ORIGIN STORY OF COCAINE
Cocaine is a highly addictive stimulant drug. The coca leaves (Erythroxylon coca) have been chewed and ingested by the people in South America mainly for their stimulant properties for thousands of years. More than 100 years ago, cocaine hydrochloride was isolated from the plant. Cocaine was used for several illnesses, from pain to anxiety and anaesthetic during operations. Once upon a time, it was also an ingredient of Coca Cola. Medical research has seen that cocaine is a highly addictive substance that can alter brain structure and function.
Cocaine is a Schedule II drug. Doctors use it in exceptional medical cases as it has a great potential for abuse. Many dealers cut /dilute the cocaine with corn starch, crushed paracetamol, other stimulants like amphetamines or even downers like heroin to create more profits.
There are two forms of cocaine — the water-soluble hydrochloride form and the water-insoluble cocaine base. Users inject or snort the water-soluble salt. The base is created by mixing cocaine with ammonia and sodium bicarbonate to be smoked – called free-basing.
Snorting– Users snort the cocaine powder intranasally, which gets absorbed faster through the nasal mucosa giving an instant high.
Intravenously Mixed with water, it is injected into the body’s veins, thereby entering the bloodstream directly, also called “fixing”. The euphoric effects were faster.
Free-basing/ smoking. Crack cocaine became popular when heating and inhaling its fumes or smoking was as effective, direct and enhanced as injecting it.
The patterns of use range from occasional to repetitive to very frequent use. These patterns can release toxic amounts of cocaine into the bloodstream, resulting in heart attacks, strokes, and seizures- all potentially fatal.
Cocaine affects the reward pathway in the brain that releases dopamine (the feel-good hormone ), usually activated by anything rewarding activity, food, sex and various substances.
The reward pathway extends from the Ventral Tegmental area (VTA) to the Nucleus accumbens. It is also the pathway that regulates emotions and motivation.
In the normal communication process, a neuron release dopamine into the synapse (the small gap between two neurons), where it binds to specialized proteins called dopamine receptors on the adjoining neuron. Through this process, dopamine acts as a chemical messenger, carrying a signal from neuron to neuron. Another specialized protein called a transporter removes dopamine to recycle from the synapse for further use.
How does cocaine affect the pathway?
Cocaine attaches itself to the dopamine reuptake receptors/dopamine transporters, thereby preventing the dopamine reuptake from the synapse. It leads to an excessive and longer-lasting accumulation of dopamine. It is what gives rise to the immense euphoria felt immediately after consumption of cocaine (Image 1)
Cocaine induces long term changes in the brain.
It modifies the brain’s neuroadaptation abilities, making it more prone to stress, especially the glutamate transmitters controlling how much is released and its levels. It happens in the reward pathway in the nucleus accumbens.
It affects the stress responses by elevating the stress hormones, which overlap the reward pathway. Hence stress many times results in a relapse of cocaine use.
Cocaine use affects the functioning of the Oribito Frontal Cortex (OFC), which causes the following :
-Cocaine use affects decision-making abilities; the user cannot accept the harmful effects of drug use and lacks insight into oneself.