Cocaine Update
10/19/07 11:08 AM
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COCAINE cutting it fine
Cocaine Update
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What is cocaine? Cocaine is a stimulant which, when pure, is a white crystalline powder with a bitter, numbing taste. This powder is called cocaine hydrochloride and is made by processing and treating the leaves of the coca plant originally found in South America. Cocaine is one of the most widely used illegal drugs in the USA and other parts of the world, however, it has never achieved the same level of use in Australia. Recently, there has been an increase in the availability of cocaine in Sydney, resulting in an increase in use by injecting drug users in that city. Cocaine is also known as coke, Charlie, snow, blow, toot, C, crack, cola, nose candy and white dust. Don’t be fooled by these names - cocaine can be a very dangerous drug.
What are the effects of cocaine? Cocaine can give a user an intense sense of pleasure and well being. Users may also experience elevated mood, alertness and sexual arousal. The drug also gives some people a heightened sense of self-confidence verging on invincibility. Cocaine is very short acting (up to 30 minutes). It is also very “more-ish” – the ‘rush’ followed by the ‘crash’ may cause users to binge on cocaine until physical exhaustion or until the drug runs out. Cocaine is an addictive drug and tolerance can build up very quickly. Regular users find that they need more cocaine to get the effects they want and also use much more cocaine for longer than they originally planned. The need for cocaine can lead users to do things they wouldn’t normally, like sharing fits, having unprotected sex and committing crime.
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How is cocaine used? Cocaine may be used by rubbing on the gums, swallowing, snorting, smoking or injecting. In Australia, cocaine is mostly snorted or injected. Cocaine hydrochloride in powder form cannot be smoked effectively because the drug is destroyed at high temperatures. By removing the hydrochloride through a chemical process the drug is converted into ‘freebase’, which can then be smoked. ‘Crack’ is a form of freebase cocaine which is particularly pure. It is sold in the form of small lumps known as ‘rocks’. There have been major problems with crack in the USA. However, it is rarely seen in Australia. ‘Speedballing’ is another way that cocaine is used. Users mix cocaine and heroin in the same shot.This is thought to take the ‘edge’ off both drugs. Some users like sex workers take cocaine and heroin alternatively while they work – cocaine gives them the energy to work while heroin helps them when they take a break.
What is in ‘street cocaine’? Street cocaine is usually ‘cut’ or diluted with other substances. Some of these substances mimic the taste or appearance of cocaine. There is not a great deal of information on the other things found in street cocaine, but glucose, lactose, baking soda and even talcum powder have been found. However, there is little evidence to suggest that harmful contaminants such as powdered glass or rat poison are intentionally used. Amphetamine can also be used to cut cocaine.
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What are the harms associated with cocaine? Cocaine users, both injectors and snorters, have reported a number of health problems that are related to their cocaine use. Some of the most common problems are heart palpitations, nausea/vomiting, shortness of breath, sleep disturbances and headaches/migraines. Among people who inject cocaine, collapsed veins is a particular problem. Coke can be hard on veins especially if you do a lot of injections. Missed shots or skin ‘popping’ wastes a shot and can lead to serious infections. Remember, if you’re using with other people, lots of messy shots can put you at risk of hepatitis C or even HIV. Talk to a health care worker about safer injecting. There are also a number of psychological problems that are associated with cocaine use, such as anxiety, depression, mood swings, paranoia, and psychosis. For some people, these problems may cease when the effect of the drug wears off, but others have reported experiencing these problems even when they are not using cocaine.
Can I become addicted to cocaine? Cocaine is a very addictive drug. Cocaine use can get out of control very quickly. It is a very expensive drug in Australia but that has not stopped people from spending all of their money on cocaine in a very short period of time and turning to crime or other things they wouldn’t normally do. Signs of cocaine dependence include needing more cocaine to get the effect you want, taking more cocaine for longer than you planned, feeling bad when you can’t get cocaine and spending a lot of time scoring, using and getting over the effects of cocaine.
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A lot of people say cocaine dependence is all in the mind. But the cravings associated with cocaine are very real. New studies are showing that cocaine does affect brain chemistry which may lead to addiction. The good news is that these brain changes and the cravings do resolve quickly (in about a month). Nevertheless it can be very difficult for people during this time.
What is cocaine psychosis? Cocaine can cause a particular type of psychosis. Psychosis is a mental illness where you can become paranoid and suspicious (thinking people are spying on you, following you or out to get you) when they are not. You might start seeing or hearing things that aren’t there. Some people start to scratch at imaginary ‘coke bugs’ on their skin, causing sores. Some people can become violent or take stupid risks. Cocaine psychosis is usually seen after a long cocaine binge where the user has not slept or eaten properly for several days.The psychosis will usually settle down once the user has stopped taking coke. Sometimes hospitalisation and anti-psychotic medications are needed.
Can you overdose on cocaine? It is easy to use too much cocaine and overdose, regardless of how you use it. Cocaine overdoses can involve fits, seizures, strokes, heart attacks or other cardiovascular problems and, in some cases, have resulted in death. Cocaine increases the heart rate but can also cause the blood vessels near the heart to close down or constrict. This can cause a heart attack. It can also cause heat to build up inside the body which is unable to escape.
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The first signs of an overdose can include: a sudden rise in body temperature chest pain a flushed face hot skin, but no sweating muscle cramps stiffness in the arms or legs
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What do I do if someone overdoses on cocaine? Cocaine overdoses are unpredictable. They can happen to new users, recreational users and regular users. If someone you know has used cocaine and begins to panic and starts breathing rapidly, take them to a quiet place and calm them down by reassuring them that they are safe. Do not give them anything to eat or drink other than sips of water. Help them to breathe slowly and deeply by counting each breath slowly in and out with them. If they do not calm down, seek medical help. If a person collapses (eyes rolled back, erratic breathing, skin cold and clammy) do the following:
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call Emergency 000 for an ambulance
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check breathing. If the person is not breathing be prepared to immediately start mouth to mouth resuscitation
check that the person’s airway is clear. If not remove anything from the person’s mouth and extend the neck to open the airway
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check circulation by feeling for a pulse in the person’s neck. If there is no pulse then immediately commence heart massage
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if airway, breathing and circulation are OK, put the person in the recovery position
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loosen any tight clothing that might restrict breathing
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do not leave the person until after professional help arrives
keep the person comfortably warm with a blanket or a coat do not give the person fluids explain to the ambulance crew what has happened and what you have done. If you have the information, tell them what the person has taken and how long ago
What if I only snort cocaine? Snorting should not be regarded as a “safe” way of using cocaine. Snorting cocaine can result in bleeding and/or ulceration in the nose and/or sinuses, which can lead to long-term damage to the sensitive nasal membranes.Although rare, there have been cases where the nasal septum (cartilage between the nostrils) has been completely eroded by heavy, long-term use of cocaine. Remember, the risks of overdose, psychosis and dependence are almost the same for injectors and snorters.
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What can I do about my cocaine use? It is easy to get into problems with cocaine. Some people don’t even realise the damage it is doing to them until it’s too late. The best way to cut down or take a break from cocaine is to know what to expect. The most important thing to understand is your own personal reasons why, when and where you use cocaine. You can protect yourself from cocaine psychosis by making sure you get enough sleep, eat properly and keep up lots of (non-alcoholic) fluids. Remember that the paranoia and mood swings are all part of cocaine’s effects and these will pass, sometimes within days of having a break from cocaine. Taking more cocaine will just make them worse. If you feel that the downsides of cocaine are bigger than the high, then talking to a counsellor or your doctor can help understand why you are using and work out ways to cut back or take a break. Some people keep a diary to identify when and why they’ve used cocaine and also when they get cravings to use cocaine and what they could do to get through them. Once you’ve worked out what gets you started you can then work out ways of avoiding those situations, people or things. If you have a particular pattern of use, you can aim to break it up so it’s not such a habit. If stress is a trigger then relaxation techniques or exercise could help. For some, alcohol is a trigger. Talking about your cocaine use and the problems it is causing you can be really helpful because all cocaine users have different stories. A part of cocaine addiction is spending less time with friends or family who don’t use cocaine. But these are just the people you need to have around you as you cut back or have a break.
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Groups like NA are also really helpful for some people. You’d be surprised how many different kinds of people have had cocaine problems. Cocaine withdrawal is most intense for about the first month but quickly weakens. During this time you may feel irritable, depressed and find it hard to concentrate. Many people with serious habits find getting away from the places and people they use with makes a big difference. Doing a ‘geographical’ can be really effective with cocaine because it is still hard to get in most places in Australia. Money is a big problem for lots of people who have problems with cocaine use. Try not to buy cocaine on credit and get your rent taken out automatically when you get paid. If you have someone you really trust who doesn’t use cocaine give your credit or ATM cards to them for safekeeping. Don’t carry a lot of cash on you. There are no treatments like methadone for cocaine. If these techniques don’t work consider rehab to take you out of harm’s way while you detox. Once you’re clean from cocaine you’ll be better able to work out how to avoid relapsing or getting back into cocaine. Disclaimer: All information contained in this booklet was correct at the time of publication. ©2002, NDARC, UNSW Acknowledgements:
This booklet was written by James Shearer, Paul Dillon and Sharlene Kaye and produced by the National Drug and Alcohol Research Centre. We thank all the users who generously gave their time to provide us with the much needed information provided in this booklet. ISBN 1 8770202 Copies of this booklet can be purchased from:The National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, 2052 Ph: (02) 9385 0333 Fax: (02) 9385 0222