cocaine

Question 1

what is cocaine?

Answer 1

white crystalline powder derived from coca leaves

cocaine base (crack) looks like small, irregularly shaped white rocks

cocaine is intense, euphoria-producing stimulant drug with strong addictive potential

Question 2

where can you get cocaine?

Answer 2

South America (Colombia, Peru, Bolivia)

Question 3

how is cocaine used by miners?

Answer 3

traditional use - Bolivian miners chew coca leaves to reduce hunger, fatigue and pain, helping them endure harsh working conditions

economic impact - global demand for cocaine has led to illegal coca cultivation and drug trafficking, affecting miners’ livelihoods and communities

cultural significance - coca leaves deeply engrained in Bolivia cultures, efforts to support miners should focus on sustainable economic development and alternative livelihoods

Question 4

what are the international implications of the significance of cocaine in Bolivia?

Answer 4

major international row with wide-ranging implications for global drugs policy over the right of Bolivia’s indigenous Indians to chew coca leaves, principal ingredient of cocaine

Bolivia obtained special exemption from the (1961) global drugs convention on narcotic drugs that governs international drug policy, despite international opposition

Question 5

what are the different methods of ingestion?

Answer 5

snorting

smoking

injecting

Question 6

what does snorting cocaine lead to?

Answer 6

leads to a high lasting 15-30 minutes high

can cause severe nasal damage, including loss of small and chronic nosebleeds

Question 7

what does smoking cocaine lead to?

Answer 7

results in a rapid, intense high lasting 5-10 minutes

risks of severe respiratory issues and higher addiction potential

Question 8

what does injecting cocaine lead to?

Answer 8

produces immediate, intense high

carries risk of overdose, infections and disease transmission through needle sharing

Question 9

what are the effects of cocaine?

Answer 9

massive sense of euphoria

when euphoria wears off, can lead to negative effects (insomnia, depression)

effects on short-term memory and decision making abilities

depend on the individual - pre-existing arousal and/or stress level of the user

depends on dose, route of administration, pattern and duration of use and environmental context

Question 10

what mild to moderate effects can cocaine cause?

Answer 10

mood amplification - both euphoria and dysphoria

heightened energy

sleep disturbance, insomnia

motor excitement, restlessness

talkativeness, pressure of speech

hyperactive ideation

increased sexual interest

anger, verbal aggression

mild to moderate anorexia

inflated self-esteem

Question 11

what severe effects can cocaine have?

Answer 11

irritability, hostility, anxiety, fear, withdrawal

extreme energy or exhaustion

total insomnia

compulsive motor stereotypies

rambling, incoherent speech

disjointed flight of ideas

decreased sexual interest

possible extreme violence

total anorexia

delusions of grandiosity

Question 12

what did Freud say about cocaine?

Answer 12

professed benefits of cocaine

prescribed it to his patients

Question 13

what is Coca-Cola’s (1906) relationship with cocaine?

Answer 13

original formula - Coca-Cola originally contained cocaine derived from coca leaves, marketed as a medicinal tonic in late 19th century

removal of cocaine - by 1904, Coca-Cola began using “de-cocainised” coca leaves, effectively eliminating cocaine from the formula due to growing health concerns and changing societal attitudes

cultural revolution - Coca-Cola successfully transitioned to a non-cocaine formula, maintaining its reputation and becoming one of the world’s most popular soft drinks

Question 14

what are the neural mechanisms of cocaine action?

Answer 14

activates reward system

dopamine is key

microinjections to nucleus accumbens (NAc) increase locomotor activity

Question 15

what are the neurotransmitters involved in cocaine action?

Answer 15

cocaine inhibits transporter to increase synaptic levels (DA, NA, 5-HT)

Question 16

how can cocaine block nerve conduction?

Answer 16

by inhibition of Na+ channels

local anaesthetic

Question 17

how does cocaine inhibit the reuptake of dopamine?

Answer 17

dopamine reuptake transporters are blocked by cocaine

increased dopamine concentrations in synaptic cleft

leading to behavioural symptoms of cocaine use

Question 18

what is the relationship between neurotransmitters and behaviour?

Answer 18

low mood drives craving

Question 19

how does cocaine activate the sympathetic nervous system?

Answer 19

high and “rush”

but also vasoconstriction, hypertension

so possibly stroke or intracranial haemorrhage

Question 20

what is the nucleus accumbens?

Answer 20

brain structure that plays a key role in motivation, reward and decision-making

also involved in addiction, anxiety, depression

Question 21

what are the behavioural symptoms of cocaine use?

Answer 21

restlessness

confusion and disorientation

paranoia and irritability

insomnia

social withdrawal

Question 22

what is restlessness?

Answer 22

users often appear unable to sit still

may seem overly energetic or agitated

Question 23

how can cocaine cause confusion and disorientation?

Answer 23

chronic use can impair cognitive functions

making it difficult for users to recall factors or events

Question 24

how can cocaine cause paranoia and irritability?

Answer 24

long-term use can lead to heightened paranoia and irritability

sometimes escalating to full-blown psychosis

Question 25

what is insomnia?

Answer 25

difficulty sleeping is a common symptom often leading to exhaustion

Question 26

what is social withdrawal?

Answer 26

users may become isolated, withdrawing from friends and family

Question 27

what are the anatomical/physical effects of cocaine use?

Answer 27

heart damage blood clots lung disease sinus damage organ stress

Question 28

how does cocaine cause heart damage?

Answer 28

chronic high blood pressure irregular heartbeats increase risk of heart attacks

Question 29

what is the risk of blood clots?

Answer 29

may result in strokes or pulmonary embolisms

Question 30

what lung diseases can chronic use lead to?

Answer 30

chronic bronchitis pneumonia

Question 31

how does cocaine use cause sinus damage?

Answer 31

snorting cocaine damages the mucous membranes in the nose potentially leading to septal perforations

Question 32

how can cocaine cause organ stress?

Answer 32

puts significant stress on liver and kidneys can eventually lead to organ failure

Question 33

what neurological effects does cocaine have?

Answer 33

dopamine system disruption cognitive decline reduced gray matter volume white matter damage shrinkage of prefrontal cortex

Question 34

what does it mean that cocaine causes dopamine system disruption?

Answer 34

increase dopamine levels in the brain leading to feelings of euphoria over time, can disrupt brain's reward system, making it difficult to experience pleasure without the drug and contributing to addiction

Question 35

what does it mean that cocaine can cause cognitive decline?

Answer 35

users may experience problems with attention, memory and executive functions can persist even after stopping cocaine use

Question 36

what does it mean that cocaine can cause reduced gray matter volume?

Answer 36

chronic cocaine use can lead to a reduction in gray matter volume affecting areas involved in decision-making, emotion regulation and memory

Question 37

what does it mean that cocaine can cause white matter damage?

Answer 37

white matter is crucial for communication between different brain regions damage to white matter can result in impaired coordination and slower cognitive processing

Question 38

what does it mean that cocaine can cause shrinkage of the prefrontal cortex?

Answer 38

this part of the brain is responsible for higher-order cognitive functions and emotional regulation long-term cocaine use can cause shrinkage in this area

Question 39

how did Inada et al (1992) investigate tolerance?

Answer 39

11 days continuous iv infusion (to total 60mg/kg/day) in mice 20 mg/kg cocaine challenge schedule quickly produced tolerance

Question 40

what has been found about cocaine tolerance?

Answer 40

MRI - in people addicted, don't seem same reward as controls does seem to get better with abstinence

Question 41

what are the pharmacological treatment strategies?

Answer 41

tricyclic antidepressants most commonly prescribed to treat cocaine addiction dopamine based substances that can reduce the euphoric effects of cocaine or reduce cravings during withdrawal immunisation against cocaine

Question 42

what are the behavioural treatment strategies?

Answer 42

contingency management (CM) cognitive behavioural therapy (CBT) therapeutic communities (TCs)

Question 43

what is contingency management?

Answer 43

uses a reward-based system to encourage abstinence from cocaine by providing incentives for drug-free urine tests not clear how well works in long-term developing initial abstinence

Question 44

what is CBT?

Answer 44

helps patients develop skills to recognise and avoid triggers teaches coping mechanisms to deal with problems associated with drug use

Question 45

what are therapeutic communities?

Answer 45

drug-free residences where individuals support each other in understanding and changing their behaviours fostering long-term recovery