Cocaine
"Talc", "snow", "snow", "blow", "lady", "flake".
What is cocaine ?
Cocaine known as benzoylmethylecgonine, is an alkaloid substance obtained from the leaves of the Erytroxylon coca bush.
Popularly and commercially, the name cocaine is given to the salts of cocaine (cocaine hydrochloride and cocaine sulfate ), which are the two purest products in the coca refining process.
Cocaine is also known by the names of " talc ", " snow ", " snow ", " blow ", " lady ", " flake ".
What are the presentations of cocaine and its routes of administration?
Coca leaf
The leaves are ingested orally
Cocaine hydrochloride or cocaine salts
Diffusible in water and thermolabile easily absorbed by the nasal mucosa (“ sniffin ”), it does not allow them to be smoked, they can also be absorbed parenterally (intravenously) (Téllez and Cote, 2005).
Snorted cocaine hydrochloride is the classic form of consumption and the one with the lowest potential acute toxicity (except for the ambe of coca leaves), in the form of microcrystals by endonasal aspiration
The parenteral or intravenous route is another form of consumption, except for the risk of transmission of infectious diseases, it presents the potential acute toxicity inherent in the substance itself (Llopis, 2001).
Coca base
Also called "Basuco" or "Bazuco", "Crack", "Rock" and "Freebase".
White or brownish, semi-solid or solid substance, obtained from the refining of cocaine salts, It contains multiple impurities such as methanol , ether , acetone , potassium permanganate , other coca alkaloids , benzoic acid , kerosene , alkaline substances , sulfuric acid or hydrochloric acid and other variable substances that are added to increase its weight.
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Insoluble in water, but soluble in lipids and organic solvents.
Its chemical composition depends on the impurities that accompany it.
Its main route of administration is inhalation in smoked form . (Téllez and Cote, 2005).
Basuco is consumed in the form of tobacco-colored powder that is smoked mixed with marijuana or tobacco (Llopis, 2001),
It can be said that it is a remnant that remains in the production process of cocaine salts. (Téllez and Cote, 2005)
Some characteristics of cocaine according to its presentation
The effects, the speed of appearance and their duration depend largely on the presentation of the substance and the route of administration, below you can find the differences in these
Frequently asked questions about cocaine
The parakeet and the cocaine are the same ?
In Colombia and other countries in the world, in the circle of consumers, cocaine salts with “lowered” concentrations are called “perico” or “perica” (Téllez and Cote, 2005).
How does cocaine work in the brain ?
Cocaine facilitates the accumulation of norepinephrine or dopamine in the synaptic cleft.
The increase in dopamine mediates euphoria and appears to be involved in the addiction mechanism.
Chronic cocaine use produces changes in dopamine availability.
Excess norepinephrine is responsible for most of the pharmacological effects and acute complications of cocaine (increased blood pressure, pupillary dilation, sweating, tremor, etc.).
Cocaine also blocks the reuptake of serotonin and chronic use of this substance produces changes in these neurotransmitters with a decrease in their bioavailability.
These effects on catecholaminergic and serotonergic neurotransmission also constitute the basis of its mechanism of action as a drug with addictive potential . (Lizasoain, Moro and Lorenzo, 2002)
What are the normal effects of cocaine?
Cocaine administered locally either in the form of "mambeo" or as a local anesthetic does not present notable systemic effects and its action is predominantly anesthetic, by stabilizing the axonal membrane and blocking peripheral nerve conduction.
The true systemic action of cocaine occurs with inhalation and parenteral administration , which rapidly triggers notable effects in the body (Téllez and Cote, 2005).
Although its effects as such depend on factors such as type of consumer, environment, dose and route of administration.
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Some of these effects according to Lizasoain, Moro and Lorenzo (2002) are:
Sympathetic nervous system cardiovascular system
Cocaine produces vasoconstriction and increases in blood pressure and heart rate, it can cause bradycardia although more frequently it produces tachycardia.
It also causes mydriasis, tremor, and sweating.
Temperature
bodily
Cocaine increases body temperature due to loss of dopaminergic control of temperature-regulating hypothalamic receptors, added to the heat generated by muscular activity.
This hyperthermia can be accompanied by seizures and cause sudden death with low but continuous doses of the drug.
System
central nervous
Cocaine is a CNS stimulant.
Moderate doses cause: elevation of mood, feeling of energy and lucidity, decreased appetite, insomnia, better performance in performing tasks, decreased feelings of fatigue, motor, verbal and ideational hyperactivity.
Intravenously, it produces a sensation of "flash", intensely pleasant and described as analogous to orgasm.
There are alterations in perception, critical and discriminatory capacity (wrong decisions), tactile pseudo-hallucinations ("bugs" or sand sliding on the skin), auditory (self-criticism and reproach that generate uncontrollable fear) and visual (bright or colored snowflakes ), stereotypical behavior, bruxism and compulsive movements.
What is the toxic dose of cocaine ?
The toxic dose varies widely and depends on individual tolerance.
The route of administration and the presence of other drugs as well as other factors. (Lizasoain, Moro and Lorenzo, 2002)
The fatal intravenous dose for adults is 1 gram due to direct toxicity to the myocardium.
The average dose of abuse by inhalation or oral route is estimated between 8.7 and 14mg but can be of the order of 200mg.
The lethal dose of cocaine is between 0.5 and 1.5 g (each line has 15 to 25 mg).
How to identify a cocaine intoxication?
According to Lizasoain, Moro and Lorenzo (2002), acute cocaine intoxication is characterized by manifestations of noradrenergic and dopaminergic hyperactivity mainly, which affects the different devices and systems.
In general, the clinical alterations produced by cocaine appear in three phases, which are summarized as follows:
Initial stimulation
This first phase occurs rapidly (in nasal absorption, begins 1-3 minutes after contact) and is clinically characterized by increased pulse, tachycardia, increased blood pressure, headache, emotional instability and involuntary movements (“tics”) of small muscles of the face; in the eye there is mydriasis.
These symptoms can be observed with blood levels above 40 mcgr%. (Téllez and Cote, 2005)
Advanced stimulation
This phase occurs between 30-60 minutes after contact with cocaine.
Tachycardia increases, hypertension increases, respiratory distress appears and even breathing can become irregular; in the central nervous system there is hyperkinesia and tonic-clonic seizures.
Seizures are a common phenomenon and are usually short and self-limited; status epilepticus may suggest continued drug absorption or hyperthermia.
A coma caused by a postictal state, hyperthermia, or intracranial hemorrhage caused by cocaine-induced hypertension may also occur.
These clinical manifestations can be observed in individuals with levels of cocaine in the blood between 100 and 200 mcgr%. (Téllez and Cote, 2005)
Depression
It is the most severe phase of acute cocaine intoxication and depending on the dose ingested, it can occur 1-2 hours after consumption.
This phase is characterized by perioral cyanosis (purple lips and mouth), great respiratory distress that can lead to respiratory failure, filiform (fast and weak) or non-palpable pulse, generalized hyporeflexia (change in heart rate, excessive sweating, hypertension, muscle spasms, changes in skin color), decreased vital functions, muscle paralysis, unconsciousness and death.
Suicide attempts or suicides occur frequently in this phase.
This symptomatology is observed with levels above 3 milligrams per 100 milliliters of blood (Téllez and Cote, 2005).
There is no specific pharmacological treatment for acute cocaine intoxication since the behavioral symptoms and signs (such as psychomotor agitation) can be totally different from the physiological symptoms or signs (decrease or increase in blood pressure, etc).
Because the cardiovascular, cerebrovascular, gastrointestinal complications secondary to cocaine and because cocaine-induced deaths generally occur in the first hours after cocaine use, it is very important to admit and monitor the person in the emergency services.
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The plasma half-life of cocaine is short (50 minutes) and most of the serious adverse effects secondary to the consumption of this drug diminish in the first hours after its use . The treatment of people intoxicated by cocaine in any of its forms of administration would be hospitable (Lizasoain, Moro and Lorenzo, 2002).
If you want to know some recommendations to reduce risks and damages in consumption
of cocaine do not miss our blog post.
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General recommendations for the consumption of psychoactive substances:
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📌Do not consume any psychoactive substance, if you do so other than on a regular basis.
📌 Take care of yourself physically before, during and after consumption through nutrition and hydration.
📌Implement detoxification strategies the days after consumption
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🔥 Warning signs 🔥
If you feel the need to increase the dose to feel the effects you initially felt, give yourself a break and do not consume for a long time, this will decrease tolerance, keep it there through non-habitual consumption, that is, do not take part of your routine or that the consumption does not present a pattern.
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💡Want to detox? 💡
At # deliberate we have designed a DETOX program at home: 7 days with nutritional advice, physical activity, recipes (breakfast, lunch and dinner), mindfulness exercises, imagery exercises and steam baths; Give your body a detoxification day once every six months and avoid negative consequences for your health in the medium and long term. More info here
💡Do you want to manage your consumption? 💡
Book an appointment with our healthcare professionals. Find out whether or not you have a problem use and acquire strategies to reduce risks and harm from using psychoactive substances. More info here