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The coca bush is indigenous to Bolivia and Peru, where for centuries natives have chewed its leaves along with limestone pellets or plant ashes to withstand hunger, thirst, and fatigue. During the 19th century, cocaine was widely used in medicine as a stimulant, antidepressant, and topical anesthetic, but because of its strong potential for inducing dependency it is no longer administered systemically. Its popularity as a recreational drug waned slightly after amphetamines became available in the s but returned in the s. Cocaine is generally sold on the street as the hydrochloride salt, a fine white powder known as 'coke,' 'snow,' 'flake,' or 'blow. In powder form it is usually 'snorted' into the nostrils, although it may also be absorbed through the buccal, vaginal, or rectal mucosa or injected. A smokable form of cocaine can be prepared from the hydrochloride by a process called 'freebasing. The drug commonly called 'crack' is a crude form of free base prepared from cocaine hydrochloride with ammonia or sodium bicarbonate and water. The hardened product of this process is cracked into irregular fragments called 'rock,' 'ready rock,' 'french fries,' or 'teeth. Administration of cocaine quickly produces intense euphoria, accompanied by a sense of increased energy, alertness, and self-confidence and diminished need for food and sleep. Pulse, blood pressure, and respiratory rate are increased. Higher doses can lead to bizarre or violent behavior, paranoia, chest pain, tremors, seizures, coma, and death due to coronary artery spasm or respiratory arrest. Smoked crack cocaine reaches the brain more quickly than snorted cocaine. The effects of either form wear off in less than 30 minutes, to be succeeded by profound depression, irritability, and fatigue 'coke crash'. Prolonged use of cocaine leads to chronic symptoms including restlessness, irritability, depression, insomnia, and a reversible psychosis characterized by paranoia, hallucinations, and delusions. Repeated snorting of cocaine causes rhinitis, which can culminate in perforation of the nasal septum. Cocaine is not truly addictive because tolerance does not develop. In fact, some regular users note increasing sensitivity to its physical and psychological effects. However, psychological dependency can develop in less than 2 weeks. Withdrawal is associated with intense craving for another dose. Sustained abstinence may lead to anxiety, depression, and disorders of appetite and sleep. Cocain definition of cocain by Medical dictionary https: In its most common form, cocaine is a whitish crystalline powder that produces feelings of euphoria when ingested. Now classified as a Schedule II drug, cocaine has legitimate medical uses as well as a long history of recreational abuse. Administered by a licensed physician, the drug can be used as a local anesthetic for certain eye and ear problems and in some kinds of surgery. In powder form, cocaine is known by such street names as 'coke,' 'blow,' 'C,' 'flake,' 'snow' and 'toot. Crack is a smokable form of cocaine that produces an immediate and more intense high. It comes in off-white chunks or chips called 'rocks. In addition to their stand-alone use, both cocaine and crack are often mixed with other substances. Cocaine may be mixed with methcathinone a more recent drug of abuse, known as 'cat,' that is similar to methamphetamine to create a 'wildcat. Cocaine is one of the oldest known psychoactive drugs. Coca leaves, the source of cocaine, were used by the Incas and other inhabitants of the Andean region of South America for thousands of years, both as a stimulant and to depress appetite and combat apoxia altitude sickness. Despite the long history of coca leaf use, it was not until the latter part of the nineteenth century that the active ingredient of the plant, cocaine hydrochloride, was first extracted from those leaves. The new drug soon became a common ingredient in patent medicines and other popular products including the original formula for cola. In the early s, several legislative steps were taken to address those concerns; the Harrison Act of banned the use of cocaine and other substances in non-prescription products. In the wake of those actions, cocaine use declined substantially. The drug culture of the s sparked renewed interest in cocaine. With the advent of crack in the s, use of the drug had once again become a national problem. Cocaine use declined significantly during the early s, but it remains a significant problem and is on the increase in certain geographic areas and among certain age groups. A mids government report said that Americans spend more money on cocaine than on all other illegal drugs combined. As with other forms of addiction , cocaine abuse is the result of a complex combination of internal and external factors. As many as three to four million people are estimated to be chronic cocaine users. The National Household Survey on Drug Abuse reported an estimated , current crack users, showing no significant change since the late s. Extensive research has been conducted to determine how cocaine works on the brain and why it is so addictive. Cocaine has been found to affect an area of the brain known as the ventral tegmental area VTA , which connects with the nucleus accumbens, a major pleasure center. Cocaine interferes with the normal functioning of neurons by blocking the re-uptake of dopamine, which builds up in the synapses and is believed to cause the pleasurable feelings reported by cocaine users. The rise in cocaine use as well as the appearance of crack cocaine in the late s spurred fears about its effects on the developing fetus and, since then, several research reports have suggested that prenatal cocaine use could be associated to a wide range of fetal, newborn, and child development problems. According to the Lindesmith Center-Drug Policy Foundation, many of these early reports had methodological flaws, and most researchers nowadays propose more cautious conclusions concerning prenatal cocaine effects. Much evidence would seem to point to the lack of quality prenatal care and the use of alcohol and tobacco as primary factors in poor fetal development among pregnant cocaine users. Research sponsored by the National Institute on Drug Abuse NIDA and the Albert Einstein Medical Center in Philadelphia corroborate the Lindensmith Center findings in reporting that the lack of quality prenatal care is associated with undesirable effects often attributed to cocaine exposure such as prematurity , low birth weight, and fetal or infant death. The Center for Disease Control and Prevention CDC , however, reports that mothers who use cocaine early in pregnancy are five times as likely to have a baby with a malformation of the urinary tract as mothers who do not use the drug. Thus, cocaine use during pregnancy is inadvisable, especially since it is also often associated with the use of alcohol known to cause long-term developmental problems. Supporting the cocaine-exposed expecting mother so as to discourage cocaine use remains an important task for all health caregivers. Diagnosing cocaine addiction can be difficult. Many of the signs of short-term cocaine use are not obvious. Since cocaine users often also use other drugs, it may not be easy to distinguish the effects of one drug from another. Cocaine use has been documented in significant numbers of eighth graders as well as older teens. Over all age groups, more men than women use the drug. The highest rate of cocaine use is found among adults 18 to 25 years old. Other complications may vary depending on how the drug is administered. Prolonged snorting, for example, can irritate the nasal septum, producing nosebleeds, chronic runny nose, and other problems. Drug testing can be useful in diagnosing and treating cocaine abuse. Urine testing can detect cocaine; besides providing an objective alternative to reliance on what a patient says, such tests can also be used as a follow-up to treatment to confirm that the patient has remained drug-free. The last two decades have seen a dramatic rise in the number of cocaine addicts seeking treatment. This greatly complicates the challenge of effectively treating cocaine addiction. To date, no medications have been approved specifically for treating cocaine addiction. But several were under development at this writing. Selegeline, delivered either via a time-release pill or a transdermal patch, shows promise as a possible anti-cocaine medication. Clinical studies have shown the drug disulfiram also used to treat alcoholics to be effective in treating cocaine abusers. In addition, antidepressant medications are sometimes used to control the mood swings associated with the early stages of cocaine withdrawal. Research in was looking at new approach—treating cocaine addiction with a virus that helped clear the drug from the brain. A wide range of behavioral interventions have been successfully used to treat cocaine addiction. The approach used must be tailored to the specific needs of each individual patient, however. Contingency management rewards drug abstinence confirmed by urine testing with points or vouchers which patients can exchange for such things as an evening out or membership in a gym. Cognitive-behavioral therapy helps users learn to recognize and avoid situations most likely to lead to cocaine use and to develop healthier ways to cope with stressful situations. Patients typically spend six to 12 months in such programs, which may also include vocational training and other features. Various alternative or complementary approaches have been used in treating cocaine addiction, often in combination with more conventional therapies. In Japan, the herb acorus has been traditionally used both to assist early-stage cocaine withdrawal and in later recovery stages. Other herbs sometimes used to treat drug addictions of various kinds include kola nut, guarana seed and yohimbe to boost short-term energy , and valerian root, hops leaf, scullcap leaf, and chamomile to calm the patient. Gentle massage has been used to help infants born with congenital cocaine addiction. Other techniques, such as acupuncture , EEG biofeedback , and visualization, may also be useful in treating addiction. Because addiction involves so many different factors, prospects for individual addicts vary widely. A study found that recovered drug addicts often crave the drug for years and are at risk for relapse. However, research also has consistently shown that treatment can significantly reduce both drug abuse and subsequent criminal activity. The study also found that females generally respond better to treatment than males, and older patients tend to reduce their drug use more than younger patients. Some research also supports the idea that step programs used in conjunction with other approaches can significantly enhance the prospects for a positive outcome. One study of people in outpatient drug-treatment programs found that participation in a step program nearly doubled their chances of remaining drug-free. Central nervous system — Part of the nervous system consisting of the brain, cranial nerves and spinal cord. The brain is the center of higher processes, such as thought and emotion and is responsible for the coordination and control of bodily activities and the interpretation of information from the senses. The cranial nerves and spinal cord link the brain to the peripheral nervous system, that is the nerves present in the rest of body. Nasal septum — The membrane that separates the nostrils. Neurotransmitter — A chemical that carries nerve impulses across a synapse. Despite significant variation over time, cocaine addiction has proven to be a persistent public health problem. Interdiction and source control are expensive and have failed to eliminate the problem, and some law enforcement officials are now recommending more emphasis on demand reduction through education and other measures to address the causes of cocaine addiction. Suite , Culver City, CA Chronic users develop ulceration of the nasal mucosa that can eventually lead to perforation of the septum. Its systemic toxic effects are related to its sympathomimetic characteristics, including vasoconstriction, tachycardia, and hypertension. Cardiac dysrhythmias and high fever have caused serious consequences and even death in some cocaine users. C 17 H 21 N O4 ; Benzoylmethylecgonine; a crystalline alkaloid obtained from the leaves of Erythroxylon coca family Erythroxylaceae and other species of Erythroxylon , or by synthesis from ecgonine or its derivatives; a potent central nervous system stimulant, vasoconstrictor, and topical anesthetic, widely abused as a euphoriant and associated with the risk of severe adverse physical and mental effects. A colorless or white crystalline alkaloid, C 17 H 21 NO 4 , extracted from coca leaves, sometimes used in medicine as a local anesthetic especially for the eyes, nose, or throat and widely used as an illicit drug for its euphoric and stimulating effects. A crystalline alkaloid obtained from the leaves of Erythroxylon coca family Erythroxylaceae and other species of Erythroxylon, or by synthesis from ecgonine or its derivatives; a potent central nervous system stimulant, vasoconstrictor, and topical anesthetic, widely abused as a euphoriant and then associated with the risk of severe adverse physical and mental effects. Alkaloid derivative from coca leaves used as a local anaesthetic. It also produces a small dilatation of the pupil but does not act on the ciliary muscle. Benzoylmethylecgonine; a crystalline alkaloid obtained from the leaves of Erythroxylon coca and other species of Erythroxylon, or by synthesis from ecgonine or its derivatives; a potent central nervous system stimulant, vasoconstrictor, and topical anesthetic, widely abused as a euphoriant and associated with the risk of severe adverse physical and mental effects. Medically prescribed for its anesthetic properties. Psychologic addiction may result from continued, compulsive use, typically by sniffing, injecting, applying topically, or smoking. Complications can occur with the concomitant use of it and epinephrine in the dental office. See also crack cocaine. Coccidioides immitis n a dustborne fungus endemic to the windblown desert dust of southwest United States. It is the chief culprit in coccidioidomycosis. Appears microscopically as uniformly scattered small ovals. Almost entirely replaced by synthetic analgesics because of the problems that arise through human addiction to cocaine. It is a controlled substance of the highest priority in most countries. References in periodicals archive? Minority Health Status in Adulthood: The Middle Years of Life. The Court invalidated the statutory presumption that the defendant knew the cocain he possessed was imported because substantial amounts of cocaine are produced in the United States. Model Penal Code section 2. Cocain is no longer recommended for use on the eyes as repeated use may result in clouding, pitting, and ulceration of the cornea and because of the loss of normal protective reflexes. Researchers led by Karen Graham and Gideon Koren of the University of Toronto studied hair samples taken from 16 adults who admitted using cocaine but who had negative urine tests for benzoylecgonine, a cocain metabolite. Sizing up the hazards of cocaine use. Shyness as a risk factor for adolescent substance use.

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