition is heavily reliant on the prefrontal cortex for processing complex data, focused attention, problem solving and critical thining. When this region becomes impaired, a person may display classic signs of ADHD – irrational and distractive behavior.
  • Dependence: Dependency on cocaine often evolves in order to function throughout the day. Once the brain has become tolerant to the drug, a person will continuously need more of it in order to maintain their same level of functioning. If they try to attempt to go through cocaine withdrawal, symptoms may prove to be too severe to cope with. Left alone, a person may become dependent on higher doses of the drug, leading to greater psychological damage.
  • Dopamine levels: It is known that dopamine is involved in regulating attention, appetite, motivation, and a variety of other processes – often considered as the ‘reward pathway’ contributing to learning. Cocaine usage can make enduring lasting changes to the levels of dopamine within the brain, leading to dopamine deficiency, which can create problems such as attentional deficits, impulsivity, mood swings, and cognitive impairment. Such dopamine depletion is assoicated to Parkinsons Disease.
  • Emotional dysfunction: Extremely common are experience emotional disturbances over the long-term that stem from cocaine usage. These emotional disturbances are associated with alterations in regional functioning within the brain as well as neurotransmitter changes. Fortunately  abstinence from cocaine use for a prolonged period of time allows the brain to readjust.
    • Aggression:  Increasingly aggressive behavior may evolve over the long-term, due to the fact that the brain is not designed to handle prolonged stress and becomes sensitized. Users may find themselves lashing out at others in order to cope with the pent-up aggression that they feel. This is also associated with increased levels of cortisol and adrenaline.
    • Anger:  Anger is believed to be due to changes in neurotransmitter levels as well as certain changes in regional functioning such as the prefrontal cortex and is associated with stress, adrenaline and cortisol also
    • Anxiety: It is common for a person to develop extreme anxiety as a result of their cocaine habit as well as paranoia and psychotic symptoms during heavy use. This may be a result of dopamine deficiency and/or an alteration in the way their brain processes and also be associated to criminal activity and illegal drug possession.
    • Apathy: When a person has severely decreased dopamine and prefrontal activity, they may become apathetic. Characterized as a lack of caring about someones circumstances their situation and inability to summon up motivation to make changes in their life. These are also the associated feeling that accompany the helplessness of addiction itself.
    • Depression: With decreased prefrontal activity as well as deficiency in the neurotransmitter dopamine, depression can become a long-term condition.  This is why it is so important to consider dopamine vs. serotonin in depression among drug abusers as most who’ve abused psychostimulants are often deficient in dopamine production.
    • Paranoia: Paranoia which is often transient if drug induced will often receed over the long-term, but it can still be highly disturbing. The longer a person remains sober and dopamine levels stabilize, paranoia tends to decrease.
    • Psychosis: As cocaine alters dopamine levels to a significant extent it can produce a drug-induced form of psychosis. In other words, one may develop hallucinations and/or delusions that mimic schizophrenia as a result of long-term usage. Although this isn’t permanent, it can be difficult to overcome and requires appropriate intervention.
    • Stress response:  The brain becomes unable to properly process stress with frequent cocaine usage, meaning that someone may react with more animalistic instincts instead of using higher-order brain functions lie thought and consideration to combat any stress. Things that previously wouldn’t have caused stress may start to agitate someone over the long-term as their natural capacity has dwindled.
  • Gray matter reduction: Brain scans of  cocaine dependent individuals compared to a control group revealed that the group with dependence had lost significant amounts of grey matter. On average, those who used cocaine had lost approximately 3.08 ml (milliliters) of brain volume per year, which was approximately double that of the healthy control group.
  • Headaches: Many people report headaches as a long-term effect of using cocaine. This could be due to a variety of reasons including damage to the brain, changes in brain activity, alterations in blood flow, and constriction of blood vessels. Some individuals may even experience migraines as a result of their cocaine use.
  • Prefrontal cortex impairment: Perhaps the most detrimental aspect of using cocaine is that it alters activity in the prefrontal cortex. This is a region involved in high-level processes such as logic, decision making, solving complex equations, critical thinking, and attention. Using cocaine can result in lasting impairment to this region, leading the user to display increasingly animalistic behavior.
  • Receptor dysregulation: Not only do dopamine levels tend to be abnormally low in heavy cocaine users compared to a non-cocaine user, but the receptors of these neurotransmitters are also affected; potentially causing a variety of problems.
  • Stroke risk: Some studies have suggested that using cocaine over a long-term may lead to increased risk for a stroke. A stroke is characterized as lack of blood flow to the brain, which leads a person to suffer (potentially) irreversible mental impairment.

Effects of Cocaine on the Body

  • Bone density decrease: Cocaine causes you to loss of both muscle mass and bone density. People that use this drug often do not eat well due to suppression of the appetite. The malnourishment can lead to a host of health problems, one of which is decreased bone density. Studies in rats suggest that exposure may cause decreases in spine density.
  • Coughing: Development in the long-term of chronic coughing which  is due to an array of damaging effects that the drug has on the respiratory system.
  • Chest pains: Chest pains may start to become more severe with increased usage. This is because the cocaine takes a toll on the heart, and some may experience cardiovascular toxicity. The damage endured by various organs may also contribute to an increase in pain.
  • Heart problems: Some believe that there are clear links between long-term cocaine abuse and heart attacks. There is also some evidence to suggest that cocaine usage is capable of causing an irregular heartbeat. It is also thought that long-term usage is capable of damaging the heart muscle walls.
  • High blood pressure: Blood pressure may spike over the long-term from using this drug. Although it is common to experience elevated blood pressure while intoxicated, blood pressure may stay high as a result of long-term usage.
  • Malnutrition: The highly stimulating nature of cocaine, release of adrenaline and vaso constriction all lead to a loss of appetite. A reduced appetite may result in nutritional deficiencies. If a person is deficient in various vitamins and nutrients, this can put them at increased risk for a variety of other chronic health conditions.
  • Organ damage: Cocaine can cause cumulative damage to major organs such as your heart, kidneys, liver, and lungs – especially over the long-term. This is mostly due to a chemical intermediate being released called “methylecgonidine.” It is this substance that is directly capable of eliciting damage, which can increase over time.
  • Reproductive damage: Another physical effect that’s associated with long-term cocaine usage is that of reproductive problems. Some hypothesize that long-term usage can damage sperm quality, decrease sperm count, cause sexual dysfunction, as well as infertility (in both males and females).
  • Tooth decay: Although tooth decay isn’t directly caused by cocaine, it can be caused by “bruxism” (or tooth grinding). Many people who use cocaine over the long-term are unable to deal with the tension they experience while “high” – leading to frequent grinding of teeth. This grinding mashes the tooth enamel and can lead to decay.
  • Weight loss: Using any CNS stimulant over the long-term can lead to a significant amount of weight loss and may be one factor that increases use as a desire to maintain weight loss especially in females. Some of the weight loss is a result of bone density reduction and muscle loss (stemming from decreased food consumption). In some individuals, losing excessive weight can be unhealthy, and put them at risk for a variety of health conditions.