Key:ZPUCINDJVBIVPJ-LJISPDSOSA-N Y See also: N Y Cocaine, also known as coke, is a strong mostly used as a. It is commonly, inhaled as smoke, or dissolved and injected into a.
Mental effects may include, an,. Physical symptoms may include a, sweating,. High doses can result in very. Effects begin within seconds to minutes of use and last between five and ninety minutes. Cocaine has a small number of accepted medical uses such as and decreasing bleeding during nasal surgery.
Cocaine is due to its effect on the in the brain. After a short period of use, there is a high risk that will occur. Its use also increases the risk of, lung problems in those who smoke it,. Cocaine sold on the street is commonly mixed with, cornstarch, or sugar, which can result in additional toxicity. Following repeated doses a person may have and be very physically tired. Cocaine acts.
Learn about the symptoms and effects of cocaine addiction or abuse, as well as effective, evidence-based options for detox, treatment, or rehab.
This results in greater concentrations of these three in the brain. It can easily cross the and may lead to the breakdown of the barrier. Cocaine is a naturally occurring substance found in the which is mostly grown in South America. In 2013, 419 kilograms were produced legally. It is estimated that the illegal market for cocaine is 100 to US$500 billion each year. With further processing can be produced from cocaine.
Cocaine is the second most frequently used globally, after. Between 14 and 21 million people use the drug each year. Use is highest in North America followed by Europe and South America. Between one and three percent of people in the have used cocaine at some point in their life. In 2013, cocaine use directly resulted in 4,300 deaths, up from 2,400 in 1990. The leaves of the coca plant have been used by since ancient times.
Cocaine was first isolated from the leaves in 1860. Since 1961, the international has required countries to make recreational use of cocaine a. Cocaine hydrochloride Topical cocaine can be used as a local to help with painful procedures in the mouth or nose.
Cocaine is now predominantly used for nasal and surgery. The major disadvantages of this use are cocaine's potential for toxicity,. Medicinal use of cocaine has decreased as other synthetic local anesthetics such as, and are now used more often.
If vasoconstriction is desired for a procedure (as it reduces bleeding), the anesthetic is combined with a vasoconstrictor such as. Some specialists occasionally use cocaine within the practice when performing procedures such as nasal. In this scenario dissolved cocaine is soaked into a ball of cotton wool, which is placed in the nostril for the 10–15 minutes immediately before the procedure, thus performing the dual role of both numbing the area to be cauterized, and vasoconstriction. Even when used this way, some of the used cocaine may be absorbed through oral or nasal mucosa and give systemic effects. An alternative method of administration for ENT surgery is mixed with and, as. Recreational Cocaine is a powerful nervous system stimulant. Its effects can last from 15 or 30 minutes to an hour.
The duration of cocaine's effects depends on the amount taken and the route of administration. Cocaine can be in the form of fine white powder, bitter to the taste. When inhaled or injected, it causes a numbing effect. Crack cocaine is a smokeable form of cocaine made into small 'rocks' by processing cocaine with sodium bicarbonate (baking soda) and water. Crack cocaine is referred to as 'crack' because of the crackling sounds it makes when heated. Cocaine use leads to increases in alertness, feelings of well-being and, increased energy and motor activity, and increased feelings of competence and sexuality.
Coca leaves leaves are typically mixed with an alkaline substance (such as ) and chewed into a wad that is retained in the mouth between gum and cheek (much the same as is chewed) and sucked of its juices. The juices are absorbed slowly by the mucous membrane of the inner cheek and by the gastrointestinal tract when swallowed. Alternatively, coca leaves can be infused in liquid and consumed like tea. Ingesting coca leaves generally is an inefficient means of administering cocaine. Because cocaine is and rendered inactive in the acidic stomach, it is not readily absorbed when ingested alone. Only when mixed with a highly alkaline substance (such as ) can it be absorbed into the bloodstream through the stomach. The efficiency of absorption of orally administered cocaine is limited by two additional factors.
First, the drug is partly catabolized by the liver. Second, capillaries in the mouth and esophagus constrict after contact with the drug, reducing the surface area over which the drug can be absorbed. Nevertheless, cocaine metabolites can be detected in the urine of subjects that have sipped even one cup of coca leaf infusion. Orally administered cocaine takes approximately 30 minutes to enter the bloodstream. Typically, only a third of an oral dose is absorbed, although absorption has been shown to reach 60% in controlled settings. Given the slow rate of absorption, maximum and effects are attained approximately 60 minutes after cocaine is administered by ingestion. While the onset of these effects is slow, the effects are sustained for approximately 60 minutes after their peak is attained.
Contrary to popular belief, both ingestion and result in approximately the same proportion of the drug being absorbed: 30 to 60%. Compared to ingestion, the faster absorption of insufflated cocaine results in quicker attainment of maximum drug effects. Snorting cocaine produces maximum physiological effects within 40 minutes and maximum psychotropic effects within 20 minutes, however, a more realistic activation period is closer to 5 to 10 minutes.
Physiological and psychotropic effects from nasally insufflated cocaine are sustained for approximately 40–60 minutes after the peak effects are attained., an infusion of coca leaves, is also a traditional method of consumption. The tea has often been recommended for travelers in the Andes to prevent. However, its actual effectiveness has never been systematically studied. In 1986 an article in the revealed that U.S. Were selling dried coca leaves to be prepared as an infusion as 'Health Inca Tea.' While the packaging claimed it had been 'decocainized,' no such process had actually taken place. The article stated that drinking two cups of the tea per day gave a mild, increased, and elevation, and the tea was essentially harmless.
Despite this, the seized several shipments in, and several locations on the, and the product was removed from the shelves. Insufflation. Lines of cocaine prepared for insufflation Nasal (known colloquially as 'snorting', 'sniffing', or 'blowing') is a common method of ingestion of recreational powdered cocaine. The drug coats and is absorbed through the lining the. Cocaine's desired euphoric effects are delayed when snorted through the nose by about five minutes. This occurs because cocaine's absorption is slowed by its constricting effect on the blood vessels of the nose. Insufflation of cocaine also leads to the longest duration of its effects (60–90 minutes).
When insufflating cocaine, absorption through the nasal membranes is approximately 30–60%, with higher doses leading to increased absorption efficiency. Any material not directly absorbed through the mucous membranes is collected in and swallowed (this 'drip' is considered pleasant by some and unpleasant by others). In a study of cocaine users, the average time taken to reach peak subjective effects was 14.6 minutes.
Any damage to the inside of the nose is because cocaine highly constricts blood vessels – and therefore blood and oxygen/nutrient flow – to that area. Nosebleeds after cocaine insufflation are due to irritation and damage of mucus membranes by foreign particles and adulterants and not the cocaine itself; as a vasoconstrictor, cocaine acts to reduce bleeding.
Rolled up, hollowed-out, cut, pointed ends of keys, specialized spoons, long, and (clean) tampon applicators are often used to insufflate cocaine. Such devices are often called 'tooters' by users. The cocaine typically is poured onto a flat, hard surface (such as a mirror, CD case or book) and divided into 'bumps,' 'lines' or 'rails,' and then insufflated.
The amount of cocaine in a line varies widely from person to person and occasion to occasion (the purity of the cocaine is also a factor), but one line is generally considered to be a single dose and is typically 35 mg (a 'bump') to 100 mg (a 'rail'). – As tolerance builds rapidly in the short-term (hours), many lines are often snorted to produce greater effects. A 2001 study reported that the sharing of straws used to 'snort' cocaine can spread blood diseases such as. Injection by turning the drug into a solution provides the highest blood levels of drug in the shortest amount of time.
Subjective effects not commonly shared with other methods of administration include a ringing in the ears moments after injection (usually when in excess of 120 milligrams) lasting two to 5 minutes including and audio distortion. This is colloquially referred to as a 'bell ringer'. In a study of cocaine users, the average time taken to reach peak subjective effects was 3.1 minutes. The euphoria passes quickly. Aside from the toxic effects of cocaine, there is also danger of circulatory from the insoluble substances that may be used to cut the drug. As with all injected illicit substances, there is a risk of the user contracting blood-borne infections if sterile injecting equipment is not available or used. Additionally, because cocaine is a vasoconstrictor, and usage often entails multiple injections within several hours or less, subsequent injections are progressively more difficult to administer, which in turn may lead to more injection attempts and more consequences from improperly performed injection.
An injected mixture of cocaine and, known as ' is a particularly dangerous combination, as the converse effects of the drugs actually complement each other, but may also mask the symptoms of an overdose. It has been responsible for numerous deaths, including celebrities such as comedians/actors and, grunge singer and actor. Experimentally, cocaine injections can be delivered to animals such as to study the mechanisms of cocaine addiction. See also: Inhalation by smoking cocaine is one of the several ways the drug is consumed. The onset of cocaine's desired euphoric effects is fastest with inhaling cocaine and begins after 3–5 seconds. In contrast, inhalation of cocaine leads to the shortest duration of its effects (5–15 minutes). The two main ways cocaine is smoked are and by using cocaine which has been converted to smokable '.
Cocaine is smoked by inhaling the vapor produced when solid cocaine is heated to the point that it sublimates. In a 2000 Brookhaven National Laboratory medical department study, based on self reports of 32 abusers who participated in the study,'peak high' was found at mean of 1.4min +/- 0.5 minutes. Products of cocaine that occur only when heated/smoked have been shown to change the effect profile, i.e. Anhydroecgonine methyl ester when co-administered with cocaine increases the dopamine in CPu and NAc brain regions, and has M 1- and M 3- receptor affinity. Smoking freebase or crack cocaine is most often accomplished using a pipe made from a small glass tube, often taken from ', small glass tubes with a paper rose that are promoted as romantic gifts. These are sometimes called 'stems', 'horns', 'blasters' and 'straight shooters'.
A small piece of clean heavy copper or occasionally stainless steel scouring pad – often called a 'brillo' (actual contain soap, and are not used) or 'chore' (named for brand copper scouring pads) – serves as a reduction base and flow modulator in which the 'rock' can be melted and boiled to vapor. Crack smokers also sometimes smoke through a with small holes on the side or bottom. Crack is smoked by placing it at the end of the pipe; a flame held close to it produces vapor, which is then inhaled by the smoker. The effects, felt almost immediately after smoking, are very intense and do not last long – usually 2 to 10 minutes. When smoked, cocaine is sometimes combined with other drugs, such as, often rolled into a joint.
Powdered cocaine is also sometimes smoked, though heat destroys much of the chemical; smokers often sprinkle it on cannabis. The language referring to paraphernalia and practices of smoking cocaine vary, as do the packaging methods in the street level sale. Suppository Another way users consume cocaine is by making it into a which they then insert into the anus or vagina. The drug is then absorbed by the membranes of these body parts. Little research has been focused on the suppository (anal or vaginal insertion) method of administration, also known as 'plugging'. This method of administration is commonly administered using an.
Cocaine can be dissolved in water and withdrawn into an oral syringe which may then be lubricated and inserted into the anus or vagina before the plunger is pushed. Anecdotal evidence of its effects is infrequently discussed, possibly due to social taboos in many cultures. The rectum and the vaginal canal is where the majority of the drug would be taken up through the membranes lining its walls. Adverse effects Acute. Side effects of chronic cocaine use Chronic cocaine intake causes strong imbalances of transmitter levels in order to compensate extremes.
Thus, receptors disappear from the cell surface or reappear on it, resulting more or less in an 'off' or 'working mode' respectively, or they change their susceptibility for binding partners (ligands) – mechanisms called. However, studies suggest cocaine abusers do not show normal age-related loss of (DAT) sites, suggesting cocaine has neuroprotective properties for dopamine neurons. Possible side effects include insatiable hunger, aches, insomnia/oversleeping, lethargy, and persistent runny nose. Depression with suicidal ideation may develop in very heavy users. Finally, a loss of, neurofilament proteins, and other morphological changes appear to indicate a long term damage of dopamine neurons. All these effects contribute a rise in tolerance thus requiring a larger dosage to achieve the same effect.
The lack of normal amounts of serotonin and dopamine in the brain is the cause of the dysphoria and depression felt after the initial high. Physical withdrawal is not dangerous. Physiological changes caused by cocaine withdrawal include vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite and psychomotor retardation or agitation.
Physical side effects from chronic smoking of cocaine include, diffuse alveolar infiltrates without effusions, pulmonary and systemic, chest pain, lung trauma, sore throat, hoarse voice, (shortness of breath), and an aching, -like syndrome. Cocaine, and increases body temperature, heart rate, and blood pressure. It can also cause headaches and gastrointestinal complications such as abdominal pain and nausea. A common but untrue belief is that the smoking of cocaine chemically breaks down and causes. However, cocaine does often cause involuntary tooth grinding, known as, which can deteriorate tooth enamel and lead to.
Additionally, stimulants like cocaine, methamphetamine, and even caffeine cause dehydration. Since saliva is an important mechanism in maintaining one's oral pH level, chronic stimulant abusers who do not hydrate sufficiently may experience demineralization of their teeth due to the pH of the tooth surface dropping too low (below 5.5). Cocaine use also promotes the. This increase in blood clot formation is attributed to cocaine-associated increases in the activity of, and an increase in the number, activation, and aggregation of. Chronic intranasal usage can degrade the separating the (the ), leading eventually to its complete disappearance.
Due to the absorption of the cocaine from cocaine hydrochloride, the remaining hydrochloride forms a dilute hydrochloric acid. Cocaine may also greatly increase this risk of developing rare autoimmune or connective tissue diseases such as, and other diseases. It can also cause a wide array of kidney diseases and kidney failure. Cocaine use leads to an increased risk of hemorrhagic and ischemic. Cocaine use also increases the risk of having a. See also: occurs through overexpression in the, which results in altered in neurons within the.
ΔFosB levels have been found to increase upon the use of cocaine. Each subsequent dose of cocaine continues to increase ΔFosB levels with no ceiling of tolerance. Elevated levels of ΔFosB leads to increases in brain-derived neurotrophic factor levels, which in turn increases the number of branches and present on neurons involved with the nucleus accumbens and areas of the brain. This change can be identified rather quickly, and may be sustained weeks after the last dose of the drug. Transgenic mice exhibiting inducible expression of ΔFosB primarily in the nucleus accumbens and exhibit behavioural responses to cocaine.
They self-administer cocaine at lower doses than control, but have a greater likelihood of when the drug is withheld. ΔFosB increases the expression of subunit GluR2 and also decreases expression of, thereby enhancing sensitivity to reward. Dependence and withdrawal is a form of that develops from regular cocaine use and produces a state with emotional-motivational deficits upon cessation of cocaine use. During pregnancy Cocaine is known to have a number of deleterious effects during pregnancy. Pregnant people who use cocaine have an elevated risk of, a condition where the placenta detaches from the uterus and causes bleeding.
Due to its vasoconstrictive and hypertensive effects, they are also at risk for. Cocaine is also teratogenic, meaning that it can cause birth defects and fetal malformations. In-utero exposure to cocaine is associated with behavioral abnormalities, cognitive impairment, cardiovascular malformations, preterm birth, urinary tract malformations,. Pharmacology Pharmacodynamics The pharmacodynamics of cocaine involve the complex relationships of neurotransmitters (inhibiting uptake in rats with ratios of about:: = 2:3, serotonin: = 2:5).
The most extensively studied effect of cocaine on the is the blockade of the protein. Dopamine released during neural signaling is normally recycled via the transporter; i.e., the transporter binds the transmitter and pumps it out of the synaptic cleft back into the neuron, where it is taken up into storage. Cocaine binds tightly at the dopamine transporter forming a complex that blocks the transporter's function. The dopamine transporter can no longer perform its reuptake function, and thus accumulates in the.
Cocaine's affects certain serotonin (5-HT) receptors; in particular, it has been shown to antagonize the, which is a. The overabundance of 5-HT3 receptors in cocaine conditioned rats display this trait, however the exact effect of 5-HT3 in this process is unclear. The (particularly the subtypes 5-HT2AR, 5-HT2BR and 5-HT2CR) are involved in the locomotor-activating effects of cocaine. Cocaine has been demonstrated to bind as to directly stabilize the DAT transporter on the open outward-facing conformation. Further, cocaine binds in such a way as to inhibit a hydrogen bond innate to DAT. Cocaine's binding properties are such that it attaches so this hydrogen bond will not form and is blocked from formation due to the tightly locked orientation of the cocaine molecule.
Research studies have suggested that the affinity for the transporter is not what is involved in habituation of the substance so much as the conformation and binding properties to where and how on the transporter the molecule binds. Are affected by cocaine, as cocaine functions as a sigma ligand agonist. Further specific receptors it has been demonstrated to function on are and the D1 dopamine receptor. Cocaine also blocks, thereby interfering with the propagation of; thus, like and, it acts as a local anesthetic.
It also functions on the binding sites to the dopamine and serotonin sodium dependent transport area as targets as separate mechanisms from its reuptake of those transporters; unique to its local anesthetic value which makes it in a class of functionality different from both its own derived phenyltropanes analogues which have that removed. In addition to this cocaine has some target binding to the site of the Kappa-opioid receptor as well.
Cocaine also causes, thus reducing bleeding during minor surgical procedures. The locomotor enhancing properties of cocaine may be attributable to its enhancement of dopaminergic transmission from the. Recent research points to an important role of circadian mechanisms and in behavioral actions of cocaine. Cocaine can often cause reduced food intake, many chronic users lose their appetite and can experience severe malnutrition and significant weight loss. Cocaine effects, further, are shown to be potentiated for the user when used in conjunction with new surroundings and stimuli, and otherwise novel environs. Pharmacokinetics Cocaine has a short half life of 0.7-1.5 hours and is extensively by enzymes (primarily in the and ), with only about 1% excreted unchanged in the urine. The metabolism is dominated by cleavage, so the eliminated metabolites consist mostly of (BE), the major, and other significant metabolites in lesser amounts such as ecgonine methyl ester (EME).
Further minor metabolites of cocaine include, p-hydroxycocaine, m-hydroxycocaine, p-hydroxybenzoylecgonine (pOHBE), and m-hydroxybenzoylecgonine. If consumed with, cocaine combines with alcohol in the to form. Studies have suggested cocaethylene is both more, and has a higher toxicity than cocaine by itself. Depending on liver and kidney function, cocaine metabolites are detectable in urine. Benzoylecgonine can be detected in urine within four hours after cocaine intake and remains detectable in concentrations greater than 150 ng/mL typically for up to eight days after cocaine is used.
Detection of cocaine metabolites in hair is possible in regular users until the sections of hair grown during use are cut or fall out. Chemistry Appearance. A piece of compressed cocaine powder Cocaine in its purest form is a white, pearly product. Cocaine appearing in powder form is a, typically cocaine. Street cocaine is often adulterated or 'cut' with,. The color of depends upon several factors including the origin of the cocaine used, the method of preparation – with or – and the presence of impurities. It will generally range from white to a yellowish cream to a light brown.
Its texture will also depend on the adulterants, origin and processing of the powdered cocaine, and the method of converting the base. It ranges from a crumbly texture, sometimes extremely oily, to a hard, almost crystalline nature. Forms Salts Cocaine – a – is a weakly alkaline compound, and can therefore combine with acidic compounds to form salts. The (HCl) salt of cocaine is by far the most commonly encountered, although the (SO 4 2-) and the (NO 3 -) salts are occasionally seen.
Different salts dissolve to a greater or lesser extent in various solvents – the hydrochloride salt is polar in character and is quite soluble in water. Main article: As the name implies, 'freebase' is the form of cocaine, as opposed to the form. It is practically insoluble in water whereas hydrochloride salt is water-soluble. Smoking freebase cocaine has the additional effect of releasing into the user's system due to the of the substance (a side effect which or injecting powder cocaine does not create). Some research suggests that smoking freebase cocaine can be even more cardiotoxic than other because of methylecgonidine's effects on lung tissue and liver tissue. Pure cocaine is prepared by neutralizing its compounding salt with an alkaline solution, which will precipitate to non-polar basic cocaine.
It is further refined through aqueous-solvent. Crack cocaine. 'Rocks' of crack cocaine Crack is a lower purity form of free-base cocaine that is usually produced by neutralization of cocaine hydrochloride with a solution of baking soda (sodium bicarbonate, NaHCO 3) and water, producing a very hard/brittle, off-white-to-brown colored, amorphous material that contains sodium carbonate, entrapped water, and other by-products as the main impurities.
The 'freebase' and 'crack' forms of cocaine are usually administered by vaporization of the powdered substance into smoke, which is then inhaled. The origin of the name 'crack' comes from the 'crackling' sound (and hence the moniker 'crack') that is produced when the cocaine and its impurities (i.e. Water, sodium bicarbonate) are heated past the point of vaporization. Pure cocaine base/crack can be smoked because it vaporizes smoothly, with little or no decomposition at 98 °C (208 °F), which is below the boiling point of water. In contrast, cocaine hydrochloride does not vaporize until heated to a much higher temperature (about 197 °C), and considerable decomposition/burning occurs at these high temperatures. This effectively destroys some of the cocaine and yields a sharp, acrid, and foul-tasting smoke.
Smoking or vaporizing cocaine and inhaling it into the lungs produces an almost immediate 'high' that can be very powerful (and addicting) quite rapidly – this initial crescendo of stimulation is known as a 'rush'. While the stimulating effects may last for hours, the euphoric sensation is very brief, prompting the user to smoke more immediately. Coca leaf infusions. This article needs additional citations for.
Unsourced material may be challenged and removed. ( April 2014) Coca herbal (also referred to as ) is used in coca-leaf producing countries much as any herbal medicinal infusion would elsewhere in the world. The free and legal commercialization of dried coca leaves under the form of filtration bags to be used as 'coca tea' has been actively promoted by the governments of and for many years as a drink having medicinal powers. Visitors to the city of in Peru, and in Bolivia are greeted with the offering of coca leaf infusions (prepared in teapots with whole coca leaves) purportedly to help the newly arrived traveler overcome the malaise of high altitude sickness. The effects of drinking coca tea are a mild stimulation and mood lift. It does not produce any significant numbing of the mouth nor does it give a rush like snorting cocaine.
In order to prevent the demonization of this product, its promoters publicize the unproven concept that much of the effect of the ingestion of coca leaf infusion would come from the secondary alkaloids, as being not only quantitatively different from pure cocaine but also qualitatively different. It has been promoted as an adjuvant for the treatment of cocaine dependence. In one controversial study, coca leaf infusion was used—in addition to counseling—to treat 23 addicted coca-paste smokers in, Peru. Relapses fell from an average of four times per month before treatment with coca tea to one during the treatment. The duration of abstinence increased from an average of 32 days prior to treatment to 217 days during treatment. These results suggest that the administration of coca leaf infusion plus counseling would be an effective method for preventing relapse during treatment for cocaine addiction.
Importantly, these results also suggest strongly that the primary pharmacologically active metabolite in coca leaf infusions is actually cocaine and not the secondary alkaloids. The cocaine metabolite can be detected in the urine of people a few hours after drinking one cup of coca leaf infusion. Main article: Global estimates of drug users in 2016 (in millions of users) Substance Best estimate Low estimate High estimate 34.16 13.42 55.24 192.15 165.76 234.06 18.20 13.87 22.85 20.57 8.99 32.34 19.38 13.80 26.15 34.26 27.01 44.54 According to a 2016 United Nations report, are the countries with the highest rate of cocaine usage (2.4% of adults in the previous year). Other countries where the usage rate meets or exceeds 1.5% are Spain and Scotland (2.2%), the United States (2.1%), Australia (2.1%), Uruguay (1.8%), Brazil (1.75%), Chile (1.73%), the Netherlands (1.5%) and Ireland (1.5%).
Europe Cocaine is the second most popular illegal recreational drug in Europe (behind ). Since the mid-1990s, overall cocaine usage in Europe has been on the rise, but usage rates and attitudes tend to vary between countries. European countries with the highest usage rates are the United Kingdom, Spain, Italy, and the Republic of Ireland. Approximately 12 million Europeans (3.6%) have used cocaine at least once, 4 million (1.2%) in the last year, and 2 million in the last month (0.5%).
About 3.5 million or 87.5% of those who have used the drug in the last year are young adults (15–34 years old). Usage is particularly prevalent among this demographic: 4% to 7% of males have used cocaine in the last year in Spain, Denmark, Republic of Ireland, Italy, and the United Kingdom.
The ratio of male to female users is approximately 3.8:1, but this statistic varies from 1:1 to 13:1 depending on country. In 2014 London had the highest amount of cocaine in its sewage out of 50 European cities. United States. Main article: Cocaine is the second most popular illegal recreational drug in the United States (behind ) and the U.S. Is the world's largest consumer of cocaine. Cocaine is commonly used in middle to upper-class communities and is known as a 'rich man's drug'.
It is also popular amongst college students, as a party drug. A study throughout the entire United States has reported that around 48 percent of people who graduated from high school in 1979 have used cocaine recreationally during some point in their lifetime, compared to approximately 20 percent of students who graduated between the years of 1980 and 1995. Its users span over different ages, races, and professions. In the 1970s and 1980s, the drug became particularly popular in the culture as cocaine usage was very common and popular in many discos such as. History Discovery. Advertisement in the January 1896 issue of Magazine for Burnett's Cocaine 'for the hair'. With the discovery of this new alkaloid, Western medicine was quick to exploit the possible uses of this plant.
In 1879, Vassili von Anrep, of the, devised an experiment to demonstrate the analgesic properties of the newly discovered alkaloid. He prepared two separate jars, one containing a cocaine-salt solution, with the other containing merely salt water. He then submerged a frog's legs into the two jars, one leg in the treatment and one in the control solution, and proceeded to stimulate the legs in several different ways. The leg that had been immersed in the cocaine solution reacted very differently from the leg that had been immersed in salt water.
(a close associate of, who would write about cocaine later) experimented with cocaine for usage. In an infamous experiment in 1884, he experimented upon himself by applying a cocaine solution to his own eye and then pricking it with pins. His findings were presented to the Heidelberg Ophthalmological Society. Also in 1884, Jellinek demonstrated the effects of cocaine as a anesthetic. In 1885, demonstrated nerve-block anesthesia, and demonstrated anesthesia. 1898 saw use cocaine for.
In this 1904 from, 'Madame ' recommended that be treated with a solution of, cocaine,. By the late, cocaine use had appeared as a vice in. For example, it was injected by 's fictional, generally to offset the boredom he felt when he was not working on a case. In early 20th-century, cocaine was sold in neighborhood drugstores on, costing five or ten cents for a small boxful.
Stevedores along the Mississippi River used the drug as a stimulant, and white employers encouraged its use by black laborers. In 1909, took 'Forced March' brand cocaine tablets to, as did a year later on his ill-fated journey to the. During the mid-1940s, amidst World War II, cocaine was considered for inclusion as an ingredient of a future generation of 'pep pills' for the German military, code named. In modern popular culture references to the drug are prevalent, in it the drug has a glamorous image associated with the rich, famous and powerful with it also making users to 'feel rich and beautiful'. In addition the pace of modern society − such as in finance − gives many the incentive to make use of the drug. Mayor captured on a surveillance camera smoking crack cocaine during a sting operation by the. In many countries, cocaine is a popular.
In the United States, the development of introduced the substance to a generally poorer inner-city market. Use of the powder form has stayed relatively constant, experiencing a new height of use during the late 1990s and early 2000s in the U.S., and has become much more popular in the last few years in the UK. Cocaine use is prevalent across all socioeconomic strata, including age, demographics, economic, social, political, religious, and livelihood. The estimated U.S. Cocaine market exceeded US$70 billion in street value for the year 2005, exceeding revenues by corporations such as.
There is a tremendous demand for cocaine in the U.S. Market, particularly among those who are making incomes affording spending, such as single adults and professionals with discretionary income. Cocaine's status as a shows its immense popularity among the 'party crowd'. In 1995 the (WHO) and the (UNICRI) announced in a press release the publication of the results of the largest global study on cocaine use ever undertaken. However, a decision by an American representative in the banned the publication of the study, because it seemed to make a case for the positive uses of cocaine. An excerpt of the report strongly conflicted with accepted paradigms, for example 'that occasional cocaine use does not typically lead to severe or even minor physical or social problems.'
In the sixth meeting of the B committee, the US representative threatened that 'If World Health Organization activities relating to drugs failed to reinforce proven drug control approaches, funds for the relevant programs should be curtailed'. This led to the decision to discontinue publication.
A part of the study was recuperated and published in 2010, including profiles of cocaine use in 20 countries, but are unavailable as of 2015. In October 2010 it was reported that the use of cocaine in Australia has doubled since monitoring began in 2003.
A problem with illegal cocaine use, especially in the higher volumes used to combat fatigue (rather than increase euphoria) by long-term users, is the risk of ill effects or damage caused by the compounds used in adulteration. Cutting or 'stepping on' the drug is commonplace, using compounds which simulate ingestion effects, such as (procaine) producing temporary anesthaesia, as many users believe a strong numbing effect is the result of strong and/or pure cocaine, ephedrine or similar stimulants that are to produce an increased heart rate. The normal adulterants for profit are inactive sugars, usually mannitol, creatine or glucose, so introducing active adulterants gives the illusion of purity and to 'stretch' or make it so a dealer can sell more product than without the adulterants. The adulterant of sugars allows the dealer to sell the product for a higher price because of the illusion of purity and allows sale of more of the product at that higher price, enabling dealers to significantly increase revenue with little additional cost for the adulterants. A 2007 study by the showed that the purity levels for street purchased cocaine was often under 5% and on average under 50% pure.
Society and culture Legal status. Main article: The production, distribution, and sale of cocaine products is restricted (and illegal in most contexts) in most countries as regulated by the, and the. In the United States the manufacture, importation, possession, and distribution of cocaine are additionally regulated by the 1970. Some countries, such as Peru and Bolivia permit the cultivation of coca leaf for traditional consumption by the local, but nevertheless, prohibit the production, sale, and consumption of cocaine. The provisions as to how much a coca farmer can yield annually is protected by laws such as the Bolivian.
In addition, some parts of Europe the United States and Australia allow processed cocaine for medicinal uses only. Australia Cocaine is a prohibited substance in Australia under the (July 2016). A schedule 8 substance is a controlled Drug – Substances which should be available for use but require restriction of manufacture, supply, distribution, possession and use to reduce abuse, misuse and physical or psychological dependence. In under the 4.0g of cocaine is the amount of prohibited drugs determining a court of trial, 2.0g is the amount of cocaine required for the presumption of intention to sell or supply and 28.0g is the amount of cocaine required for purposes of drug trafficking. United States. Killed more than 72,000 Americans in 2017, with making up 14,556 of those deaths.
The US federal government instituted a national labeling requirement for cocaine and cocaine-containing products through the Pure Food and Drug Act of 1906. The next important federal regulation was the of 1914.
While this act is often seen as the start of prohibition, the act itself was not actually a prohibition on cocaine, but instead set up a regulatory and licensing regime. The Harrison Act did not recognize addiction as a treatable condition and therefore the therapeutic use of cocaine, heroin or morphine to such individuals was outlawed – leading a 1915 editorial in the journal American Medicine to remark that the addict 'is denied the medical care he urgently needs, open, above-board sources from which he formerly obtained his drug supply are closed to him, and he is driven to the underworld where he can get his drug, but of course, surreptitiously and in violation of the law.' The Harrison Act left manufacturers of cocaine untouched so long as they met certain purity and labeling standards.
Despite that cocaine was typically illegal to sell and legal outlets were rarer, the quantities of legal cocaine produced declined very little. Legal cocaine quantities did not decrease until the of 1922 put serious restrictions on cocaine manufactures. Interdiction In 2004, according to the, 589 of cocaine were seized globally by law enforcement authorities.
Seized 188 t, the United States 166 t, Europe 79 t, Peru 14 t, Bolivia 9 t, and the rest of the world 133 t. Economics Because of the drug's potential for addiction and overdose, cocaine is generally treated as a ', with severe penalties for possession and trafficking. Demand remains high, and consequently, black market cocaine is quite expensive. Unprocessed cocaine, such as, are occasionally purchased and sold, but this is exceedingly rare as it is much easier and more profitable to conceal and smuggle it in powdered form. The scale of the market is immense: 770 times $100 per gram retail = up to $77 billion.
Production Until 2012, Colombia was the world's leading producer of cocaine. Three-quarters of the world's annual yield of cocaine has been produced in Colombia, both from cocaine base imported from Peru (primarily the ) and Bolivia, and from locally grown coca. There was a 28% increase from the amount of potentially harvestable coca plants which were grown in Colombia in 1998. This, combined with crop reductions in Bolivia and Peru, made Colombia the nation with the largest area of after the mid-1990s. Coca grown for traditional purposes by indigenous communities, a use which is still present and is permitted by Colombian laws, only makes up a small fragment of total coca production, most of which is used for the illegal drug trade. An interview with a coca farmer published in 2003 described a mode of production by that has changed little since 1905. Roughly 625 pounds (283 kg) of leaves were harvested per, six times per year.
The leaves were dried for half a day, then chopped into small pieces with a string trimmer and sprinkled with a small amount of powdered cement (replacing from former times). Several hundred pounds of this mixture were soaked in 50 US gallons (190 L) of gasoline for a day, then the gasoline was removed and the leaves were pressed for remaining liquid, after which they could be discarded. Then (weak ) was used, one bucket per 55 lb (25 kg) of leaves, to create a separation in which the cocaine in the gasoline was acidified and extracted into a few buckets of 'murky-looking smelly liquid'.
Once powdered was added to this, the cocaine precipitated and could be removed by filtration through a cloth. The resulting material, when dried, was termed and sold by the farmer. The 3750 pound yearly harvest of leaves from a hectare produced 6 lb (2.5 kg) of pasta, approximately 40–60% cocaine. Repeated recrystallization from solvents, producing pasta lavada and eventually crystalline cocaine were performed at specialized laboratories after the sale.
Attempts to eradicate coca fields through the use of have devastated part of the farming economy in some coca growing regions of Colombia, and strains appear to have been developed that are more resistant or immune to their use. Whether these strains are natural mutations or the product of human tampering is unclear.
These strains have also shown to be more potent than those previously grown, increasing profits for the drug cartels responsible for the exporting of cocaine. Although production fell temporarily, coca crops rebounded in numerous smaller fields in Colombia, rather than the larger plantations.
The cultivation of coca has become an attractive economic decision for many growers due to the combination of several factors, including the lack of other employment alternatives, the lower profitability of alternative crops in official crop substitution programs, the eradication-related damages to non-drug farms, the spread of new strains of the coca plant due to persistent worldwide demand. Estimated Andean region coca cultivation and potential pure cocaine production 2000 2001 2002 2003 2004 Net cultivation km 2 (sq mi) 1,875 (724) 2,218 (856) 2,007.5 (775.1) 1,663 (642) 1,662 (642) Potential pure cocaine production 770 925 830 680 645 The latest estimate provided by the U.S. Authorities on the annual production of cocaine in Colombia refers to 290 metric tons. As of the end of 2011, the seizure operations of carried out in different countries have totaled 351.8 metric tons of cocaine, i.e. 121.3% of Colombia's annual production according to the U.S.
Department of State's estimates. Synthesis Synthetic cocaine would be highly desirable to the illegal drug industry as it would eliminate the high visibility and low reliability of offshore sources and international smuggling, replacing them with clandestine domestic laboratories, as are common for illicit. However, natural cocaine remains the lowest cost and highest quality supply of cocaine. Actual full synthesis of cocaine is rarely done.
Formation of inactive (cocaine has 4 chiral centres – 1 R, 2 R, 3 S, and 5 S, 2 of them dependent, hence a total potential of 8 possible stereoisomers) plus synthetic by-products limits the yield and purity. Names like 'synthetic cocaine' and 'new cocaine' have been misapplied to (PCP) and various. Trafficking and distribution. Cocaine smuggled in a, 2008 gangs operating on a large scale dominate the cocaine trade. Most cocaine is grown and processed in South America, particularly in Colombia, Peru, and smuggled into the United States and Europe, the United States being the world's largest consumer of cocaine, where it is sold at huge markups; usually in the US at $80–120 for 1 gram, and $250–300 for 3.5 grams ( 1 / 8 of an ounce, or an 'eight ball').
Caribbean and Mexican routes As of 2005, cocaine shipments from South America transported through or were generally moved over land or by air to staging sites in northern Mexico. The cocaine is then broken down into smaller loads for smuggling across the.
The primary cocaine importation points in the United States have been in, southern, southern,. Typically, land vehicles are driven across the U.S.–Mexico border. Sixty-five percent of cocaine enters the United States through Mexico, and the vast majority of the rest enters through Florida. As of 2015, the is the most active involved in smuggling illicit drugs like cocaine into the United States and trafficking them throughout the United States. Cocaine traffickers from Colombia and Mexico have established a labyrinth of routes throughout the Caribbean, the Bahama Island chain, and South Florida.
They often hire traffickers from Mexico or the to transport the drug using a variety of smuggling techniques to U.S. These include airdrops of 500 to 700 kg (1,100 to 1,500 lb) in the or off the coast of, mid-ocean boat-to-boat transfers of 500 to 2,000 kg (1,100 to 4,400 lb), and the commercial shipment of tonnes of cocaine through the port of. Chilean route Another route of cocaine traffic goes through Chile, which is primarily used for cocaine produced in Bolivia since the nearest seaports lie in northern Chile. The arid Bolivia–Chile border is easily crossed by 4×4 vehicles that then head to the seaports of. While the price of cocaine is higher in Chile than in Peru and Bolivia, the final destination is usually Europe, especially Spain where drug dealing networks exist among South American immigrants. Techniques Cocaine is also carried in small, concealed, kilogram quantities across the border by couriers known as ' (or 'mulas'), who cross a border either legally, for example, through a port or airport, or illegally elsewhere.
The drugs may be strapped to the waist or legs or hidden in bags, or hidden in the body. If the mule gets through without being caught, the gangs will reap most of the profits. If he or she is caught, however, gangs will sever all links and the mule will usually stand trial for trafficking alone. Bulk cargo ships are also used to smuggle cocaine to staging sites in the western Caribbean– area.
These vessels are typically 150–250-foot (50–80 m) coastal freighters that carry an average cocaine load of approximately 2.5 tonnes. Commercial fishing vessels are also used for smuggling operations. In areas with a high volume of recreational traffic, smugglers use the same types of vessels, such as, as those used by the local populations. Sophisticated are the latest tool drug runners are using to bring cocaine north from Colombia, it was reported on 20 March 2008. Although the vessels were once viewed as a quirky sideshow in the drug war, they are becoming faster, more seaworthy, and capable of carrying bigger loads of drugs than earlier models, according to those charged with catching them. Sales to consumers. Cocaine adulterated with fruit flavoring Cocaine is readily available in all major countries' metropolitan areas.
According to the Summer 1998 Pulse Check, published by the U.S., cocaine use had stabilized across the country, with a few increases reported in, Miami,. In the West, cocaine usage was lower, which was thought to be due to a switch to among some users; methamphetamine is cheaper, three and a half times more powerful, and lasts 12–24 times longer with each dose.
Nevertheless, the number of cocaine users remain high, with a large concentration among urban youth. In addition to the amounts previously mentioned, cocaine can be sold in 'bill sizes': As of 2007 for example, $10 might purchase a 'dime bag', a very small amount (0.1–0.15 g) of cocaine. Twenty dollars might purchase 0.15–0.3 g. However, in lower Texas, it is sold cheaper due to it being easier to receive: a dime for $10 is 0.4 g, a 20 is 0.8–1.0 g and an 8-ball (3.5 g) is sold for $60 to $80, depending on the quality and dealer. These amounts and prices are very popular among young people because they are inexpensive and easily concealed on one's body. Quality and price can vary dramatically depending on supply and demand, and on geographic region.
In 2008, the reports that the typical retail price of cocaine varied between €50 and €75 per gram in most European countries, although Cyprus, Romania, Sweden and Turkey reported much higher values. Consumption World annual cocaine consumption, as of 2000, stood at around 600 tonnes, with the United States consuming around 300 t, 50% of the total, Europe about 150 t, 25% of the total, and the rest of the world the remaining 150 t or 25%.
It is estimated that 1.5 million people in the United States used cocaine in 2010 down from 2.4 million in 2006. Conversely, cocaine use appears to be increasing in Europe with the highest prevalences in, the,. The 2010 UN concluded that 'it appears that the North American cocaine market has declined in value from US$47 billion in 1998 to US$38 billion in 2008. Between 2006 and 2008, the value of the market remained basically stable'. Research In 2005, researchers proposed the use of cocaine in conjunction with administered in the form of an as a diagnostic test for.
In this classic piece, Stanton and Richard DeGrandpre review human and animal research against the claim that cocaine is such a powerful reinforcer that it invariably causes the organism with unlimited access to self-administer the drug to the exclusion of all other activity and reward, often until death. In place of this model, Stanton and Rich apply behavioral economic research and models which show that animals balance the opportunities for available rewards, among which cocaine appears to be a strong but far from overwhelming or unique example. They contrast their view with that of Nobel prize-winning economist Gary Becker, who rather than suggesting an economic model of behavior instead imagines that drugs create a biologically compelling state that drives the addict's behavior. Published in Addiction Research, 6:235-263, 1998. © 1998 Overseas Publishers Association.
Reprinted with permission from Gordon and Breach. Cocaine and the Concept of Addiction: Environmental Factors in Drug Compulsions Stanton Peele Morristown, New Jersey Richard J.
DeGrandpre Dept. Of Psychology, Saint Michael's College, Colchester, Vermont Contents. Addiction is an evocative psychological and medical term whose meaning has changed significantly over time. For most of this century it has been described in terms of an abstinence syndrome (dependence and withdrawal) and associated with heroin use. In the 1980s, however, cocaine replaced heroin as the prototypical drug of abuse.
Cocaine had heretofore not been considered to produce 'physical dependence.' Nonetheless, for both cocaine and heroin, current models of addiction models widely propagated by the media reduce drug use patterns to the properties of drugs and biological characteristics of the user.
In creating this model, scientific and clinical debates along with public debates rely on the supposedly typical, inevitably addicting results of repeated cocaine consumption. Yet naturalistic human drug use and drug taking by animals in the laboratory instead reinforce the picture that use of all drugs depends on the user's environment. Indeed, even the most severe examples of compulsive drug use can be reversed when key elements in the setting are modified. Such findings should by now play a fundamental role in both scientific and public conceptions of addiction, but they do not. From antiquity into the nineteenth and twentieth centuries, the term addiction meant abandonment to a bad habit so that habitues totally ignored other life considerations. Addiction was not specifically associated with narcotics or with drugs at all (Peele, 1985; Sonnedecker, 1958). Around the turn of the twentieth century, addiction was appropriated by medical authorities as a property of narcotics (Berridge and Edwards, 1987; Isbell, 1958).
The behavioral and psychological markers of addiction were codified as pathologic withdrawal and craving in a deterministic model that replicated the alcoholism-as-disease notion of drug-induced loss of control (Levine, 1978; see Peele, 1990). For most of this century, the idea that addiction is a physiological process set off by heroin consumption dominated popular and pharmacological thinking (Musto, 1987; Peele, 1985). However, even the earliest efforts at systematic research with addicts did not find that heroin use conformed to this simple, billiard-ball causation (Light & Torrance, 1929; see Peele, 1990). While the public, media, and medical authorities assumed that addiction was a well-defined physiological construct, pharmacologists were compelled instead to construct descriptions of drug use in behavioral, phenomenologic, and existential terms. Thus the World Health Organization (WHO) Expert Committee on Addiction-Producing Drugs separated addiction into 'physical dependence' and 'psychic dependence' in the 1960s, claiming that psychic dependence is 'the most powerful of all factors involved in chronic intoxication with psychotropic drugs.even in the case of most intense craving and perpetuation of compulsive abuse' (Eddy, Halbach, Isbell, & Seevers, 1965, p. In a primary pharmacology reference text, Jaffe (1980) defined addiction as 'a behavioral pattern of drug use, characterized by overwhelming involvement with the use of a drug compulsive use, the securing of its supply, and a high tendency to relapse after withdrawal' (p. By the mid-1980s, cocaine had supplanted heroin as the drug said to be most dangerous and quickly addictive (for historical overviews of cocaine's public image, see Harrison, 1994; Jones, 1992).
Cocaine came to be seen as the major public health menace in this country (before AIDS), and the imagery previously associated with heroin was usurped by cocaine: Cocaine-driven humans will relegate all other drives and pleasures to a minor role in their lives. If we were to design deliberately a chemical that would lock people into perpetual usage, it would probably resemble. (Cohen, 1984, pp. 151-153) Cocaine (and later crack) addiction became the major focus of government funding for research and treatment on illicit drug use.
Since cocaine had not been classified as a drug capable of producing physical dependence, the experiential effects that compel continued drug use once more rose to the fore of theorizing about addiction: That cocaine produces no gross physiological withdrawal symptoms.demonstrates that subjective experiences or symptoms other than physiological discomfort are crucial in addiction to cocaine and to other substances of abuse. Investigators are now exploring how psychological symptoms in drug withdrawal, particularly unpleasant mood states and craving for drug euphoria, maintain chronic drug addiction. (Gawin, 1991, p. 1580) But this recognition of the centrality of lived experience in cocaine addiction did not halt speculation that 'cocaine causes a neurophysiological addiction' or slow the search for an understanding of addiction based exclusively on 'unraveling the neurophysiological mysteries of human experiences of pleasure and pain' (Gawin, 1991, pp. 1580, 1585; see also Wise, 1988). This view recombines the psychic and physical dependence categories into a single biological construct. After a period of convoluted reasoning about cocaine's addiction-like properties stretching over the decade from the mid-1980s to the mid-1990s (cf.
Peele, 1985), the elaborate distinctions drawn over the previous quarter-century between physical dependence and addiction were lost. Today, the director of the National Institute of Mental Health (Hyman, 1996, p. 611) may simply identify cocaine (and amphetamines, which mimic the effects of cocaine) as addictive in the same sense and as a result of the same changes in 'molecular mechanisms' following chronic drug ingestion as heroin: 'Repeated doses of addictive drugs opiates, cocaine, and amphetamine cause drug dependence and, afterward, withdrawal.' Our modern pharmacological era strives to understand addiction as foremost a biologic response of the organism. Even when researchers and clinicians claim to recognize the multideterminacy of cocaine and other drug addiction (as Gawin above does), they treat the environmental and experiential components in the equation as unmeasurable and unscientific and strive to reduce addiction to a drug's chemical structure and pharmacological effects.
This article argues instead that addiction cannot be defined strictly in terms of the addicted organism and a chemical substance, and that drug problems in this case, compulsive drug use can never be isolated from cultural and other contextual factors and from the situation of the actor (DeGrandpre & White, 1996; Sidman, 1956; Zinberg, 1984). We review animal laboratory and human epidemiologic studies to show that environmental factors ultimately determine drug use, including the very addictiveness of a drug's appeal and the urge to continue compulsively consuming the substance (Peele, 1985). Such alternative attachments and rewards are powerful enough or can be made so to overcome the allure of any pharmacological substance (Reinarman et al., 1994). If addiction is not identified with any chemical or biological process, moreover, then it can occur with a wide range of involvements in addition to drug use, such as love and gambling (Peele & Brodsky, 1975).
Each type of addictive involvement, moreover, does not require a separate theory of addiction. The addictive process with different activities and in different individuals shares a variety of common elements and influences, even though the exact pathways to addiction will most certainly vary from person to person, time to time, and place to place (see Bry, 1996). Research on human cocaine use refutes the dominant image of the effects of cocaine and of the typical behavior of regular cocaine users. Even researchers aware of these results can shade or ignore them, however, by proposing that the underlying biological reaction to cocaine is uncontrollable escalation of use and effects. While in this view human users may escape the inevitable addictive consequences of regular use, captive animal cocaine users accurately reflect this addictive pattern uncomplicated by superfluous environmental factors. This view, too, rather than accurately reflecting the research, has been disproven by the evidence.
In contrast to an experiential model of addiction which focuses on sentient human beings and their involvement with their surroundings, the prevailing, reductionistic view of addiction points to evidence that animals will self-administer drugs such as cocaine as proof that human psychology and environment are irrelevant to addiction. The study of animal drug self-administration was begun by behavioral pharmacologists who implanted intravenous catheters so that animals could directly express a desire for drugs in measurable self-administered drug doses (Schuster & Thompson, 1969; Yanagita, Deneau, & Seevers, 1965). Behavioral-pharmacologic research with both animals and humans in laboratory settings since the 1950s has focussed on pharmacological and environmental conditions which maintain or modify an organism's response to various drugs. This work indicates that drug properties alone offer only a partial explanation for animal drug-taking behavior, to wit: A drug is not a reinforcer because it has a certain molecular structure capable of exciting specific receptors. The structures and events so described yield, at best, only a potential for reinforcing action that is realized if, and only if, a set of additional conditions are satisfied. Neither is reinforcement a sensory experience that can be experimenter imposed. It is not a thing at all; it is a relational construct.
(Falk, 1994, p, 48) This quote indicates that mainstream pharmacologic research with animals can be conceived in a way very similar to an experiential model. But alarm about spreading cocaine use in the late 1980s challenged this viewpoint, and several key studies revealing dramatic animal cocaine self-administration and toxicity have been selectively and repeatedly cited to prove that cocaine has special pharmacologic properties that inevitably lead animals and humans to addiction.
The results of these cocaine toxicity studies were welcomed for their anti-drug implications. Their impact was multiplied by their frequent citation in the media, in drug education programs (including films of monkeys self-administering cocaine and undergoing convulsions), and in scientific arguments about the unique reinforcing properties of cocaine. For example: Cocaine's power of reinforcement produces its most notorious effects: the desire to keep taking it as long as the drug is available. In one series of experiments. Scientists let caged monkeys self administer.
Cocaine until they died. The drug made them monomaniacal.
( Rolling Stone, February 9, 1989, p. 72; cited in Morgan & Zimmer, in press) and, In laboratory animals, the intravenous injection of cocaine serves to initiate and maintain specific behaviors required to obtain additional injections.
Such repetitive behaviors are. The equivalent of human cocaine-seeking and compulsive use patterns. (Cohen, 1985, pp. 151-152) Some behavioral pharmacologists likewise attribute special addictive reinforcement properties to cocaine: Cocaine appears to be a most potent reinforcer, and the self-administering organism is resistant to any attempts to decrease drug-taking. Indeed, the drug is so reinforcing that the organism self-administering it becomes totally preoccupied with drug acquisition. (Fischman, 1988, p.
7) The four primary studies cited in support of these views were published between 1969 and 1985. The studies showed that rhesus monkeys and rats will prefer cocaine to food (Aigner & Balster, 1978), will more often die from cocaine than heroin use (Bozarth & Wise, 1985), and will self-administer cocaine until death or near-death (Aigner & Balster, 1978; Bozarth & Wise, 1985; Deneau, Yanagita, & Seevers, 1969; Johanson, Balster, & Bonese, 1976). The stark picture presented by these studies, however, contrasts sharply with most other laboratory animal research on cocaine.
Such studies typically manipulate factors commonly shown to affect human drug taking in natural settings, including (1) drug dose, (2) access to the drug, (3) effort required to obtain the drug, and (4) the presence or absence of alternative nondrug reinforcers. The four toxicity studies are notable for eliminating most such environmental variation, thus establishing baseline conditions under which animals can be induced to self-administer fatal doses of cocaine.
The conditions making potent doses of the drug available in an unlimited and rapidly-delivered intravenous (IV) fashion via an implanted catheter, requiring only minimal responding to gain drug reinforcement, and placing the animal in a highly restricted and impoverished context are designed to limit the animal's behavioral repertoire and to program cocaine self-administration. However, even a change in basic elements of the cocaine-toxicity procedures engenders a qualitatively different picture of cocaine self-administration. Cocaine dosage and access Having access to an unlimited, direct flow of high concentrations of cocaine at all times at little or no cost (effort) is an unusual situation. On the other hand, animals readily 'manage' their cocaine use within daily routines when they are given only periodic opportunities to inject cocaine. For example, rhesus monkeys with regular, intermittent access to cocaine 'regulated their drug intake to a remarkable degree' (Johanson & Fischman, 1989, p. Wilson, Hitomi, & Schuster, 1971). Such results suggest that applying even modest environmental constraints to drug use, as opposed to uninterrupted access, dramatically affects cocaine self-administration.
Two studies of cocaine use following the unlimited-access studies have compared unlimited with somewhat limited-access conditions. Dworkin, Goeders, Grabowski, and Smith (1986) compared a group of rats that had unlimited access to cocaine and a group that were switched from unlimited access every hour to every other hour. Note that this second group of experienced cocaine-using rats still had considerable access to cocaine, which was fully available on alternating hours throughout the entire day. The former group of rats died within 28 days of being given unlimited access, while none of the rats in the limited-access condition died by the time the study was terminated (90-120 days). Fitch and Roberts (1993) reported similar results in a study that varied both dose and schedule of cocaine self-administration. When varying amount of access to cocaine, they found cyclic (as opposed to uncontrolled or lethal) cocaine self-administration in a condition that scheduled up to four self-administrations per hour.
At this point of frequent but not unlimited access to cocaine, patterns of self-administration were intense, but animals did not develop 'outward signs of ill health.' Even in the unlimited access conditions of that study, only the highest of three concentrations of cocaine dose led to erratic and self-destructive drug-taking behavior in the rats. At the middle dose, animals self-administered cocaine reliably, but intermittently or cyclically. At the lowest dose, they even failed to reliably self-administer the drug.
When dose and access are constrained, as they would be in any naturalistic context of drug use, animals show patterns of drug taking typical for those of other drugs. Cocaine versus other stimulant drugs Cocaine self-administration has frequently been compared with patterns of use of other stimulants in the same studies.
One of the four toxicity studies also offered rhesus monkeys unlimited self-administration of d-amphetamine (Deneau et al., 1969) which resulted in similarly intensive drug use, but without convulsions or death. Another toxicity study (Johanson et al., 1976), while reporting that two monkeys died from cocaine self-administration, also reported that six monkeys given unlimited access to d-amphetamine and d-methamphetamine self-administered remarkably large amounts of the synthetic stimulants. All six of these animals died.
The setting of toxicity studies Consideration of the conditions in which cocaine self administration takes place is also crucial to understanding cocaine's toxicity. The settings of the toxicity studies with cocaine and amphetamines were highly impoverished relative to the settings in which these animals would live naturally, or the settings in which humans might acquire drug compulsions (Aigner & Balster, 1978; Deneau et al., 1969; Johanson et al., 1976). Drug administration was in small cubicles (1.3-1.5 meters) where the animals were attached to harnesses which held in place an implanted IV catheter.
These harnesses require that the animals' mobility be curtailed, thus restricting other activities. Such conditions are, of course, dictated by the research goal of allowing the animals to express urges for the drug via direct drug self-administration. Alternative research methods for studying drug reinforcement could offer a tradeoff between options for self-administering drugs versus conducting ordinary species activities.
Alexander and his colleagues (Alexander, Peele, Hadaway et al., 1985) addressed this issue with narcotics by measuring oral morphine self-administration (a less powerful means for inculcating dependence) under different housing conditions. (Note that rats in self-administration studies have somewhat greater mobility than monkeys through the use of an extended tube for housing the implanted catheter; see Bozarth & Wise, 1985.) Rats exposed to the option of a sweetened morphine solution drank one-eighth as much morphine in a large cage they shared with other rats as did rats housed in small, socially-isolating cages. Further experiments by this group indicated that both the added space and companionship were critical factors affecting drug use. In other words, fundamental species activity played an essential role in drug reinforcement when rats were free to roam and have sex, the morphine solution actually seemed to be negatively reinforcing, presumably because it interfered with these preferred activities. That animals often control their self-administration of cocaine and that cocaine is no more lethal than other commonly-abused stimulants make the grounds for cocaine's unique reinforcement potency or any idea of a universally enslaving drug reinforcer dubious. As shown in the toxicity study comparing cocaine and heroin self-administration in rats by Bozarth and Wise (1985), although cocaine was more often fatal, all animals reliably self-administered morphine, while only 83 percent self-administered cocaine.
Moreover, the daily intake for the cocaine-using rats unlike those using heroin was highly erratic, varying from none to extremely high intake even after many days of unlimited access (see Figure 1). This pattern is typical in studies of unlimited access to cocaine and other psychomotor stimulants in laboratory animals (Johanson et al., 1976; Thompson & Pickens, 1970). Erratic daily drug intake for typical subject self-administering cocaine hydrochloride (mg/kg per infusion). Data are expressed as mean number of infusions per hour of testing, and error bars represent SEM.
Figure derived from from Bozarth and Wise (1985) Cocaine creates cyclic patterns of intake marked by periods when the animal administers little or no drug even though cocaine is constantly available. This does not support the idea that cocaine is an especially reinforcing pharmacological compound that leads to compulsive drug use, but rather suggests that the erratic self-administration of cocaine is a direct behavioral effect of the drug.
In other words, drug activation is channeled into furthered cocaine use when (a) cocaine is freely available and (b) this is the only significant response available to the animal. Canadian researchers Fitch and Roberts (1993) expressed a similar view: Our data suggest that when drug access is discontinued after several hours, allowing drug levels to clear from the system, the disruptive influence of the drug can be minimized. Conversely, if extended drug access permits continued accumulation of drug levels, then the influence of the drug may be carried forward to sustain self-administration behavior and disrupt other functions. 120) The accepted, classical view is that animals self-administer the drug to maintain the highest possible levels of drug reinforcement. If compulsive usage patterns serve to achieve such ends, then animals which have experienced unlimited access should respond more frenetically as access becomes constrained. For example, in the study described above by Dworkin et al. (1986), when access was changed from every hour to every-other hour, responding at the same rate would yield about one-half the previous levels of cocaine exposure.
If maintaining high drug levels is the motivation, then animals in this condition should respond at about double the rate (a response rate which they can easily manage). Instead, the animals which had cocaine available every other hour reduced their responding and cocaine intake fell, not to one-half, but to one-fourth the exposure animals received in the unlimited-access condition. This finding affirms the view that toxic levels of cocaine self-administration occur more as a function of the direct behavioral effects of the psychomotor stimulant (including motivational effects on animal hunger) than as a result of any unique reinforcing properties inherent to cocaine. Addicts' descriptions of their harrowing drug habits are typical media fare and, along with repeated references to animal cocaine-toxicity studies, comprise the major source for claims of cocaine's addictiveness (see DeGrandpre, 1996). 'Cocaine addicts tend to go on binges, and monkeys hooked up intravenously will inject themselves repeatedly, rejecting food, sex and sleep until they die' ( New York Times, June 14, 1992, p. 7; cited in Morgan & Zimmer, in press).
For most of the 1980s, 'few data existed on the characteristics of cocaine users who are not seeking advice or treatment' (Johanson & Fischman, 1989, p. By the late 1980s and continuing to the present, however, a sizable amount of epidemiologic and community-based (as opposed to clinically-based) data on cocaine use have been accumulated which do not indicate that cocaine whether snorted, smoked, or injected is especially or inevitably addictive for humans (Erickson, 1993; Erickson & Alexander, 1989; Harrison, 1994). In 1995, WHO in conjunction with the United Nations Interregional Crime and Justice Research Institute published results from the 'largest global study on cocaine use ever undertaken,' conducted from 1992 to 1994. Among other findings, summarized in a WHO press release (March 20, 1995), the study reported that there is 'an enormous variety in the types of people who use cocaine, the amount of drug used, the frequency of use, the duration and intensity of use, the reasons for using cocaine and any associated problems that users experience.'
The results of this comprehensive survey simply lent weight to what had already been established about cocaine and other drug use. Such evidence on human reactions to cocaine includes the following sources: Drug use surveys After a decade when cocaine use was reported to be rampant and uncontrollable for a sizable group of Americans, the 1990 National Household Survey of Drug Abuse (NHSDA) found that 11.5 percent of Americans reported ever using cocaine, 3 percent used cocaine within the past year, and 0.9 percent used in the last month (NIDA, 1991; see Harrison, 1994). Of current users (those who have used the drug in the last year), a third used the drug 12 or more times a year, and 10 percent used cocaine once a week or more.
These results replicate another, earlier study: Cocaine use appears to be experimental in nature and to involve few experiences for a substantial portion of those who report any lifetime experience with the drug. One-half (53%) of the male users and two-thirds (67%) of the female users have used cocaine less than 10 times in their lives; 34% and 28%, respectively, have used 10 to 99 times, 9% and 3% have used 100 to 999 times, 3% and 2% have used 1,000 or more times. (Kandel, Murphy, & Karus, 1985) A Canadian survey found 5 percent of current users used monthly or more often (Adlaf, Smart, & Canale, 1991).
But monthly and weekly use are far from addiction, and only 10-25 percent of regular users resemble clinical addicts, or about 1-2 percent of all current users (Erickson & Alexander, 1989). Natural history or longitudinal data Indeed, only a small minority of long-term cocaine users actually progress to addiction (i.e., compulsive use that leads to disruption in other life areas, such as health and work). Of the 50 regular users Siegel (1984) tracked for over a decade, only five became compulsive users at any point. The failure of most users to progress to addiction occurred even though average level of use increased during the study, seemingly because subjects who were college students when first identified had more disposable income. Studies of ongoing cocaine users in Canada, Scotland, Australia, and Holland identify controlled use as the most common usage pattern (Cohen, 1989; Ditton, Farrow, Forsyth et al., 1991; Fagan & Chin, 1989; Mugford & Cohen, 1989; Murphy, Reinarman, & Waldorf, 1989; see Harrison, 1994).
At the same time, as found in WHO's global study of cocaine, the level of use and appearance of problems vary with setting and lifephase. Problems connected with drug use of a variety of types sleeplessness, nasal irritation, financial and family problems, unintended heavy use do appear with many users. However, what is most notable is that, in response to these problems, heavy users in these studies rarely seek treatment and typically quit or cut back on their own (Erickson et al., 1987; Waldorf et al., 1991).
In Holland, of 64 users of cocaine for five or more years, only one (2%) actually underwent any treatment for cocaine use (Cohen & Sas, 1994). In these studies, the most common pattern for users who at some point experience problems is decreased or intermittent use (see Cohen & Erickson, unpublished results on 100 intensive crack/cocaine users, cited in Erickson, 1993; Cohen & Sas, 1994; Erickson et al., 1987).
Thus, even in periods of heavy, repeated, and problematic use, users do not abandon themselves to their drug habit in a way characterizable as 'loss of control' and depicted as the typical result of prolonged cocaine use (Cohen & Sas, 1992, reviewed in Cohen & Sas, 1994; Siegel, 1984). Predictive variables in cocaine abuse The NIMH (National Institute of Mental Health) Epidemiological Catchment Area (ECA) Program identified 1.8 percent of those at risk for cocaine use in urban areas who did begin or progress in their cocaine use (Ritter & Anthony, 1991). The relative risk (RR) of initiation/progression was 32 times as great for those who recently used marijuana and other illicit drugs; other risk factors were persistent depression (12), recent use of marijuana alone (10), recently gaining a job after being unemployed (5), and higher income (with a 1.0 increase in RR with each increment of income level). Risk was lower for married subjects and diminished with age. Longitudinal studies which model the factors that cause progression to cocaine abuse among adolescents identify prior histories of use of other drugs (such as alcohol, marijuana, cigarettes, amphetamines), disturbed family and social environments, and clinical profiles marked by antisocial personality dispositions and other psychological problems, such as depression, prior to cocaine use (Newcomb & Bentler, 1986a, b). The idea that experienced cocaine-using humans will be as irresistibly drawn to self-administer cocaine as are animals in the laboratory (Cohen, 1985; Wise, 1988) is not supported by results of human research in naturalistic environments (see also Morgan & Zimmer, in press). Compared to the toxicity studies, human drug use in natural settings is less passive, constrained, and irreversible.
As well as being more actor-determined, human drug use also takes place within a set of values and a cultural milieu for which animals have no equivalent. When people quit smoking or other drug addictions, they typically cite family, career, or existential motivations (Peele, 1987). One study of heavy cocaine users, including crack users and freebasers, described how controlled users and former addicts balance urges to use cocaine intensively against 'meaningful roles which provided a positive identity and a stake in conventional daily life' (Waldorf, Reinarman, & Murphy, 1991, p. Cocaine elevates the mood of most human subjects in a way indistinguishable from amphetamines (Fischman, Schuster, Resnekov et al., 1976) and is now labelled addictive like heroin (Hyman, 1996).
In an experimental study of preferences for oral doses of d-amphetamine among human volunteers (Johanson & Uhlenhuth, 1981), subjects reported clear elevation of mood (friendliness, elation, arousal) and strongly preferred the drug over placebo in initial trials. This preference disappeared over several trials, however, despite the subjects' continued identification of positive mood changes from drug use. Over time, these subjects were less interested in savoring the mood enhancement of the drug than in conducting their ordinary lives. Viewing reinforcement as a drug property would predict that the subjects continued taking the drugs; their actual behavior shows that drug use was competing against other activities that maintained a higher priority for users (see also Lamb et al., 1991). Drugs which animals can be made to self-administer compulsively also have strong abuse potential for humans (Johanson, 1984).
Thus, the World Health Organization (WHO) uses animal drug self-administration data as a baseline for assessing a drug's abuse liability (WHO, 1981). If addictive liability is a property of drugs, then their addictive potential or 'reinforcer efficacy' can be scaled as invariant drug traits. Yet, behavioral pharmacology has produced a body of results that indicate reinforcement potency cannot be reduced into purely pharmacological terms, since the potency of a drug's reinforcement capacity depends so greatly on the conditions under which the drug is used (Hughes, Higgins, & Bickel, 1988; Katz, 1990). Pharmacological properties may make certain drugs suitable for compulsive use by humans, but these properties alone are insufficient to predict or explain the variability inherent in human usage patterns. In fact, drug self-administration by animals alone does not predict the drugs most commonly abused by humans (Hartnoll, 1990). In Table 1, the psychoactive drugs most widely used by humans caffeine, alcohol, nicotine, marijuana, and benzodiazepines are those that animals are least likely to self-administer in the laboratory.
Nor do animals respond compulsively to the substances to which Americans or Britons are most commonly addicted: caffeine (Hughes et al., 1992), nicotine, alcohol, and benzodiazepines. By WHO animal-testing criteria, therefore, tobacco, alcohol, and caffeine would be rated as low or nondependence-producing drugs with little potential for human abuse. Obviously, a range of legal, psychological, social, and economic factors influence patterns of use of drugs.
But these factors counterbalance subjugation to drugs among humans for even the most dependence-producing drugs, such as nicotine: Non-pharmacological factors such as availability, relative cost, social pressures, legal consequences of use, and marketing practices provided the best explanation for the greater number of deaths associated with nicotine and the greater incidence of progression to addictive levels of intake than occurs with other addicting drugs. (Henningfield, Cohen, & Slade, 1991, p.
568) Table I. Reinforcement potency of psychoactive drugs judged by laboratory and human usage patterns.
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