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Cocaine Abuse (cont.)

Other Symptoms of Cocaine Abuse

  • Lung effects: The direct effects of smoking cocaine are responsible for most lung and breathing complications. The large surface area of the lungs and its great blood supply cause rapid and profound brain stimulation known as the head rush.
    • Smoking the freebase, crack, or paste is done using a glass pipe, water pipes, or cigarettes, which are heated by butane lighters or matches. The residue from the tars, matches, cocaine contaminants, and additives, such as marijuana, often cause chronic bronchitis, chronic coughing, and coughing up black, non-bloody phlegm. These conditions can cause shortness of breath and chest pain.
    • Utilizing the technique of deep inhalation and breath holding to maximize the amount of cocaine inhaled and absorbed can cause the lung to collapse. These cocaine users will complain of sharp chest pain, often worse with deep breathing, neck pain, difficult or painful swallowing, and air under the skin in the neck that feels like Rice Krispies under the skin when touched (subcutaneous emphysema). Though unusual, the user's lungs can fill with fluid (pulmonary edema), causing extreme shortness of breath, sometimes respiratory failure, and death.
    • In one study of the cocaine abusers who came to an emergency department, 40% complained of chest pain -- the most common complaint -- and 22% complained of shortness of breath or were unable to breathe.
  • Cardiovascular (heart, blood vessels) effects: The major effect of cocaine is to stimulate the sympathetic nervous system. This system is responsible for the "fight or flight response" and is controlled primarily by adrenaline or epinephrine. The effects include increased heart rate, blood vessel narrowing, and high blood pressure. Angina or the chest pain that is felt with decreased blood supply to the heart and heart attack have accounted for more reports in medical journals than any other complication of cocaine intoxication. Chest pain associated with cocaine use is now a common problem in many emergency departments.
    • Other cardiovascular complications include abnormal heart rhythms or rapid heart rate, cardiomyopathy, which is disease of the heart muscle, or aortic rupture or dissection in which there is weakening of the walls of the aorta. The acute use, despite the amount or route, causes narrowing of the arteries to the heart and vasospasm resulting in decreased blood flow to the heart. This causes angina, which can lead to a heart attack that means death of heart tissue. Chronic use of cocaine, again regardless of the route, leads to accelerated hardening and subsequent narrowing of the coronary arteries. Therefore, angina, heart attacks, and cardiac deaths have occurred in young users from 19-44 years of age.
    • The overstimulation of the sympathetic system with the rapid heart rate, high blood pressure, and vasospasm also cause abnormal heart rhythms. Those rhythms may be ventricular tachycardia and ventricular fibrillation and may cause sudden death. Chest pain has been the most common complaint to the emergency department, up to 40% of people; 21% complain of palpitations, the sensation that their hearts are racing or going fast.
  • Pregnancy effects: Cocaine use during pregnancy can increase the complications of pregnancy and affect the fetus directly. Abusers of this drug may also use other drugs, alcohol, and nicotine, which adversely affect the pregnancy as well. They have an increased rate of miscarriages and placental abruption, in which the placenta separates from the wall of the uterus and results in stillbirth. There is increasing information that cocaine may cause birth defects with increased rates of malformation, low birth weights, and behavioral abnormalities.
  • Infections: The infectious complications related to IV use of cocaine are not unique to cocaine. All IV drug users are at risk for infections such as cellulitis (soft-tissue infection at the injection site), abscesses at the injection sites, tetanus or lockjaw, lung or brain abscesses, or infection of the heart valves. These are due to non-sterile techniques of IV injections. Contagious viruses such as hepatitis B, hepatitis C, and HIV (AIDS virus) are transmitted by sharing IV needles. The abuser may complain of pain, swelling, and redness at the injection site or fever. Abusers may also complain of jaundice or turning yellow, abdominal pain, nausea, vomiting, loss of appetite, or the multitude of complaints that accompany hepatitis or AIDS.
  • Body packers or stuffers: People smuggle the processed cocaine across international borders. They often swallow drug-filled packets or stuff them into body openings such as the vagina or rectum. The "body packer" or "mule" can carry 50-200 tightly wrapped condoms or latex bags filled with high-grade cocaine hydrochloride. If the containers break or leak, the cocaine can be absorbed by the person's body. Most mules have no symptoms and may be apprehended by an astute official who notices some suspicious behavior. Some will become acutely ill when the packets leak or rupture, resulting in massive intoxication, seizures, and death. A similar problem may occur with "body stuffers." These are cocaine users or traffickers who swallow bags of cocaine when arrested so there is no evidence.
Medically Reviewed by a Doctor on 9/3/2015

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