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Cocaine
Effects How
does cocaine produce its effects?
Cocaine
in the brain - In the normal communication process, dopamine is released by a
neuron into the synapse, where it can bind with dopamine receptors on neighboring
neurons. Normally dopamine is then recycled back into the transmitting neuron
by a specialized protein called the dopamine transporter. If cocaine is present,
it attaches to the dopamine transporter and blocks the normal recycling process,
resulting in a buildup of dopamine in the synapse which contributes to the pleasurable
effects of cocaine. Researchers have discovered that, when a pleasurable event is occurring, it is accompanied by a large increase in the amounts of dopamine released in the nucleus accumbens by neurons originating in the VTA. In the normal communication process, dopamine is released by a neuron into the synapse (the small gap between two neurons), where it binds with specialized proteins (called dopamine receptors) on the neighboring neuron, thereby sending a signal to that neuron. Drugs of abuse are able to interfere with this normal communication process. For example, scientists have discovered that cocaine blocks the removal of dopamine from the synapse, resulting in an accumulation of dopamine. This buildup of dopamine causes continuous stimulation of receiving neurons, probably resulting in the euphoria commonly reported by cocaine abusers.
As cocaine abuse continues, tolerance often develops. This means that higher doses
and more frequent use of cocaine are required for the brain to register the same
level of pleasure experienced during initial use. Recent studies have shown that,
during periods of abstinence from cocaine use, the memory of the euphoria associated
with cocaine use, or mere exposure to cues associated with drug use, can trigger
tremendous craving and relapse to drug use, even after long periods of abstinence.
What
are the short-term effects of cocaine use? Short-term effects of cocaine:
The
duration of cocaine's immediate euphoric effects depends upon the route of administration.
The faster the absorption, the more intense the high. Also, the faster the absorption,
the shorter the duration of action. The high from snorting is relatively slow
in onset, and may last 15 to 30 minutes, while that from smoking may last 5 to
10 minutes The short-term physiological effects of cocaine include constricted blood vessels; dilated pupils; and increased temperature, heart rate, and blood pressure. Large amounts (several hundred milligrams or more) intensify the user's high, but may also lead to bizarre, erratic, and violent behavior. These users may experience tremors, vertigo, muscle twitches, paranoia, or, with repeated doses, a toxic reaction closely resembling amphetamine poisoning. Some users of cocaine report feelings of restlessness, irritability, and anxiety. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest. What
are the long-term effects of cocaine use? Long-term effects of cocaine Addiction:
An
appreciable tolerance to cocaine's high may develop, with many addicts reporting
that they seek but fail to achieve as much pleasure as they did from their first
experience. Some users will frequently increase their doses to intensify and prolong
the euphoric effects. While tolerance to the high can occur, users can also become
more sensitive (sensitization) to cocaine's anesthetic and convulsant effects,
without increasing the dose taken. This increased sensitivity may explain some
deaths occurring after apparently low doses of cocaine. Use of cocaine in a binge, during which the drug is taken repeatedly and at increasingly high doses, leads to a state of increasing irritability, restlessness, and paranoia. This may result in a full-blown paranoid psychosis, in which the individual loses touch with reality and experiences auditory hallucinations. Medical consequences of cocaine abuse:
Different
routes of cocaine administration can produce different adverse effects. Regularly
snorting cocaine, for example, can lead to loss of sense of smell, nosebleeds,
problems with swallowing, hoarseness, and an overall irritation of the nasal septum,
which can lead to a chronically inflamed, runny nose. Ingested cocaine can cause
severe bowel gangrene, due to reduced blood flow. And, persons who inject cocaine
have puncture marks and "tracks," most commonly in their forearms. Intravenous
cocaine users may also experience an allergic reaction, either to the drug, or
to some additive in street cocaine, which can result, in severe cases, in death.
Because cocaine has a tendency to decrease food intake, many chronic cocaine users
lose their appetites and can experience significant weight loss and malnourishment.
Research has revealed a potentially dangerous interaction between cocaine and alcohol. Taken in combination, the two drugs are converted by the body to cocaethylene. Cocaethylene has a longer duration of action in the brain and is more toxic than either drug alone. While more research needs to be done, it is noteworthy that the mixture of cocaine and alcohol is the most common two-drug combination that results in drug-related death.
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