Cocaine

prof.aza

prof. aza
 What is cocaine?
 Cocaine belongs to a group of drugs known
as ‘stimulants’. Stimulants speed up the
activity of the central nervous system‑the
messages going to and from the brain.
Amphetamines (or ‘speed’) and nicotine
 are also stimulants.
 Cocaine most commonly comes in the form
of a white, odourless powder called
‘cocaine hydrochloride’. It has a bitter,
numbing taste. The powder is extracted
from the leaves of the coca bush, found
mainly in Peru and Bolivia . The extract is
then processed with various chemicals.
prof. aza
 How is it used?
 Cocaine is inhaled (snorted) through the nose, or injected. It is
also smoked through a process known as ‘freebasing’‑where the
cocaine is converted to an alkaloid form. Cocaine hydrochloride
cannot be smoked, since the drug is destroyed at high
temperatures.
 ‘Crack’ is a very pure form of freebase cocaine sold in the form of
small crystals or rocks. Crakc is smoked in pipes or in cigarettes,
mixed with tobacco or marijuana. Crack has rarely been seen in
Australia .
 Like other illegally manufactured drugs, such as ‘speed’, there
are no controls on factors such as the strength and hygiene of
cocaine. Cocaine may be mixed, or ‘cut’, with other substances
such as sugar, baking soda and talcum powder to increase
profits. This increases the risk of experiencing harmful or
unpleasant effects.
 Cocaine was used as a local anaesthetic for eye, ear and throat
surgery. Recently cocaine has been replaced with synthetic
anaesthetics (e.g. lidocaine), but it continues to have limited use
in certain surgical procedures.
prof. aza
 Like other illegally manufactured drugs, such as
‘speed’, there are no controls on factors such as the
strength and hygiene of cocaine. Cocaine may be
mixed, or ‘cut’, with other substances such as
sugar, baking soda and talcum powder to increase
profits. This increases the risk of experiencing
harmful or unpleasant effects.
 Cocaine was used as a local anaesthetic for eye,
ear and throat surgery. Recently cocaine has been
replaced with synthetic anaesthetics (e.g.
lidocaine), but it continues to have limited use in
certain surgical procedures.

prof. aza
 Street names
 C,coke, flake, nose
candy, snow, dust,
white, white lady,
toot, crack, rock,
freebase

prof. aza
 Cocaine use in Australia
According to the Australian Institute of Health
and Welfare’s 2001 National Drug Household
Survey 1 of Australians aged 14 and over:
 4.4 per cent of Australians reported having
used cocaine at some stage in their life.
 Of those who had ever used cocaine, the
average initiation age was 22.6.
 1 Australian Institute of Health and Welfare
(AIHW) 2002 2001 National Drug Household
Survey First Results, AIHW, Canberra

prof. aza
 Effects of cocaine
 The effects of any drug (including cocaine)
vary from person to person. It depends on
many factors, including an individual’s size,
weight and health, how much and how the
drug is taken, whether the person is used to
taking it and whether other drugs are taken.
It also depends on the environment in which
the drug is used‑for example, whether the
person is alone, with others or at a party.

prof. aza
 Immediate effects
Many people have
experienced the
following effects
shortly after taking
cocaine:
 physiological arousal,
including increased
body temperature and
heart rate
 exhilaration
 anxiety
 feelings of well-being
 decreased hunger
 panic
prof. aza
 poor concentration
and judgement
 indifference to pain
and fatigue
 feelings of great
physical strength and
mental capacity
 enlarged pupils
 sexual arousal
 unpredictable and/or
violent behaviour
 When inhaled, the effects of cocaine peak after 15
to 30 minutes, and then diminish.
In greater quantities
Using large quantities of
cocaine repeatedly over a
period of hours can lead to:
 extreme agitation
 loss of coordination
 anxiety
 loss of interest in sex
 paranoia
 loss of ambition and
 hallucinations
motivation
 dizziness  heart pain
 nausea and vomiting  heart attack
 tremors  paranoid psychosis
 unpredictable  increased body temperature
violent/aggressive behaviour  rapid, irregular and shallow
 loss of concentration breathing.

prof. aza
 Overdose
The dosage and method of use that can cause
cocaine overdose varies from person to person.
The effects of overdose are very intense and,
generally, short in nature. Although uncommon,
deaths have been recorded from cocaine
overdose due to:
 seizures
 heart attack
 brain haemorrhage
 kidney failure
 stroke
 repeated convulsions
prof. aza
 Long-term effects
People who have used cocaine over longer periods
tend to take cocaine in high quantities‑‘binges’
interrupted by ‘crashes’.
 A ‘binge’ is where the drug is taken repeatedly over
several hours or days. The person may attempt to
end the binge by taking a depressant drug such as
alcohol, benzodiazepines or heroin. The binge is
followed by the ‘crash’‑a period characterised by
intense depression, lethargy and hunger.
 The unpleasant effects of cocaine increase with
more frequent, long-term use. This often results in
the person discontinuing their use for a period of
time. Most of the following symptoms will dissipate
once cocaine use ceases:

prof. aza
 Most of the following symptoms will
dissipate once cocaine use ceases:

 restlessness  psychosis
 nausea  paranoia
 hyper-excitability  exhaustion

 insomnia  hallucinations

 weight  depression/inability to
loss
experience pleasure
(anhedonia).

prof. aza
Dangers in method of use
There are a number of dangers relating to the
method of using cocaine:
 Repeated snorting damages the lining of the nose
and nasal passages, and can also damage the
structure separating the nostrils.
 Cocaine is often mixed with substances that are
poisonous when injected. This may cause
collapsed veins, abscesses and damage to the
heart, liver and brain. In addition, because people
who use cocaine often don’t know the exact
purity and strength of the drug they are taking,
chances of overdose and death are also
increased.
prof. aza
 If injected into the skin, either by intent or
accident, cocaine causes severe
vasoconstriction, which may prevent blood
flowing to the tissue, potentially resulting in
severe tissue damage. This can occur after
just one injection of cocaine.
 There is increased risk of transmission of
blood-borne viruses and infections such as HIV
, hepatitis B and hepatitis C.
 Smoking cocaine can cause breathing
difficulties, chronic cough, chest pain and lung
damage
prof. aza
 Long-term injection can
result in:
 blood vessels becoming blocked by
substances mixed with cocaine, which can
lead to major damage to bodily organs
 inflamed blood vessels and abscesses.
 HIV and hepatitis: sharing needles, syringes
and other injecting equipment can greatly
increase the risk of contracting blood-borne
viruses such as hepatitis B, hepatitis C and
HIV  (Human Immunodeficiency Virus - the
virus that causes AIDS).

prof. aza
 Cocaine and other drugs
 Cocaine is often mixed with other drugs to enhance
its desirable effects or to help the person cope with
the undesirable effects of cocaine. These substances
may include alcohol, cannabis, heroin or
benzodiazepines. The consequences of mixing
cocaine with other substances are often
unpredictable. Mixing cocaine with alcohol produces a
substance in the blood called ‘cocaethylene’, which
can be more toxic to the body than the cocaine itself.
Injecting cocaine and heroin at the same time can
affect the area of the brain that controls breathing,
increasing the chances of coma and death.
 Generally, health risks increase when mixing cocaine
with other drugs, especially when large quantities are
taken.

prof. aza
 Tolerance and
dependence
Tolerance
 Initial tolerance to cocaine develops rapidly
with continual heavy use. After this initial
level is reached, people who use cocaine
don’t appear to develop tolerance for
increasing amounts. Regular users may in
fact develop a ‘reverse tolerance’, whereby
they experience the effects of the drug more
intensely. Tolerance to cocaine may not be
obvious due to the tendency to mix cocaine
with other drugs such as heroin and alcohol.

prof. aza
 Dependence
 Physical dependence upon a drug occurs when a person’s
body is used to functioning with the drug present in the
system. Physical dependence on cocaine has not yet
been established.
 Psychological dependence occurs when using a drug
becomes more important than other activities in a
person’s life. Because of its powerful euphoric effects,
cocaine users may develop a strong psychological
dependence upon it. Even after long periods of
abstinence, strong cravings can persist.
 A person who has become dependent upon cocaine may
find it difficult to stop using it. Those who have stopped
using cocaine may be prone to relapse.

prof. aza
 Withdrawal
 Withdrawal symptoms occur when a
person dependent on a drug stops using
it or significantly cuts down the amount
they are using. Cocaine withdrawal
generally occurs in three phases:
 1. ‘Crash’, which describes symptoms
experienced immediately after the
person stops using cocaine‑usually in the
first two to four days

prof. aza
1. ‘Crash’, which describes symptoms
experienced immediately after the
person stops using cocaine‑usually in
the first two to four days. Symptoms
include:
 agitation
 depression
 intense craving for the drug
 extreme fatigue
prof. aza
2. Withdrawal, which can last up to ten
weeks and is characterised by:
 depression
 lack of energy
 anxiety
 intense craving
 angry outbursts

prof. aza
3. Extinction, which can last indefinitely, and includes
symptoms of episodic cravings for cocaine, usually in
response to conditioned cues. These cravings may surface
months or years after the person has stopped using
cocaine.
 Other withdrawal symptoms that may be experienced
include:
 lack of motivation
 inability to feel any pleasure
 nausea/vomiting
 shaking
 irritability/agitation
 muscle pain
 long, but disturbed sleep.

prof. aza
 Treatment options
 There are a number of drug treatment
options available in Australia . While
abstinence may be a suitable treatment
aim for some people, many programs
recognise that for others this may not be
possible or realistic. Most programs adopt
strategies that have an overall aim of
reducing the harms and risks related to the
person’s drug use.
 Some treatment options include
counseling, withdrawal (detoxification) and
pharmacotherapy. Residential and ‘out-
patient’ programs are available.
prof. aza
 Pregnancy and
breastfeeding
 Pregnancy
 Research indicates that effects of cocaine use during
pregnancy may cause bleeding, miscarriage, premature
labour and stillbirth.
 Cocaine increases the heart rate in both the mother and baby,
and the supply of blood and oxygen to the baby is reduced.
This means the baby is more likely to be small and grow
slowly both before and after birth. If cocaine is used close to
birth, the baby may be born intoxicated, showing symptoms of
hyperactivity and agitation. Withdrawal symptoms can occur
in the babies of mothers who use cocaine regularly. These
include sleepiness and lack of responsiveness.
 To date, research is inconclusive as to whether children of
mothers who use cocaine experience any long-term mental or
physical effects. Some studies suggest that malformations of
the genito-urinary tract, heart, limbs and/or face occur in the
babies of women who use cocaine

prof. aza
 Breastfeeding
 Itis likely that cocaine will reach the baby
through breast milk. The effect this has on
the baby will depend on factors such as the
amount and strength of cocaine used, and
the time between using cocaine and
feeding the baby. Symptoms may include
the baby being irritable, unsettled and
difficult to feed.
 See your doctor or other health
professional if you are taking or planning to
take any substances while pregnant or
breastfeeding, including prescribed and
over-the-counter medications
prof. aza
 Cocaine and driving
 Itis illegal for anyone to drive under the
influence of any drug (including cocaine).
Breaking this law carries penalties including
disqualification from driving, heavy fines
and/or imprisonment. Due to the nature of its
psychological and physical effects, it is
dangerous to drive a vehicle after taking
cocaine. If cocaine is combined with other
drugs, such as alcohol, the risk of accident is
further increased.

prof. aza
 Cocaine and social problems
 Cocaine users can become preoccupied with
purchasing, preparing, using and recovering
from the effects of use of cocaine, neglecting
other areas of their life. All areas of a person’s
life, including family, work, and personal
relationships, can be affected by drug use. For
example, arguments over drug use can cause
family and relationship problems that may lead
to break-up. Some effects of cocaine, such as
anxiety, paranoia and irrational behaviour, may
further exacerbate these problems.

prof. aza
 Reducing the risks
 Australian drug policy is based on harm
minimisation. This is about reducing drug-related
harm to both the community and individual drug
users.
 Harm-minimisation strategies range from
encouraging ‘non-use’ through to providing the
means for people to use drugs with fewer risks.
 For further ‘tips’ on how to reduce the risks of
using cocaine, call the
alcohol and drug information service in your
State or Territory.
 Remember there is no safe level of drug
use.

prof. aza
 What to do in a crisis
 If someone overdoses or has an adverse reaction while
using cocaine it is very important that they receive
professional help as soon as possible. A quick response can
save their life.
 Call an ambulance. Dial 000. Don't delay because you
think you or the person might get into trouble. Ambulance
officers are not obliged to involve the police.
 Stay with the person until the ambulance arrives. Find out
if anyone at the scene knows mouth-to-mouth
resuscitation or cardiopulmonary resuscitation (CPR).
 Ensure the person has adequate air by keeping crowds
back and opening windows. Loosen tight clothing.

prof. aza
 If the person is unconscious, don’t leave them on their back
—they could choke. Turn them on their side and into the
recovery position. Gently tilt their head back so their tongue
does not block the airway.
 If the person has stopped breathing, give mouth-to-mouth
resuscitation. If there is no pulse, apply CPR.
 Provide the ambulance officers with as much information as
you can‑how much cocaine was taken, how long ago, and
any pre-existing medical conditions.
 Arrange with friends before cocaine is taken about what to
do in a crisis.

prof. aza
 What to do……
 If the person is unconscious, don’t leave them on their back
—they could choke. Turn them on their side and into the
recovery position. Gently tilt their head back so their tongue
does not block the airway.
 If the person has stopped breathing, give mouth-to-mouth
resuscitation. If there is no pulse, apply CPR.
 Provide the ambulance officers with as much information as
you can‑how much cocaine was taken, how long ago, and
any pre-existing medical conditions.
 Arrange with friends before cocaine is taken about what to
do in a crisis.

prof. aza
Coca eradication

prof. aza

prof. aza
 Coca eradication is a controversial strategy strongly
promoted by the United States government as part of its "
War on Drugs" to eliminate the cultivation of coca, a plant
whose leaves are not only traditionally used by indigenous
cultures but also, in modern society, in the manufacture of
cocaine. This prohibitionist strategy is being pursued in
the coca-growing regions of Colombia (Plan Colombia),
Peru, and Bolivia, where it is highly controversial because
of its environmental and its socioeconomic impact.
Furthermore, indigenous cultures living in the Altiplano,
such as the Aymaras, considers the coca leave to be a
traditional product (which they dub the "millenary leaf"),
which they use to fool the feeling of hunger, sleepiness
and head-aches linked to altitude and other
altitude sicknesses. The growers of coca are named
Cocaleros and part of the coca production for traditional
use is legal in Peru and Bolivia.

prof. aza
Coca eradication in Bolivia
prof. aza
 Environmental impact
 Plots denuded of coca plants by mechanical means (burning
or cutting) or chemical herbicides, such as Monsanto's
Roundup, are abandoned and cause serious problems with
erosion in seasonal rains.
 In addition, the U.S. has also been involved in the
application of the fungus Fusarium oxysporum to wipe out
coca[citation needed]; that fungus poses serious hazards
both to humans and to other plant species. In 2000, the
Congress of the United States approved use of Fusarium as
a biological control agent to kill coca crops in Colombia (and
another fungus to kill opium poppies in Afghanistan), but
these plans were canceled by then-President Clinton, who
was concerned that the unilateral use of a biological agent
would be perceived by the rest of the world as
biological warfare. The Andean nations have since banned
its use throughout the region. (The use of biological agents
to kill crops may be illegal under the
Biological Weapons Convention of 1975.)
prof. aza
prof. aza
 Source: DEA Intelligence Division, December
2001
 On June 25, 2003, the Superior Administrative
Court of the Colombian department of
Cundinamarca ordered a stop to the spraying of
glyphosate herbicides until the government
complies with the environmental management
plan for the eradication program. It also
mandated a series of studies to protect public
health and the environment.[1] The Colombian
State Council, the country's maximum
administrative authority, later overruled the
court's decision to stop fumigations. [2]
prof. aza
 Socioeconomic impact
 In the sierra of Peru, Bolivia, and northern Argentina, coca
has been consumed (by chewing and brewing in infusion)
for thousands of years as a stimulant and cure for
altitude sickness; it also has symbolic value. The sale and
consumption of coca (but not pure cocaine) is legal and
legitimate in these countries.
 With the growth of the Colombian drug cartels in the 1980s,
coca leaf became a valuable agricultural commodity,
particularly in Peru and Bolivia, where the quality of coca is
higher than in Colombia. To supply the foreign markets, the
cartels expanded the cultivation to areas where coca was
not a traditional crop. Many poor campesinos, driven from
the central highlands by lack of land or loss of jobs,
migrated to the lowlands and valleys of the eastern Andes,
where they turned to the cultivation of coca.

prof. aza
 To counter this development, the U.S. government,
through its foreign aid agency USAID, has promoted a
policy of crop substitution, whereby coca cultivation is
replaced by coffee, banana, pineapple, palm heart, and
other crops suitable for a tropical climate. Prices for
these products are extremely low, however; moreover,
many remote coca-growing areas lack the infrastructure
to get such perishable products to market on time. The
price of coca, on the other hand, has remained high;
and, when dried, coca stores well and is easily
transportable. To date, virtually all the crop substition
programs implemented in Peru and Bolivia have failed,
primarily because the campesinos are not guaranteed
an adequate price for alternative products.

prof. aza
The Chapare and Yungas coca-growing
zones in Bolivia. Source: US General
Accountability Office

prof. aza
 Geopolitical issues
 Given the above-mentioned considerations, many
critics of coca eradication believe the fundamental
goal of the U.S. government is to constrict the flow of
income to the Colombian Marxist rebel movement,
FARC, which is heavily funded by the illegal drug
trade, rather than combating drugs per se. Few if any
such critics have anything favorable to say about the
illicit drug trade, but they point out that under the
current coca eradication policies, poor campesinos
bear the brunt of efforts to combat it, while North
American and European chemical companies (which
supply chemicals needed in the manufacture of
cocaine) and banks (which annually launder
hundreds of billions of dollars in illegal revenues)
continue to profit from the trade.

prof. aza
 Article 26 of the Single Convention on Narcotic Drugs, a
treaty promulgated with U.S. backing in 1961, states that
"The Parties shall so far as possible enforce the uprooting
of all coca bushes which grow wild. They shall destroy the
coca bushes if illegally cultivated."
 The US-based Drug Enforcement Administration, along
with local governments, has frequently clashed with
cocaleros in attempts to eradicate coca across the Andes.
This map shows the Chapare region in Bolivia, which has
historically been heavily targeted for coca eradication.
Human rights NGOs such as Human Rights Watch have
accused the US of human rights abuses in the "coca war",
including the use of paramilitary death squads against
cocaleros [3]

prof. aza
 Results
 In November 2003, the US
Office of National Drug Control Policy (ONDCP) claimed the area
planted with coca in Peru and Bolivia combined fell by 35 km²
in the year up to June, which would suggest that a crop
eradication program in neighboring Colombia was not driving
production over the borders. According to its estimates, the
area cultivated with coca in Bolivia rose from 244 km² in 2002
to 284.5 km² in June 2003, but this increase was more than
offset in Peru, where the area fell from 366 km² to 311.5 km².
 However, the U.S. figures were very different from preliminary
estimates in September 2003 by the head of the
UN Office on Drugs and Crime in Colombia, which indicated that
output in Peru and Bolivia may have risen by as much 21 %, or
150 km², so far this year. The White House office said its
estimate was based on sampling from high resolution satellite
imagery. The United Nations used a different technique and
had not yet put out any formal estimate for 2003.

prof. aza
 At the start of 2003, there were 1,740 km² of coca in worldwide cultivation,
and Colombia represented more than 60% of that total. Critics of the
Colombian eradication program had predicted that it would lead to higher
coca production in Peru and Bolivia. [4]
 However, a March 2005 report by the ONDCP indicated that despite record
aerial spraying of over 1,300 km² of coca in Colombia in 2004, the total area
under coca cultivation remained "statistically unchanged" at 1,140 km². In
response to the report, the Washington Office on Latin America (WOLA), an
NGO that monitors the impact of US foreign policy in Latin America, observed
that the aerial spraying strategy appeared to have hit its limits. According to
WOLA, the new ONDCP data suggested a continued "balloon effect" as
aggressive spraying in some areas has not deterred new cultivation
elsewhere. Official estimates coca cultivation in Peru for 2005 have yet to be
released, but the State Department’s own reporting suggests that cultivation
in Peru has increased. "The stable cultivation in 2004 throws into doubt US
officials’ predictions of a major impact on US drug prices and purity,"
commented John Walsh, WOLA Senior Associate for Drug Policy. President
Álvaro Uribe has however vowed to press ahead with U.S.-financed
fumigation of coca crops. [5]
http://www.guardian.co.uk/worldlatest/story/0,1280,-4907643,00.html

prof. aza