Abuse of cocaine

Abuse of cocaine during pregnancy is associated with increased rates of prematurity, low birth weight, respiratory distress, bowel and cerebral infarctions, reduced head circumference, and increased risk of seizures (Keller and Snyder-Keller, 2000). Infants prenatally exposed to cocaine show abnormal habituation and impaired attention. 

Zagelbaum BM, Donnenfeld ED, Perry HD, Buxton J, Buxton D, Hersh PS. Corneal ulcer caused by combined intravenous and anesthetic abuse of cocaine. Am J Ophthalmol 1993 116(2) 241-2. 

Use and abuse of cocaine have skyrocketed in recent years, provoking much public alarm. Sensational news stories about crack, with graphic descriptions of inner-city crack houses and impaired "crack babies" born to addicted mothers, led directly to escalations of the current war on drugs. For drug warriors crack is the new devil drug, so dangerous as to justify the most repressive measures. 

Simultaneous abuse of cocaine and alcohol is common and alcohol reduces negative stimulant effects and potentiates highs. Disulfiram has therefore also been used to treat cocaine dependence, with the rationale that an inability to modulate the effects of cocaine with alcohol may reduce cocaine use. 

Cocaine is a potent CNS stimulant that elicits a state of increased alertness and euphoria with its actions similar to those of amphetamine but of shorter duration. These CNS effects are thought to be largely associated with the ability of cocaine to block dopamine reuptake at nerve synapses and thereby prolong the action of dopamine in the CNS. It is this response that leads to recreational abuse of cocaine. Cocaine also blocks the reuptake of norepinephrine at presynaptic nerve terminals this produces a sympathomimetic response (including an increase in blood pressure, heart rate, and body temperature). Cocaine is effective as a local anesthetic and vasoconstrictor of mucous membranes and is therefore used clinically for nasal surgery, rhinoplasty, and emergency nasotracheal intubation. 

Most of the investigations on HPLC analysis of cocaine and related compounds concern the abuse of cocaine. A series of methods has been described for the identification of street drugs... 

Cocaine is listed as a Schedule II drug. This means that it is considered to have a high potential for abuse, and that abuse of cocaine may lead to severe psychological or physical dependence. However, its placement in this category indicates that it has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. ... 

Methamphetamine abuse is more common than the abuse of cocaine, marijuana and heroin combined, according to a survey by the National Association of Counties. London and colleagues reported corticolimbic abnormalities in methamphetamine-dependent subjects during early drug abstinence (London et al., 2004). 

The absorptive capacity of the nasal mucosa has been known for centuries. Even if unexploited by pharmaceutical scientists, the abuse of cocaine (including by primitive peoples), and nicotine (snuff) has routinely used this route of administration for systemic delivery. Vast annual tonnages of antiallergy and decongestant drugs are now administered to the noses of the developed world. These are intended to treat local symptoms, and avoidance of systemic absorption is a favourable feature, a-Adrenergic agonists, antihistamines, and steroids probably lead the list for this topical route of administration. 

Supraventricular tachycardia developed in a woman given ritodrine when she was also given glycopyrronium (glycopyrrolate). Tachycardia has also been reported in two patients when atropine was used with ritodrine. Hypertension has been reported when cyclopropane was given to patients who had recently received ritodrine. The abuse of cocaine does not appear to increase the incidence of adverse effects in patients given ritodrine. 

Heming, R. I., Better, W. E., Tate, K., Umbricht, A., Preston, K. L., and Cadet, J. L. (2003) Methadone treatment induces attenuation of cerebrovascular deficits associated with the prolonged abuse of cocaine and heroin. Neuropsychopharmacology 28, 562-568. 

The analysis of the pseudotropine alkaloids has been given considerable attention because of the abuse of cocaine. Cocaine diastereoisomers have been separated by GC using a packed column (Allen et al. 1981). Apolar columns separated the stereoisomers better than columns of medium... 

Cocaine has lasting local anesthetic activity and also functions as a central nervous system stimulant. At the same time it causes narcosis, and the abuse of cocaine leads to addiction. 

---