Leaves of coca were used for centuries, but it was in the nineteenth century when it was processed and called cocaine, and started to be used as a local anesthetic. But its mood-altering effects did not escape attention, and cocaine is used since then as an illicit stimulant that has become popular since the late 1960s and specially since the 1980s, as its price fell. With the increasing use of cocaine, a complex reality has emerged : while some of the experimenters will try cocaine and never use it again, others will become users (social-recreational users or occasional situational-circumstantial users), many of them will become abusers and many still will develop addiction with the consequent need for cocaine treatment centers.
So, distinction can be made between cocaine abuse and cocaine addiction, although there is a great risk of becoming dependent on cocaine when this substance is abused. Cocaine abuse and cocaine addiction is a matter of an interaction among the person, the drug and the circumstances, and it is related to the harmful aspects of cocaine use.
Because of the stimulant properties of cocaine, it often becomes an easy target for abuse by someone who may be experiencing emotional and psychological fatigue. This does not necessarily mean that the person is dependent on cocaine. It could be a time limited abuse pattern that may or may not disappear whenever the difficulties are behind him/her.
Summing up, cocaine abuse is different from cocaine addiction, although abuse often leads to dependence. Abusers are not necessarily addicted to cocaine, but develop problems as a result of their cocaine consumption and poor judgment, failure to understand the risks, or lack of concern about damage to themselves or others.
There are important medical complications associated with cocaine use and thus the need for specialised cocaine treatment centers. Some of the most frequent complications: cardiovascular effects including disturbances in heart rhythm and heart attacks, respiratory effects such as chest pain and respiratory failure, neurological effects including strokes, seizures, and headaches, and gastrointestinal complications including abdominal pain and nausea.
Cocaine use has been linked to many types of heart disease. Cocaine has been found to trigger chaotic heart rhythms, called ventricular fibrillation; accelerated heartbeat and breathing; and increased blood pressure and body temperature. Physical symptoms may include chest pain, nausea, blurred vision, fever, muscle spasms, convulsions and coma.
Different routes of cocaine administration can produce different adverse effects. Regularly snorting cocaine, for example, can lead to loss of sense of smell, nosebleeds, problems with swallowing, hoarseness, and an overall irritation of the nasal septum, which can lead to a chronically inflamed, runny nose. Ingested cocaine can cause severe bowel gangrene, due to reduced blood flow. Furthermore those who inject cocaine have puncture marks and "tracks", most commonly in their forearms. Intravenous cocaine users may also experience an allergic reaction, either to the drug, or to some additive in street cocaine, which can result, in severe cases, in death. Because cocaine abuse has a tendency to decrease food intake, many chronic cocaine users lose their appetite and can experience significant weight loss and malnourishment.
Research has revealed a potentially dangerous interaction between cocaine and alcohol. Taken in combination, the two drugs are converted by the body to cocaethylene. Cocaethylene has a longer duration of action in the brain and is more toxic than either drug alone. While more research needs to be done, it is noteworthy that the mixture of cocaine and alcohol is the most common two-drug combination that results in drug-related death.
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