Worldwide, it is estimated that between 14 and 20 million people use cocaine. Cocaine addiction is one of the most difficult to treat chronically relapsing disorders. Whilst the effects of this drug on behaviour have been studied since the 19th century, it was only in recent decades that scientists realized cocaine impacts and changes brain tissue and function as well.
We know by now that cocaine increases the amount of dopamine in the brain which is associated with pleasure and satisfaction. These levels are rising to over three times their normal levels. Under the influence of cocaine, dopamine gets flooded onto brain cells and since it doesn’t have anywhere to go, it stops the cells from communications with each other. As time goes by and usage continues, the brain becomes less and less sensitive to dopamine which means larger amounts of the drug are needed to produce the same effects. This long-term use and abuse has also been shown to damage the actual structure of the brain. This is why specialists believe heavy users often experience seizures and other neurological disorders.
As we grow older, our brains naturally change and start losing grey matter. In healthy people, this process can take decades. According to a study from the University of Cambridge, the process is much faster in people who abuse cocaine and who had no previous history of substance misuse. Their results indicated that grey matter was lost at double the rate – from 1.69 ml of grey matter lost per year in healthy individuals versus 3.08 ml per year in cocaine-dependent individuals.
An even more alarming finding comes to light as a result of a research by Johns Hopkins University which suggests that cocaine abuse leads to brain cells self-cannibalizing. Looking at mice studies, researchers found that cells ejected important resources during the metabolism process causing a stress reaction of consuming other internal cell structures. It was also observed that mice whose mothers had been giving cocaine during pregnancy but who were not actually cocaine addicted themselves, also showed the same presentation. These findings have substantial significance in helping the community better understand the intricate and complex ways cocaine abuse can impact users – effects which are indicative to go beyond the person using the drug.
After cannabis, cocaine is the 2nd most consumed illegal drug globally. Unlike the latter where the addiction rate is quite low in comparison to other substances and lacing is not as frequent, cocaine raises substantial dangers. Because of the price of cocaine, drug dealers tend to add substances such as laundry detergents or crushed painkillers among others to sell it a lower cost and gain more profit. In particular, the opioid fentanyl, which is about 100 times more potent than morphine, is being increasingly added to cocaine sold on the streets. Cocaine bought on the streets is believed to be only 10 per cent pure with the remaining 90 per cent consisting of other substances.
When it comes to risk factors for addiction, the answer is pretty simple: cocaine is addictive. While not everyone will get hooked after the very first use, there are a number of variables that come into play. For instance, the administration mode and the age can play a big role. Younger individuals who smoke crack cocaine are substantially more likely to abuse the drug in the future. Equally important to note is that cocaine addiction affects men and women in different ways both biologically and socially. While men are more likely to be addicted to cocaine, women transition more rapidly from use to abuse and dependence and are more prone to overdose. Men have higher risks of experiencing more intense comedowns and withdrawal symptoms.
On the other hand, genes are considered to be another driver with around 40 per cent to 60 per cent of risk being rooted in biological causes. While there is no hard evidence, it is believed that the short half-life specific to cocaine and the hard comedown that follows increase the craving and the need for more. In 2017 alone, around 1 in five fatal overdoses were attributed to cocaine.
Exactly because there seems to be insufficient research into the effects of this powerful drug and even more important, the most appropriate treatment pathway, many patients face higher rates of relapse and even death. Addiction treatment centres are central to responding to this crisis as cocaine moves from the ‘luxury drug’ to one that is widely accessible to everyone. There is also a wider issue of lack of research into how cocaine abuse impacts the lives of individuals and their loved ones as well as healthcare systems and societies as a whole.
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