Cocaine: Uses and Abuses
'Approximately 17.5 million abusers'
Charlotte Lee | 8 November 2015

Humans have been using cocaine for centuries: from the Incas chewing on coca leaves to stave off the cold, to the original Coca Cola recipe. The euphoric feeling that accompanies the drug has attracted millions of users and it is the second most trafficked drug in the world.

The most common use is recreational - this attracts approximately 17.5 million abusers (World Health Organisation, WHO) - and is taken by smoking, snorting or injecting the drug, all of which leads to its rapid absorption. The elevated mood is elicited as cocaine interferes with the brain’s chemical messengers (neurotransmitters) that nerves use to communicate with each other. The drug blocks these neurotransmitters from being reabsorbed and the build-up of the chemicals between nerves causes the ‘high’ feeling.

The common belief is that cocaine is a fairly safe drug and at first glance, this belief is statistically supported - there are approximately 3 million deaths caused by alcohol a year, but only 250,000 from cocaine, according to the WHO. However, cocaine causes the most hospital admittances of all the addictive substances and when you compare the years of life lost, not just deaths, cocaine beats all addictive substances, with about 2.1 million years lost, a number produced as most drug deaths affect younger people.

Cocaine constricts the arteries supplying blood to the heart which can result in heart attacks, even in the young and fit, and can cause a deadly heart rhythm called arrhythmia. The brain’s blood vessels are also constricted which lead to strokes. Lastly, although cocaine is known as an aphrodisiac, it actually has the opposite effect; leaving you, well, unable to finish what you started. Cocaine abuse is a prevalent issue in today’s society, with London having the highest concentration of cocaine in sewage in Europe (2014).

But cocaine is also used medically as a local anaesthetic, a drug that provides a reversible numbing effect to specific areas. The drug, properly called benzoylmethylecgonine, blocks the conduction of nerve impulses just as it does when used as a high; however, its administration differs. Topical preparations of cocaine hydrochloride are applied to the nose, mouth, ear, eye or throat prior to procedures, effectively numbing the area. The drug cannot prolifically be used clinically, even though it provides local anaesthetic effect, as we know, it has a high risk for abuse and severely narrows the blood vessels (vasoconstriction).

Cocaine, as an anaesthetic, was discovered by a young ophthalmologist Carl Koller after Sigmund Freud suggested its possible use as a local anaesthetic. Koller demonstrated its use successfully and the drug was used widely for procedures until it was discovered that it causes damage to the cornea (the transparent layer forming the front of the eye). It was this and the potential abuse of the drug that resulted in cocaine’s use as solely a topical anaesthetic.


And to Coca–Cola, cocaine free since 1929, while some still allege that the drink contains the original non-narcotic coca-leaf extract; however, Coca–Cola scientists assure us that all psychoactive elements of the leaf extract are removed. This at least gives hope; after the drug dictated its name, its product and its ethos, a world dominant corporation has become drug clean and so perhaps one day the world can too.

 

Image used under Creative Commons license

https://commons.wikimedia.org/wiki/Category:Coca-Cola#/media/File:Coca_cola_R$Brazil2014.JPG

James Routledge 2016