Cocaine: Causes and symptoms

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As with other forms of addiction, cocaine abuse is the result of a complex combination of internal and external factors. Genetic predisposition, family history, and immediate environment can all affect a person's probability of becoming addicted.

As many as three to four million people are estimated to be chronic cocaine users. The 1997 National Household Survey on Drug Abuse reported an estimated 600,000 current crack users, showing no significant change since the late 1980s.

Extensive research has been conducted to determine how cocaine works on the brain and why it is so addictive. Cocaine has been found to affect an area of the brain known as the ventral tegmental area (VTA), which connects with the nucleus accumbens, a major pleasure center. Like other commonly abused addictive drugs, cocaine's effects are related to the action of the neuro-transmitter dopamine, which carries information between neurons. Cocaine interferes with the normal functioning of neurons by blocking the re-uptake of dopamine, which builds up in the synapses and is believed to cause the pleasurable feelings reported by cocaine users.

The short-term effects of cocaine can include:

• rapid heartbeat
• constricted blood vessels
• dilated pupils
• increased temperature
• increased energy
• reduced appetite
• increased sense of alertness
• euphoria
• death due to overdose

The long-term effects of cocaine and crack use include:

• dependence, addiction
• irritability
• mood swings
• restlessness
• weight loss
• auditory hallucinations
• paranoia

The rise in cocaine use as well as the appearance of crack cocaine in the late 1980s spurred fears about its effects on the developing fetus and, since then, several research reports have suggested that prenatal cocaine use could be associated to a wide range of fetal, newborn, and child development problems. According to the The Lindesmith Center-Drug Policy Foundation, many of these early reports had methodological flaws, and most researchers nowadays propose more cautious conclusions concerning prenatal cocaine effects. Much evidence would seem to point to the lack of quality prenatal care and the use of alcohol and tobacco as primary factors in poor fetal development among pregnant cocaine users. Research sponsored by the National Institute on Drug Abuse (NIDA) and the Albert Einstein Medical Center in Philadelphia corroborate the Lindensmith Center findings in reporting that the lack of quality prenatal care is associated with undesirable effects often attributed to cocaine exposure such as prematurity, low birth weight, and fetal or infant death. The Center for Disease Control and Prevention (CDC) however, reports that mothers who use cocaine early in pregnancy are five times as likely to have a baby with a malformation of the urinary tract as mothers who do not use the drug. Thus, cocaine use during pregnancy is assuredly most inadvisable, especially since it is also often associated with the use of alcohol known to cause long-term developmental problems. Supporting the cocaine-exposed expecting mother so as to discourage cocaine use remains an important task for all health caregivers.

— Peter Gregutt