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The long term effects of cocaine

The detrimental physical effects of cocaine are well documented, but lesser known is its neurological impact on brain functioning, in areas such as attention span, decision-making and memory.

Second most commonly used narcotic after cannabis

With a business model of selling at over ten times the cost of acquisition and production, the illegal cocaine industry is estimated to be worth around $1.8 trillion.A naturally occurring stimulant and pain blocker, cocaine is extracted from the leaves of the wild growing Erythroxylon Coca in the rolling Andean highlands of western South America, and up until 1903 was an active ingredient in the Coca-Cola drink, and before that used widely in practical medicine as an anaesthetic.

Publicly used by historical figures from Freud to Hitler and known today by a number of street names, coke is the second most commonly used narcotic after cannabis and one of the most addictive, coming in at a narrow second place behind heroin.

Professor David Nutt, of the Division of Brain Sciences at Imperial College, London, along with a panel of experts, has ranked it as one of the most damaging drugs in the world, and cocaine’s destructive grasp on its user reaches far beyond its short term effects.

Cocaine affects almost every part of the body

The shocking physical effects of cocaine addiction have been widely publicised in anti-drug campaigns. Cocaine ingestion affects almost every part of the body. In the long term, cocaine users experience reduced blood flow in the gastrointestinal tract, which can lead to stomach ulcers and potentially life threatening tears, often requiring surgery.

Cocaine also serves as an appetite suppressant, and delaying or skipping food intake can lead to weight loss and malnutrition, bringing with it a whole host of health issues. It has significant and well recognised toxic effects on the heart and cardiovascular system, causing chest pain and inflammation of the heart muscle, leading to a deterioration of the ability for the heart to contract, and subsequent aortic ruptures. High blood pressure, stiffer arteries and thicker heart muscle walls are also all commonly observed side effects of long term cocaine use.

Routes of administration can cause differing effects in users. Snorting cocaine will eventually lead to extensive nasal damage, resulting in nosebleeds, a loss of smell, problems swallowing, hoarseness and irritation of the nasal septum, leading to a chronically inflamed runny nose. Smoking crack cocaine damages the lungs, and complications can result in triggering or worsening conditions such as asthma. Problems breathing can lead to respiratory failure, collapsed lungs and even death. Injecting cocaine can lead to nerve damage and increased risk of contracting blood-borne infections such as HIV and hepatitis. Puncture marks from needles can become infected and lead to septicaemia, another life threatening condition.

Brain cells begin to cannibalise themselves

The detrimental physical effects of cocaine are well documented, but lesser known is its neurological impact on brain functioning, in areas such as attention span, decision making and memory.

Firstly, cocaine use can bring about intracerebral haemorrhage (more commonly known as bleeding of the brain), a life threatening type of stroke. Repeated use leads to the neural pathways associated with sustaining attention, impulse inhibition, memory, decision-making and motor tasks becoming damaged.

A Johns Hopkins university study supports the idea that high doses of cocaine accelerate the natural process of autophagy in the brain – a normal cellular clean-up of waste materials. When this process is accelerated, it spins out of control and causes the brain cells to literally cannibalise themselves. Some researchers have suggested this could be a factor in the association between cocaine use and the increased likelihood of developing Parkinson’s disease later on in life.

Cocaine causes brain cells to eat themselves, Johns Hopkins study finds

But it’s not only long term users who are at risk of suffering severe health problems at the hands of cocaine. The side effects aren’t only apparent after many years of abuse, with some users reporting heart conditions surfacing after their first hit.

Studies have shown that in some instances, sudden death can occur during the first instance of cocaine use or shortly after. Recent alarming research conducted at UC Berkeley has suggested that cocaine can rewire the brain entirely after a single use. Studies conducted using live mice, observed substantial growth of new dendritic spines, structures that connect neurones and essentially form the nodes of the brain’s circuit wiring, in the frontal lobe of the brain. These new spines rewired the brain to actively seek cocaine, possibly explaining why the search for a hit might override other priorities in human users. The changes were observed not only in the brain scans, but in their behaviour.

Cocaine addiction is a worldwide public health problem, which has somatic, psychiatric, socio-economic and judicial complications. The number of patients entering drug treatment for primary cocaine use has been increasing in Europe for several years, and looks set to increase further in the years to come.

City Addictions, January 14, 2017

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