Cocaine mental effects

There have been two studies of the neurodevelop-mental effects of cocaine during the first 48 hours of life. In the first, 23 cocaine-exposed and 29 non-exposed infants were prospectively assessed within the first 48 hours of life infant meconium was used to detect cocaine and the BNBA Scale was used for clinical assessment (214). One-third of the cocaine-exposed neonates were born to women who denied cocaine use. In six of the seven clusters assessed, cocaine-exposed infants fared badly compared with control infants. The cocaine-exposed infants had poor autonomic stability and there was a dose-response relation between meconium cocaine concentration and poor performance in relation to orientation and so-called regulation of state, which refers to how the infant responds when aroused. The authors concluded that cocaine exposure is independently related to poor behavioral performance in areas that are central to optimal infant development. They emphasized the value of the identification and quantification of cocaine in infants. 

Cocaine has been used by the Indians of South America for at least 2500 years. Its central nervous system effects have been long known and ironically in 1884 Freud wrote one of the first reports on the mental effects of cocaine. In the mid 1980 s widespread abuse of various forms of cocaine led to major medical and social problems [128]. This coincided with a decrease in the price of the drug "on the street" and more widespread availability. The use of cocaine has changed from that of "social and recreational" use by the wealthy to a common addiction and affliction that affects all segments of the population, as many millions of Americans use cocaine. 

Fudala P., Johnson R., Jaffe J. Outpatient comparison of buprenorphine and methadone maintenance. II. Effects of cocaine usage, retention time in study and missed clinical visits. In Harrison L., Ed. Problems of Drug Dependence. Natl. Inst. Mental Health Res. Monogr. 105 587, 1991. 

Modified and reprinted with permission from American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed.r text revision. Washington, DC American Psychiatric Association, 2000 Sofuoglu M, Dudish-Poulsen S, Poling J, et al. The effect of individual cocaine withdrawal symptoms on outcomes in cocaine users. Addict Behav 2005,30 1 125-1134 and Patten SB, Barbui C. Drug-induced depression a systematic review to inform clinical practice. Psychoth Psychosom 2004 73 207-215. 

Many drugsbromides, morphine, cocaine, hashish, marijuana, mescaline, scopolamine, di-isopropyl fluorophosphate, ACTH, pervitin, sodium amytal, lysergic acid, reserpine and chlorpromazine are known to have marked effects on the mental processes of the individuals who receive them. These effects are varied and cannot be discussed here. Suffice it to say that some drugs produce symptoms which resemble those observed in mental disease others work in the opposite direction. There can be no doubt that enzyme systems are... 

Khat produces effects similar to those of other monoamine stimulants, (i.e., increases in mental stimulation, physical endurance, elevated mood) (Widler etal. 1994 Kalix 1994 Brenneisen etal. 1990). Stimulus generalization occurs between cathinone, amphetamine, and cocaine, suggesting similar subjective effects (Huang and Wilson 1986). Similar to other monoamine stimulants, cathinone causes dose-dependent reductions in eating and body weight (Islam et al. 1990 Zelger and Carlini 1980). Oral cathinone increases sexual arousal in rats, but does not affect erectile or ejaculatory responses (Taha et al. 1995). 

A great many physical and mental disorders develop because of a malfunction in the nervous system. Some examples are Alzheimer s disease, schizophrenia, Parkinson s disease, Huntington s chorea, and bipolar disorder. Most of the effects produced by recreational drugs, such as alcohol, heroin, and cocaine, are also a result of changes in the way the nervous system functions. Today, scientists have a reasonably good understanding of the way in which the nervous system operates and how many types of chemicals affect this operation. 

Action on CNS Local anaesthetics stimulate CNS and produce restlessness, tremor, mental confusion, convulsion. In toxic doses, it causes respiratory depression, coma and death. Cocaine is a powerful stimulant while procaine and other agents produce less CNS stimulant effect. 

Cocaine acts similarly to amphetamine with regard to its ability to enhance the effects of the catecholamines and serotonin at the synapse. The actions of cocaine on the brain lead to increased alertness, reduced hunger, increased physical and mental endurance, increased motor activity, and an intensification of most normal pleasures. This last feature may explain why so many claim that cocaine enhances emotional and sexual feelings. Cocaine abusers usually co-administer other drugs that are brain depressants (e.g., alcohol, heroin, or marijuana) to decrease the unpleasant hyperstimulant aspects of cocaine. 

Small doses of cocaine can cause users to feel both mentally and sexually excited, self-confident, uninhibited, talkative, clever, and in control. Larger doses and heavy use can cause the opposite effects. Heavy users can become confused mentally, uninterested in sex, paranoid (feeling everyone is against them), antisocial, aggressive, and are subject to cocaine psychosis (a mental illness whose symptoms include paranoia, disorientation, and severe depression). 

Because they both seem to function as uppers, some people think that cocaine and methamphetamine are essentially the same drug. While it is true that they both have similar mental and physiological effects, the two drugs do act quite differently. In contrast to cocaine, which is rapidly broken down in the body, methamphetamine tends to accumulate in both the body and brain, thereby leading to longer effects and more potential to cause long-term brain damage. Also, cocaine is derived from a natural substance, the coca plant, while methamphetamine is a totally synthetic chemical. 

One common pattern of amphetamine or cocaine abuse is called a "run." Repeated smoked or intravenous injections are self-administered to obtain a "rush"—an orgasm-like reaction—followed by a feeling of mental alertness and marked euphoria. When free base cocaine is smoked, entry through the lungs is almost as fast as by intravenous injection, so that effects are more accentuated... 

Cocaine is a CNS stimulant that affects blood vessels and pupils, and increases body temperature, heart rate, and blood pressure. The euphoric effects of cocaine are quick and include reduced fatigue and mental clarity, as well as hyperstimulation. Research reports that the faster the absorption, the shorter the duration of action. The effects of cocaine in humans are variable (e.g., feeling of restlessness, irritability, and anxiety). Cocaine has powerful neuropsychological-reinforcing properties that are responsible for its repeated compulsive use. In some cases, the first dose may prove fatal. Cocaine-related death may be due to cardiac arrest or convulsion followed by respiratory arrest. In drug abuse, people mix cocaine with alcohol, leading to a chemical complex called cocaethylene, which intensifies the euphoria but can culminate in death. 

Adverse effects of cocaine include constricted peripheral blood vessels, dilated pupils, and increased body temperature, heart rate, and blood pressure. Cocaine induces several immediate euphoric effects, such as hyperstimulation, reduced fatigue, and mental clarity, all of which depend on the administration route. The faster the absorption of cocaine, the more severe the effects. In contrast, faster absorption limits the duration of action. For example, the effect from snorting cocaine may last 15 to 30 minutes, whereas effects from smoking may last 5 to 10 minutes. Increased use can reduce the period of stimulation, as addicted humans may develop tolerance. In rare instances, sudden death may occur on the first use of cocaine or unexpectedly thereafter. 

In the second study there were 174 patients in two similar experimental groups in whom injectable rather than inhaled heroin was used (5). A response to treatment was defined as at least a 40% improvement in physical, mental, or social domains of quality of life, if not accompanied by a substantial (over 20%) increase in the use of another illicit drug, such as cocaine or amphetamines. After 12 months those who took methadone and heroin (smoked or injected) had significantly better outcomes. The incidences of adverse effects (constipation and drowsiness) were similar in all the groups. However, owing to the limitations of the study and the complex nature of drug dependence, the therapeutic outcomes could not be justifiably and solely attributed to the specific drug(s). 

In nine prospective, longitudinal, multicenter studies, 1227 infants who were exposed in utero to cocaine (n = 474), opiates (n = 50), cocaine + opiates (n = 48), or neither (n = 655) were followed for 1-3 years after birth. Prenatal exposure to cocaine and/or opiates was not associated with mental, motor, or behavioral defects after controlling for birth weight and environmental risks. This result should be treated with caution, since the effects of prenatal opiates or cocaine exposure may become more evident as more advanced motor, cognitive, language, and behavioral skills develop (57). 

Many poisons can disturb mental and rational function leading to behavioral abnormalities. Psychototoxins include phencyclidine, LSD, and fungal toxins. Less commonly, stimulants such as cocaine and amphetamine can cause psychiatric problems. Psychiatric effects of high doses of corticosteroids have also been described. In addition to the developmental retardation, some investigators believe that cognitive impairment, hyperactivity, and perhaps even antisocial behavior may be caused by childhood lead exposure. Public discussion of these subtle toxic effects is highly politicized because childhood exposure to lead still occurs as a risk factor in slums and tenements. 

I have considered lead pollution in detail, but lead is not the only villain in the prenatal environment. Others include methyl-mercury polychlorinated biphenyls (PCBs) dioxins pesticides ionizing radiation and maternal use of alcohol, tobacco, marijuana, and cocaine. These villains can cause a range of behavioral effects from severe mental retardation and disability to subtle changes in mental function that depend on the timing and dose of the chemical agent. Indeed, more than zoo industrial... 

Cocaine Cocaine has marked amphetamine-like effects ( super-speed ). Its abuse continues to be widespread in the USA, partly because of the availability of a free-base form ( crack ) that can be smoked. The euphoria, self-confidence, and mental alertness produced by cocaine are short-lasting and positively reinforce its continued use. 

Nalbuphine is less likely to depress respiratory function than meperidine Tolerance to ocular and gastrointestinal effects develops rapidly during chronic use Mental retardation, microcephaly, and underdevelopment of the mid face region in an infant is associated with chronic maternal abuse of (A) Amphetamine Cocaine Ethanol Mescaline Phencyclidine... 

---