Cocaine combined with other drugs

Abuse of phencyclidine hydrochloride (PCP) is a national problem that has reached epidemic proportions in urban areas of the United States. The drug is inexpensive, readily obtainable, and is usually used in combination with other drugs such as marijuana, heroin, cocaine, and alcohol (Golden et al. 1982). The routes of PCP use include inhalation, ingestion and parenteral administration. 

Other effects caused by methamphetamine include headaches, decreased appetite, dry mouth, dilated pupils, trembling, chest pains, increased respiration and shortness of breath, hyperthermia (elevated body temperature), insomnia, and nausea and vomiting. In more severe cases (i.e., overdoses) it can produce seizures and convulsions, stroke, heart attacks, and death. The risk of encountering these more serious side effects are greatly increased when methamphetamine is used in combination with other drugs like cocaine, marijuana, alcohol, and heroin. 

Ecstasy-related visits to hospital emergency rooms have skyrocketed in recent years, with approximately 250 reports of Ecstasy-related emergencies in 1994 to more than 4,500 in 2000. The majority of the visits are Ecstasy-induced malignant hyperthermia, the risk of which is increased when Ecstasy is combined with other drugs such as LSD ( candy flipping ), psychedelic mushrooms ( hippie flipping ), methamphetamine ( up Ecstasy ), heroin ( down Ecstasy ), and cocaine, Rohypnol, cough syrup, and antidepressants. 

Drug combinations. Marijuana is frequently combined with other drugs, including heroin, cocaine, crack... 

Coca leaves contain low concentrations of cocaine (usually only 0.5 percent), in combination with other drugs that modify its... 

Cocaine and other stimulant drugs are often taken in combination with other drugs, particularly alcohol and opiates. Laboratory studies in humans have shown that alcohol can enhance and prolong the subjective pleasure associated with cocaine, and this is likely the basis for their frequent association. Recent studies have revealed that when cocaine is taken with alcohol, a new compound called cocaethylene is formed in the body. Cocaethylene has pharmacological properties similar to cocaine, but it may be more toxic. Many cases of cocaine overdose may in fact involve cocaethylene toxicity caused by combining cocaine and alcohol (Raven, Necessary, Danluck, Ettenberg,... 

There are severe physical risks with using 4-MTA. It is particularly risky to use 4-MTA with other drugs, such as Ecstasy and cocaine. Whether used alone or in combination with other drugs, 4-MTA has been known to cause dangerous cases of hyperthermia that can lead to organ failure and even death. In fact, at least 15 deaths... 

Opioids frequently are used in combinations with other drugs. A common combination is heroin and cocaine ( speedball ). Users report an improved euphoria because of the combination, and there is evidence of an interaction, because cocaine reduces the signs of opiate withdrawal, and heroin may reduce the irritability seen in chronic cocaine users. 

The association of substance abuse with emergency department (ED) visits in 21 different metropolitan areas in the United States is reported by the Drug Abuse Warning Network (DAWN). This survey tracks ED visits that are due to a condition induced by or related to drug use. Included in the data are ED visits associated with alcohol, alone and in combination with other substances of abuse, including cocaine, heroin, marijuana, and major stimulants. Figure 33-2 indicates the number of ED visits that are associated with illicit... 

When users do combine inhalants with other drugs, the effects increase the health risks. Alcohol slows down the metabolism of toluene, thus raising its concentration in the blood. Cocaine can boost the... 

Methamphetamine is often combined with other illegal drugs. A common combination is mixing methamphetamine with heroin, either in an injection or in smoking. This mixture is called a speedball. Methamphetamine users will also mix in cocaine to increase the initial rush. Methamphetamine addicts are often alcoholics. 

People who take PCP often combine it with other drugs, including cocaine, LSD, MDMA (ecstasy), methamphetamine, amphetamine, marijuana, and crack. Another common practice is to take a type of tranquilizer called a benzodiazepine to come down off PCP when the party is over. These practices of combining PCP with other drugs is particularly common among young people who attend dance clubs and raves. 

The relationships people form with plants are different from those they form with white powders. Crude natural drugs tend to he less toxic, and users tend to stay in better relationships with them over time. One reason for this difference is that plants are dilute preparations, since the active principles are combined not only with other drugs but also with inert vegetable matter. Drugs plants commonly contain less than 5 percent of an active princi-pic. (Coca rarely has more than 0.5 percent cocaine. By contrast, refined preparations may approach 100 percent purity. 

Rush, C. R., Roll, J. M., 8c Higgins, S.T.( 1998). Controlled laboratory studies on the effects of cocaine in combination with other commonly abused drugs in humans. In S. T. Higgins 8c J. L. Katz (Eds.), Cocaine abuse Behavior, pharmacology, and clinical applications 239-264). San Diego Academic Press. 

Most users smoke marijuana in hand-rolled cigarettes called joints, among other names some use pipes or water pipes called bongs. Marijuana cigars called blunts have also become popular. To make blunts, users slice open cigars and replace the tobacco with marijuana, often combined with another drug, such as crack cocaine. Marijuana also is used to brew tea and is sometimes mixed into foods. 

Cocaine toxicity has both somatic and psychiatric manifestations. Somatic effects include myocardial depression, malignant dysrhythmias, stroke, and sudden death, partially due to cocaine-related myocardial sodium channel blockade and coronary and cerebral vasoconstriction. Such life-threatening conditions occur mainly when cocaine is combined with other abused drugs. Psychiatric effects can mimic the positive and negative symptoms of schizophrenia. 

---