Cocaine

Crack

Coke

**Cocaine** is a stimulant and tropane alkaloid derived largely from the leaves of two coca species, Erythroxylum coca and Erythroxylum novogranatense. It is most often used as a euphoriant and recreational drug. **Cocaine** can be snorted, heated until sublimated and then inhaled, or dissolved and injected into a vein after being extracted from coca leaves. An intense feeling of happiness, sexual arousal, loss of contact with reality, or agitation are all possible mental effects. A fast heart rate, sweating, and dilated pupils are all possible physical symptoms. High dosages might cause high blood pressure or a rise in body temperature. The effects begin seconds to minutes after application and continue between five to ninety minutes.

## Uses

### Medical

To aid with unpleasant operations in the mouth or nose, topical **cocaine** can be administered as a local numbing agent.

**Cocaine** has the potential to be utilized in nasal and lacrimal duct surgery. **Cocaine's** potential for cardiovascular toxicity, glaucoma, and pupil dilation are the major drawbacks of this use. **Cocaine's** medical use has declined as other synthetic local anesthetics such as benzocaine, proparacaine, lidocaine, and tetracaine have become more popular.

**Cocaine** hydrochloride, an ester local anesthetic, was authorized for medical use in the United States in December 2017 and is recommended for the introduction of mucous membrane local anaesthetic for diagnostic procedures and operations on or via the nasal cavities of adults. In January 2020, Cocaine Hydrochloride was authorized for medicinal usage in the United States.

### Recreational

**Cocaine** is a stimulant of the neurological system. Its effects might last anywhere between 15 minutes and an hour. The duration of **cocaine's** effects is determined by the amount consumed and the method of administration. **Cocaine** can take the appearance of a fine white powder that tastes unpleasant. Crack cocaine is a smokable type of cocaine created by processing cocaine with sodium bicarbonate and water into little "rocks." Crack cocaine gets its name from the cracking noises it produces when heated.

## Effects

### Acute

Acute **cocaine** exposure causes euphoria, increases in heart rate and blood pressure, and increases in cortisol production from the adrenal gland. In humans, acute tolerance to **cocaine's** chronotropic cardiac effects occurs after approximately 10 minutes, whereas acute tolerance to **cocaine's** euphoric effects begins after about one hour of continuous exposure at a constant blood concentration. When used excessively or over an extended period of time, the medication might induce itching, rapid heartbeat, hallucinations, paranoid delusions, or sensations of insects crawling on the skin.

### Chronic

Despite popular belief, the current data does not support the association of chronic **cocaine** use with widespread cognitive impairments. The research on age-related loss of striatal dopamine transporter sites is equivocal, raising the question of whether cocaine has neuroprotective or neurotoxic effects for dopamine neurons. **Cocaine** use may result in the breakdown of the blood-brain barrier.

### Addiction

**Cocaine** addiction is caused by FosB overexpression in the nucleus accumbens, which causes aberrant transcriptional regulation in neurons in the nucleus accumbens.

The usage of cocaine has been shown to raise FosB levels. Each consecutive dosage of **cocaine** raises FosB levels indefinitely, with no tolerance limit. Increased FosB levels cause a rise in brain-derived neurotrophic factor levels, which increases the number of dendritic branches and spines on neurons in the nucleus accumbens and prefrontal cortex regions of the brain. This alteration can be detected rapidly and may continue for weeks after the final dose of the medication.

### Dependence and Withdrawal

**Cocaine** dependency develops after even brief durations of frequent cocaine usage and results in a withdrawal state with emotional-motivational impairments when cocaine use is discontinued.

### During Pregnancy

**Cocaine** is known to have a variety of negative consequences on a pregnant woman. **Cocaine** use during pregnancy increases the chance of placental abruption, a disorder in which the placenta detaches from the uterus and causes bleeding. They are also at risk for hemorrhagic stroke and myocardial infarction due to its vasoconstrictive and hypertensive effects. **Cocaine** is also teratogenic, which means it can lead to birth abnormalities and fetal deformities. **Cocaine** exposure during pregnancy has been linked to behavioral abnormalities, cognitive impairment, cardiovascular malformations, intrauterine growth restriction, preterm delivery, urinary tract deformities, and cleft lip and palate.

### Mortality

People who use cocaine on a regular or problematic basis have a considerably higher death rate, and are especially at risk of traumatic fatalities and infectious disease deaths.

## History

Some indigenous groups chewed coca leaves nearly universally and continue to do so. Coca leaf remnants have been discovered with ancient Peruvian mummies, and pottery from the same period portrays individuals with bulging cheeks, indicating the existence of substance on which they are chewing.