Doctor's Notes on Cocaine Abuse (Addiction)
Cocaine is a crystalline alkaloid obtained from coca leaves; originally used as a local anesthetic, the drug is used currently for its stimulant and euphoric effects that often result in a compulsive psychological need (addiction) for its use (abuse); it has many different street names such as nose candy, blow, toot and many others; when it is mixed with heroin, it is termed a speedball – when it is extracted from the powdered form, with baking soda and heat, it may be termed crack or crack cocaine. In addition, cocaine may be mixed with many other drugs. Cocaine may be inhaled, ingested, smoked, or IV injected. Signs and symptoms of cocaine abuse vary; euphoria may be experienced with increased energy, excitement and sociability – some people feel great sense of power and competence to such a high level that it is delusional and allows the person to engage in extremely risky activities. However, some individuals may have signs and symptoms such as dilated pupils, nausea, vomiting, headaches, vertigo, cold sweats, tremors, tooth grinding and hallucinations. More long-term symptoms include nasal problems like nasal septum perforation, lung problems that can result in difficulty breathing, cardiovascular problems including heart attacks, problems with pregnancy and increased miscarriages, infections, especially in IV drug users, liver damage and overdoses that result in severe headaches, seizures and/or death.
Other signs and symptoms that may be related to cocaine abuse and addiction are behavioral changes such as poor family communication, family conflicts, disruptive financial situations because of the high costs to purchase cocaine and the irritation/desperation, including lying and stealing, exhibited by individuals addicted to the drug when the drug euphoria wears off and the drug is not available.
Cocaine abuse and/or addiction is to be caused by a combination of genetic and environmental risk factors. Researchers suggest that repeated exposure to cocaine changes processes in the brain that lead to altered levels of dopamine that causes addiction. Some users only want the euphoria of cocaine abuse and that causes addiction. Social acceptance is sometimes based on drug use; this can cause drug use and/or abuse and addiction.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.