Marijuana, cocaine, amphetamine, methamphetamine, MDMA, LSD and others are popular at parties, festivals or concerts. The so-called “party drugs” are a very common choice among the young as they are available, affordable and sell the promise of having a “great time”.
When dealing with drugs of abuse, there is ultimately nothing worse than the lack of information and proper education. With this in mind, let’s bust a few myths surrounding cocaine.
One of the most common questions regarding DOA in general is how long it takes “to get hooked”. Is one time enough? The consensus seems to be that cocaine takes a long time, while opioids such as heroin require only one use to achieve comparable levels of addiction.
Although in the 1880s, cocaine was considered as a stimulant, for digestive disorders, in cachexia, in the treatment of alcohol and morphine addiction, treating asthma and as a local anesthetic1, nowadays it is a Schedule II drug with high potential of abuse.
Cocaine dependence is developed within 1-3 years after initial dose with 5.5% cocaine users developing dependence in the 1st year of use. Literature estimates the probability of becoming depended within 10 years of first cocaine dose to be 15-16%2, while 21% of the users become dependent on cocaine at some point in their life3.
Nevertheless, for drugs of abuse, different people will react differently regardless of the number of doses.
While heroin is presented as a terrible, life-destroying drug, cocaine is believed to actually be relatively safe and even celebrities and Wall Street prodigies use it from time to time.
Actually, no drug is safe. Cocaine can and has resulted in deaths caused by an overdose, heart attack, or stroke.
A report performed in the US between 1999 – 2018 (NCHS data) shows an alarming increase in the number of deaths by cocaine poisoning4. According to CRC statistics, in 2016 cocaine overdose deaths were 52% higher than in 20155. In 2017, death by cocaine represented 20% of all the drug overdose related deaths5. A more recent report of NCHS (National center for health statistics) reports 1 in 5 overall deaths is due to cocaine intake (cdc.gov) in the US. In Europe, in 2016, 1 in 7 drug-related deaths was estimated to be caused by cocaine overdose6.
57% of drugs of abuse strokes are due to cocaine7. The use of cocaine can produce elevated blood pressure and heart rate8. In lower dosage it can lead to hypertension and vasoconstriction, while in higher doses it can lead to myocardial contractility and ventricular arrhythmias9. Chronic users have almost 6 times higher chances to have a stroke than non-users9. Stroke associated with cocaine use usually shows the onset symptoms either immediately or within 3 h after administration 7,8.
Acclaimed Hollywood movies of the past decade (Wolf of Wall Street being a notorious example) suggest that cocaine makes users better and more successful workers, athletes, or lovers.
|Not true! Chronic use affects the body severely. Cocaine can lead to brain seizures, reduction of the body’s ability to resist and combat infection10 along with the heart problems mentioned in the previous part. Actually, for athletes, cocaine can lead to distorted and misguided view of their actual performance. They can also experience palpitations, anxiety, breathlessness, chest pain, spasms which decrease sport performances11.|
|Only vulnerable people end up using cocaine.||
The estimated risk age for starting cocaine is around 20 years2. Around 5.8% of adults between 18-25 years use cocaine, 0.4% of 12-17 years old adolescents and 1.6% of 26+ years adults12.
The demographics of cocaine consumption have shown no strict propensity in one social group or another. It is, in fact, spread across the board, between men and women, rich and poor, regardless of the country and city.
|Regardless of any “lacing” of other drugs in other circumstances, as long as you know your dealer, you are always safe.||Cocaine, just like any other DOA or household item, is actually subject to a rather long chain of supply. Street cocaine is prepared with different cutting agents such as caffeine, lidocaine, benzocaine, diltiazem, procaine, phenacetin, hydroxyzine, levamisole, atropine13. Most of these agents can cause unimaginable adverse effects. Knowing the whole chain might guarantee a better level of safety, but even milk companies are sometimes faced with recalls, let’s not forget!|
Undoubtedly, there are many other popular opinions and beliefs that come with the endless territory of the Internet. Education and research are, as always, the best avenue to discern legends from reality.
(1) Petersen, R., Stillman, R., Cocaine; Eds.; NIDA Research Monograph, 1977.
(2) Wagner, F. A.; Anthony, J. C. From First Drug Use to Drug Dependence; Developmental Periods of Risk for Dependence upon Marijuana, Cocaine, and Alcohol. Neuropsychopharmacol. Off. Publ. Am. Coll. Neuropsychopharmacol. 2002, 26 (4), 479–488.
(3) Lopez-Quintero, C.; de los Cobos, J. P.; Hasin, D. S.; Okuda, M.; Wang, S.; Grant, B. F.; Blanco, C. Probability and Predictors of Transition from First Use to Dependence on Nicotine, Alcohol, Cannabis, and Cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Depend. 2011, 115 (1–2), 120–130.
(4) Hedegaard, H.; Minino, A.; Warner, M. Drug Overdose Deaths in the United States, 1999–2018; 2020; p 8.
(5) Kariisa, M.; Scholl, L.; Wilson, N.; Seth, P.; Hoots, B. Drug Overdose Deaths Involving Cocaine and Psychostimulants with Abuse Potential — United States, 2003–2017. MMWR Morb. Mortal. Wkly. Rep. 2019, 68.
(6) Pirona, A.; Matias, J.; Giraudon, I. Recent Changes in Europe’s Cocaine Market: Results from an EMCDDA Trendspotter Study, December 2018.; Rapid communication / European Monitoring Centre for Drugs and Drug; Publications Office of the European Union: Luxembourg, 2018.
(7) Kaku, D. A.; Lowenstein, D. H. Emergence of Recreational Drug Abuse as a Major Risk Factor for Stroke in Young Adults. Ann. Intern. Med. 1990, 113 (11), 821–827.
(8) Treadwell, S. D.; Robinson, T. G. Cocaine Use and Stroke. Postgrad. Med. J. 2007, 83 (980), 389–394.
(9) Cheng, Y.-C.; Ryan, K. A.; Qadwai, S. A.; Shah, J.; Sparks, M. J.; Wozniak, M. A.; Stern, B. J.; Phipps, M. S.; Cronin, C. A.; Magder, L. S.; Cole, J. W.; Kittner, S. J. Cocaine Use and Risk of Ischemic Stroke in Young Adults. Stroke 2016, 47 (4), 918–922.
(10) SAMSHA. Physical and Psychological Effects of Substance Use https://ncsacw.samhsa.gov/files/TrainingPackage/MOD2/PhysicalandPsychEffectsSubstanceUse.pdf
(11) Gil, F.; de Andrade, A. G.; Castaldelli-Maia, J. M. Discussing Prevalence, Impacts, and Treatment of Substance Use Disorders in Athletes. Int. Rev. Psychiatry 2016, 28 (6), 572–578.
(12) SAMSHA. Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health; 2018; p 82.
(13) Brunt, T. M.; Rigter, S.; Hoek, J.; Vogels, N.; Dijk, P. V.; Niesink, R. J. M. An Analysis of Cocaine Powder in the Netherlands: Content and Health Hazards Due to Adulterants. Addiction 2009, 104 (5), 798–805.