This column will not attempt a comprehensive review of this study, which by its very nature is without predictive value or generalizability. However, it should be noted for the record that this study and the related reports displayed a singular bias that appeared to attempt to substantiate a preconceived notion that cocaine use is relatively harmless by selectively citing supporting data. Unfortunately, these reports have the potential to do a great disservice by encouraging experimentation with cocaine without fully informing potential users of the myriad of significant physical and mental adverse effects associated with its use. The remainder of this column will address some of these effects by answering two specific related questions received from readers. The association between cocaine use and cerebrovascular accidents is quite simple and direct.
Cocaine use increases heart rate and causes vasoconstriction.
Both of these effects independently increase blood pressure, which among susceptible people, can result in a cerebral hemorrhage. This answer appears to contradict a common notion in the popular press and deserves a brief review of some of the relevant aspects of cocaine pharmacology. Cocaine can be introduced into the body by a number of different methods. The melting point of cocaine hydrochloride is twice as high as cocaine base. Conversely, the smokable forms of cocaine do not possess the hydrochloride salt and are poorly soluble in water.