Cocaine

Jerry Connolly, Student pharmacist

Fall 2022

History

People have chewed coca plants for thousands of years. Cocaine was first isolated from coca plants in 1859 from the Erythroxylon coca plant. Cocaine was widely used medically in the 19th century with the rise of many cocaine-containing tonics and elixirs that made claims to treat a variety of symptoms from headache, depression, and sexual impotence. Cocaine’s popularity skyrocketed in 1886 thanks to the creation of Coca-Cola and recreational use began to rise well into the 20th century.

Background

→ Cocaine is a naturally derived stimulant derived from the Erythroxylum coca plant grown in the Andean region of South America.

→ Cocaine is often snorted but also can be injected or used orally

→ Freebase cocaine, known as crack, is created from powdered cocaine made for smoking and has quicker, more intense effects

Pharmacology/Drug Effects

Onset → 0-5 minutes

Onset (crack) → Immediate, often before exhaling

Duration → 20-40 minutes

Duration (crack) → 5-15 minutes

Desired Effects → euphoria, mental/physical stimulation, increased sociability, increased energy, erotic/sexual stimulation

Neutral Effects → numbness and appetite suppression

Negative Effects → desire to do more cocaine, post-nasal drip, irritation in throat, dry mouth, insomnia, anxiety, paranoia, anger

Street Names

Coke Blow Snow

Nose Candy Crack (freebase cocaine)

Drug Interactions

Severe interaction with alcohol!

→ Cocaine combines with alcohol in liver to form cocaethylene which intensifies euphoric effects and increases risk of sudden death

Toxicology

Signs of overdose/toxicity

→ heart arrythmia, acute psychosis, tachycardia, seizure, death from heart attack or severe arrythmias https://smarmore-rehab-clinic.com/wp-conntent/uploads/2022/05/ Effects-of-cocaine-2.jpg

Laws

Cocaine is currently labeled as a schedule II drug under the Controlled Substances Act passed in 1971. It is illegal to sell without a DEA license and illegal to buy or possess without a license or prescription

Drug Screening

→ Cocaine use is most commonly screened for and monitored via urine tests https://www.google.com/url?sa=i&url=https%3A%2F%2Fen.wikipedia.org%2Fwiki% 2FLegal_status_of_cocaine&psig=AOvVaw1N3sRBsyeSOAJPQOOC6sR3&ust=166579 3265293000&source=images&cd=vfe&ved=0CAwQjRxqFwoTCID4sNG53voCFQAAAA AdAAAAABAK

→ is metabolized in the liver creating a primary metabolite benzoylecgonine which can be detected in urine up to eight days after consumption

Professional Opinion

Cocaine is one of the most commonly used illicit substances and there are no known medical benefits that outweigh the severe negative complications caused by cocaine use.

~ J. Connolly

References

1. The history of cocaine - where does cocaine come from? - drug-free world. Foundation for a Drug-Free World. https://www.drugfreeworld.org/drugfacts/cocaine/a-short-history.html. Accessed October 13, 2022.

2. Erowid cocaine vault. https://erowid.org/chemicals/cocaine/cocaine.shtml. Accessed October 13, 2022.

3. Cocaine: Effects, hazards & warnings. Drugs.com. https://www.drugs.com/illicit/cocaine.html. Accessed October 13, 2022.

4. O’Malley GF, O’Malley R. Cocaine - special subjects. Merck Manuals Professional Edition. https://www.merckmanuals.com/professional/special-subjects/recreational-drugs-andintoxicants/cocaine?ruleredirectid=249&qt=&sc=&alt=. Published September 26, 2022. Accessed October 13, 2022.

What does It do?

The alkaloids In Datura compete with acetylcholine at muscarinic receptors and stimulate dopaminergic neurons causing euphoria, realistic auditory and visual hallucinations, slurred speech, amnesia and extreme disorientation and delirium sometimes resulting in dangerous behaviors. Users often lose sense oftime being used for its hallucinogenic effects and intoxicating abilities to poison unsuspecting used. It's use is well-documented in Chinese medicine and sacred rituals. The plant contaings anticholinergic agents including atropine, scopolamine, and hyoscyamine. For this reason, it has also been used as a smokable asthma tratment to relax airways.

Nicknames

This plant produces white, pink, purple, or yellow trumpet-shaped flowers and can grow up to two meters tall. Both the flower and the plant emit a foul odor, earning its nickname Stinkweed. Datura is also known as: Jimson Weed, Devil's Apple, Thorn Apple, Devil's Weed, Malpitte, Moonflower, and Tolache.

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IIs it legal?

Daturaiscurrentlyun-scheduledundertheControlled SubstancesActandunregulatedunderfederallaw. WhileIt'slegaltopossessanddistributeDatura withoutrequiringalicenseorprescription,Itmay showuponadrugscreen.Onlyspecialistlaboratory testscanreliablydetectthealkaloidspresent,but they'renotroutinelyusedfordrugscreening.

Metabolism

DaturaIsreadilyabsorbedandpartiallymetabolizedby theliver.It'smostlyeliminatedIntheurinewithahalflifeofaboutfourhours.It'snotcurrentlybelievedto beaddictingandusersareunlikelytodevelopphysical orpsychologicaldependence.Nowithdrawaleffects havebeenreported.

Interactions

Daturausersshouldavoidtakingotheranticholinergic drugs,asthisputspatientsatahigherriskof experiencingundesiredsideeffects.Additionally, Daturashouldbestoppedtwoweeksbeforeany surgerytoavoiddangerouslydecreasedrespirations.

References

Lexidrugs, https://online.lexi.com/lco/action/home. Accessed October 14, 2022.

Erowid Datura Vault, https://www.erowid.org/plants/datura/ datura.shtml. Accessed October 14, 2022

Datura Wrightii: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews. WebMD. https:// www.webmd.com/vitamins/ai/ingredientmono-1491/daturawrightii. Accessed October 14, 2022

Corporate Author US Dept of Justice. Jimsonweed Datura Stramonium. https://www.ojp.gov/ncjrs/virtual-library/ abstracts/jimsonweed-datura-stramonium#:~:text=With%

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Is It Safe?

There is no way to determine a reasonably safe dose of Datura due to the variation in the potency of the plant material. Only 45g of dried Datura leaves can contain a lethal dose of alkaloids. Patients with moderate to severe toxicity may experience coma, seizure, delirium, severe agitation, and combativeness sometimes requiring restraints. Users' behavior is often irrational, putting them at risk for accidental injury. Datura causes an Inability to perspire, which can cause dangerous and potentially life-threatening hyperthermia at high doses.

So.... Should I Take It?

An overwhelming majority of users describe experiences as extremely unpleasant, both mentally and physically. The experience can be over whelming and uncomfortable, some even report lingering "weirdness" affecting coordination and speech for up to a week afteward.

~D.Bellamy