Cocaine is an alkaloid drug derived from the leaves of the coca bush. It blocks
local nerve conduction, producing local anesthesia when applied to mucous membranes. It was first used medically in 1884 by Carl Koller, an Austrian ophthalmologic surgeon, for operations involving the eye, nose, and throat. Newer local anesthetics have supplanted most medical uses of
Cocaine Since 1912, cocaine production and sale has been controlled by international treaties; it is sold illegally through much of the world.
In powder form, the drug is inhaled, or "snorted," and is rapidly absorbed through the nasal mucous membranes. Cocaine neutralized by alkali produces small, pebble-sized crystals of drug, called "crack," which is smoked, a faster route of administration. Cocaine increases
heart rate, decreases hunger, and produces feelings of exceptional well-being and enhanced mental and physical capacity. The
effects last for about 2 hours, allowing the experience to be repeated. These pleasant effects make cocaine an extremely addictive drug. The negative effects immediately following use include serious abnormal heart rhythms and heart attacks, which can cause sudden death. Cocaine can also cause strokes, or strokelike episodes, as well as convulsions. Overdoses cause marked elevation in heart rate, blood pressure, and body temperature, and may lead to death. When a user stops using cocaine, a withdrawal reaction ensues, characterized by sleepiness, fatigue, and ravenous appetite. Long-term users may develop paranoid psychoses,
poor nutrition, and poor heart function.
Cocaine use climbed throughout the 1980s; after
crack became widely available in the mid-1980s, its use increased sharply through the early 1990s. Through the middle of the 1990s, use levels remained relatively steady, but by the late 1990s, crack and cocaine use had dropped significantly. The social ills of cocaine include violent crime among dealers and stealing or prostitution among users. The fate of "crack babies"Ñchildren born of addicted mothersÑmay be less ominous than formerly believed. Treatment
programs rely mainly on "twelve-step" type programs similar to Alcoholics Anonymous. Drugs aimed at reducing cocaine cravings are under research.
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