What is Cocaine

Cocaine, or benzoylmethyl ecgonine, is a crystalline tropane alkaloid obtained from the leaves of the coca plant. The name “Cocaine” is a derivation of “coca” and the alkaloid suffix “-ine”. For over a thousand years, the leaves of the coca plant (Erythroxylon coca), were chewed by the indigenous peoples of South America. The coca plant is rich with vital nutrients, and numerous alkaloids including cocaine. Evidence of the use of coca leaves has also been found in several other medieval civilizations, and it is now an established fact that these peoples mixed the coca leaves and saliva and used it as an anesthetic for the performance of trepanation. Post the Spanish conquer of South America, the leaves were at first claimed to be devilish, but later they were legalized and taxed at 10% of the value of each crop. Chewing of these leaves was hen said to induce “great contentment”.

Cocaine acts as a stimulant of the central nervous system and as an appetite suppressant. Cocaine is a dopamine reuptake inhibitor, a noradrenaline reuptake inhibitor and a serotonin reuptake inhibitor. Since it affects the mesolimbic reward pathway, cocaine is proved to be addictive. However, the medicinal properties of cocaine indicate that it can be used as a topical anesthetic in any eye, nose and throat surgery, even in children.

Pure cocaine is a white, pearly product. Powdered cocaine is typically cocaine hydrochloride (CAS 53-21-4). Pharmacologically, there are various forms of cocaine like cocaine sulfate, freebase, crack cocaine, and types that can be chewed or eaten, injected, smoked, or snorted. Cocaine sulfate is produced by macerating coca leaves with acidulated water or an aromatic solvent like benzene or kerosene. This sulfate salt is an intermediate process in the production of cocaine hydrochloride. Cocaine hydrochloride is soluble in water and vaporizes at a very high temperature which makes it unsuitable for smoking. Freebase is the base form of cocaine which is insoluble in water. It vaporizes at a lower temperature and hence is suitable for inhalation. The first step in the production of freebase cocaine is to dissolve cocaine hydrochloride in water. Once dissolved, it dissociates into the protonated cocaine ion and the chloride ion. The solid impurities are removed from the cut by filtration. Next, an ammonia base followed by diethyl ether is added to this solution. The freebase dissolves in ether, which being insoluble in water, can be siphoned off. When left to evaporate, the freebase cocaine is left behind.

However, there were certain dangers in the use of ether, which led the producers to skip both the processes of removing the freebase precipitate from the ammonia mixture and the filtration. As a result, along with the cut, the ammonium salt and a little water remained behind in the freebase. The “rock” that was formed is called crack cocaine.

Freebase cocaine smoking releases methylecgonidine into the user’s system. This is due to pyrolysis of the substance. Infact, this is one side effect that is not created by insufflating or injecting the powder. According to certain researches, this method of consuming cocaine is more cardio-toxic than others as a result of the effects of methylecgonidine on the tissues in the lung and liver. However, this remains one of the popular methods of cocaine administration as the drug is immediately absorbed into the blood and reaches the brain in a few seconds. The high lasts about the same duration as when having the drug by injection, but in this case there are no risks associated with intravenous drug use.

Another method of consumption is through chewing. The coca leaves are mixed with some alkaline substance like lime, and chewed. The juices that are sucked out are gradually absorbed by the mucous membrane of the cheeks and then the gastrointestinal tract. Coca leaves can also be infused in a liquid and consumed much the same way as tea.

Insufflation, or what is commonly referred to as “snorting”, “blowing” or “sniffing”, is one of the other popular methods of cocaine ingestion. The powdered cocaine is inhaled or snorted through the nose, and the tissues lining the sinuses absorb it. The absorption is approximately 30-60%, and whatever is not absorbed through the mucous membrane is collected in the mucus and swallowed. However, administration of cocaine by this method has its drawbacks as the cocaine constricts the blood vessels inside the nose, leading to a constriction in the flow of blood, oxygen and nutrient to the area.

Hollow pens, straws, rolled-up bank notes, special spoons and even long fingernails are used to insufflate cocaine. The powder is poured onto a flat smooth surface and divided into “lines”. The amount of powder depends on the individual’s preferences, but a single line is generally about 35 mg to 100 mg. Just like sharing needles, the sharing of straws can lead to blood diseases like Hepatitis C.

Injecting cocaine assures a maximum intake of the drug, and also the maximum absorption of it into the blood. The effects are almost instantaneous, and an intense exhilarating rush is experienced. However, it is generally noted that the euphoria passes quickly too. The dangers of consumption of cocaine by this method include tinnitus (a form of audio distortion), toxicity, blood-borne infections, and chances of circulatory emboli from the insoluble substances.

“Speedball”, an injected mixture of cocaine and heroin is another popular and equally dangerous method of cocaine consumption. The converse effects of these two drugs complement each other, at the same time masking the symptoms of an overdose. Many deaths have been reported as a result of this.

The metabolism of cocaine is thorough, especially in the liver. Only about 1% of it is excreted unchanged in urine. Cocaine metabolites like benzoylecgonine can be detected in urine if tested within 4 hours of it intake. In concentrations greater than 150 mg/ml, cocaine remains detectable for up to 8 days. In regular users, cocaine accumulation can even be detected in the hair. When consumed together with alcohol, cocaine combines with the ethanol in the liver to form cocaethylene. This is even more euphorigenic, and results in higher cardiovascular toxicity. People often snort cocaine to relieve themselves of the depressive effects of alcohol.

Cocaine abuse has a variety of adverse effects on the human body. It increases heart rate, body temperature, and blood pressure, constricts blood vessels, and dilates pupils. Headaches, gastrointestinal complications like nausea and abdominal pain are common side effects of prolonged or regular cocaine use. People also complain of a lack of appetite, and gradually one might very well grow malnourished. Again, the methods of cocaine administration followed also leave an impact on the body. Those who generally snort the drug, are found o suffer from nosebleeds. Ingestion of cocaine can lead to severe bowel gangrene due to reduced blood flow. Using injections increase chances of contracting diseases like HIV. Irritability, restlessness, anxiety and paranoia are also commonly reported. Depending on the frequency, cocaine abuse can result in cardiovascular and cerebrovascular emergencies. Cardiac and respiratory arrests and seizures are not uncommon for those using the drug on a regular basis.

Cocaine abuse is a very wide-spread phenomenon, and till date, there are no medications available for the treatment of this addiction.