cocaine

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cocaine

(kōkān`, kō`kān), alkaloid drug derived from the leaves of the cocacoca
, common name for shrubs of the genus Erythroxylum, particularly E. coca, of the family Erythroxylaceae, and found abundantly in upland regions and on mountain slopes of South America, as well as in Australia, India, and Africa.
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 shrub. A commonly abused illegal drug, cocaine has limited medical uses, most often in surgical applications that take advantage of the fact that, in addition to its anesthetic effect, it constricts small arteries, lessening bleeding. There are many street names for cocaine, including coke, C, toot, flake, and snow.

Effects and Addictive Nature

Cocaine blocks pain sensation and stimulates the central nervous systemnervous system,
network of specialized tissue that controls actions and reactions of the body and its adjustment to the environment. Virtually all members of the animal kingdom have at least a rudimentary nervous system.
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, producing a sudden increase in heart rate, temperature, and blood pressure. In the brain, it blocks the synaptic reabsorption of certain neurotransmitters (in particular dopaminedopamine
, one of the intermediate substances in the biosynthesis of epinephrine and norepinephrine. See catecholamine.
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). The resultant buildup of neurotransmitters causes pleasurable sensations to be passed along the neural pathways over and over again, creating a feeling of profound well-being, self-confidence, and alertness. It is accompanied by lack of hunger. The effect lasts for 10 to 30 minutes, and the user begins to crave more immediately as the neurotransmitter supply is exhausted. This pattern has led to cocaine's being described as "neuropsychologically addicting" in recognition that traditional definitions of physical vs. psychological addiction do not neatly fit in this case. Most cocaine addicts in treatment report some control over their use for the first two to four years, giving them the illusion that addiction will not develop.

Addiction is characterized by binges (usually of 4 to 24 hours, one to seven times per week), movement to intravenous use or smoking, extreme euphoria, and disregard for anything other than the drug, including food, sleep, sex, family, and survival. The behavior is limited only by the high cost of the drug and its limited availability. Abstinence after a cocaine binge leads to crashing (anxiety, depression, suspiciousness, sleep craving) and withdrawal (absence of pleasure in all things, lack of motivation, and boredom). Many users take other drugs (alcoholalcohol,
any of a class of organic compounds with the general formula R-OH, where R represents an alkyl group made up of carbon and hydrogen in various proportions and -OH represents one or more hydroxyl groups.
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, marijuanamarijuana
or marihuana,
drug obtained from the flowering tops, stems, and leaves of the hemp plant, Cannabis sativa (see hemp) or C. indica; the latter species can withstand colder climates.
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, heroinheroin
, opiate drug synthesized from morphine (see narcotic). Originally produced in 1874, it was thought to be not only nonaddictive but useful as a cure for respiratory illness and morphine addiction, and capable of relieving morphine withdrawal symptoms.
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) to attenuate these effects. A dangerous combination of cocaine and heroin, known as a "speedball," is used by some. Withdrawal usually results in further use, often spurred by a conditioned cue such as a specific smell or location linked with cocaine use. If the drug is not taken again there is a gradual lessening of the craving, although conditioned cues may exert an effect years afterward. Long-term use can result in digestive disorders, weight loss, general physical deterioration, and marked deterioration of the nervous system. Most drug-related emergency room visits are cocaine-related.

Modes of Administration; "Crack" Cocaine

Cocaine is either snorted (sniffed), swallowed, injected, or smoked. Habitual snorting can result in serious damage to the nasal mucous membranes; shared needles put the user at increased risk of HIVHIV,
human immunodeficiency virus, either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States.
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 infection. The street drug comes in the form of a white powder, cocaine hydrochloride. The hydrochloride salt and the cutting agents are removed to create the pure base product "freebase." Freebase is smoked and reaches the brain in seconds. "Crack" cocaine, also called "rock," is a form of freebase that comes in small lumps and makes a crackling sound when heated. It is relatively inexpensive, but must be repeated often.

Crack cocaine magnifies the effects of cocaine and is considered to be more highly and more quickly addictive than snorted cocaine. It causes a very abrupt increase in heart rate and blood pressure that can lead to heart attack and stroke even in young people with no history of vascular disease, sometimes the first time the drug is used. It also crosses the placental barrier; babies born to crack-addicted mothers go through withdrawal and are at a higher risk of stroke, cerebral palsy, and other birth defects.

Treatment

Treatment focuses on disruption of the addict's pattern of binges, followed by prevention of relapses. Counseling combined with treatments such as acupuncture and administration of antidepressants (e.g., desipramine) has met with some success. Treatment is often complicated by underlying social problems, mental illness, and the use of multiple drugs.

Production and Distribution

Most coca is grown in ColombiaColombia
, officially Republic of Colombia, republic (2005 est. pop. 42,954,000), 439,735 sq mi (1,138,914 sq km), NW South America. Bogotá is the capital and largest city.
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, PeruPeru
, Span. Perú , officially Republic of Peru, republic (2005 est. pop. 27,926,000), 496,220 sq mi (1,285,210 sq km), W South America. It borders on the Pacific Ocean in the west, on Ecuador and Colombia in the north, on Brazil and Bolivia in the east, and on
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, and BoliviaBolivia
, officially Plurinational State of Bolivia, republic (2005 est. pop. 8,858,000), 424,162 sq mi (1,098,581 sq km), W South America. One of the two inland countries of South America, Bolivia is shut in from the Pacific in the W by Chile and Peru; in the E and N it borders
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. The farmers, for whom it is a relatively well-paying crop, harvest and dry the leaves, which are then processed into coca paste. Cocaine base is extracted from the paste in informal laboratories. Further processing produces cocaine hydrochloride, a white powder, which is exported. Once in the United States, the cocaine is cut (diluted) with ingredients such as lactose, and sold or further processed into crack.

Import and production have been controlled by enormously powerful cartels such as the Medellín and Cali cartels in Colombia; the highly armed cartels have infiltrated governments and corrupted officials and have been held responsible for assassinations of public officials. Drug trafficking reached the highest levels of government and was at least in part responsible for the U.S. invasion of Panama in 1989 and the arrest and subsequent conviction of Panama's de facto leader, Manuel NoriegaNoriega, Manuel Antonio
, 1938–, Panamanian general. Commander of the Panamanian Defense Forces from 1983, Noriega consolidated the strong-armed rule inherited from Gen. Omar Torrijos Herrera, and became the de facto leader of Panama. A one-time operative for the U.S.
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.

History of Cocaine Use

Andean Indians have long chewed leaves of the coca plant to decrease hunger and increase their stamina for work. Chewing the leaves produces no "high." Cocaine was first extracted from coca in the 19th cent. and was at first hailed as a miracle drug. By the 1880s in the United States it was freely prescribed by physicians for such maladies as exhaustion, depression, and morphine addiction and was available in many patent medicines. After users and physicians began to realize its dangers and various regulations were enacted, its use decreased, and by the 1920s the epidemic had abated.

Another epidemic began in the United States in the 1970s and peaked in the mid-1980s; again the drug was at first considered harmless. With the latter epidemic and its accompanying crack epidemic (beginning in 1985 and peaking in 1988) violence in crack-infested neighborhoods increased dramatically. Young people with few other opportunities were lured by the power and money of being crack dealers; most carried guns and many were murdered in drug-gang wars that ensued. By the late 1990s the cocaine and crack epidemic had subsided as heroinheroin
, opiate drug synthesized from morphine (see narcotic). Originally produced in 1874, it was thought to be not only nonaddictive but useful as a cure for respiratory illness and morphine addiction, and capable of relieving morphine withdrawal symptoms.
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 regained popularity among illicit drug users.

Bibliography

See publications of the Drugs & Crime Data Center and Clearinghouse, the Bureau of Justice Statistics Clearinghouse, and the National Clearinghouse for Alcohol and Drug Information.

Cocaine

 

an alkaloid obtained from the leaves of the coca shrub. It is an anodyne. Cocaine is used in the form of powders and solutions as a local anesthetic in ophthalmology, otolaryngology, urology, and stomatology. It is highly toxic. When first absorbed, it is a stimulant; it later inhibits the nervous system. Repeated, uncontrolled use of cocaine may result in addiction, or cocainism.

cocaine

[kō′kān]
(pharmacology)
C17H21O4N An alkaloid obtained from coca leaves that is used for local anesthesia and as a tonic in digestive and nervous disorders.

cocaine

, cocain
an addictive narcotic drug derived from coca leaves or synthesized, used medicinally as a topical anaesthetic. Formula: C17H21NO4
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Probing the Meaning of Racial/Ethnic Group Comparison in Crack Cocain Smoking.
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