Epidemiologic data suggest that cocaine use is a serious public health problem because it is highly addictive and is
associated with a variety of neurological complications.
Cocaine, a natural alkaloid, is extracted from leaves of an Andean shrub, Erythroxylon coca. Coca leaves were used by
the native populations to alleviate the rigors of high altitude and to diminish fatigue. Although cocaine was extracted in
pure form from coca in 1860, Europeans became aware of its potential medical complications only after Sigmund Freud's
Über Coca was published in 1884. It was described by Freud as a wonder drug that …show more content…
Ischemic and hemorrhagic strokes are equally likely
after alkaloid cocaine use, whereas cocaine HCl use is more likely (approximately 80% of the time) to cause hemorrhagic
stroke; approximately half the intracranial hemorrhages occurring after cocaine use are from ruptured cerebral saccular
aneurysms or vascular malformations. Acute effects of cocaine include decreased food intake, increased activity,
effusiveness, and diminished fatigue. Repetitive motor activity is observed with higher doses. Overdose can result in
convulsions, hyperthermia, coma, and death. A dose-dependent increase in heart rate and blood pressure can occur.
Regular cocaine use interferes with sleep and suppresses rapid eye movement (REM) sleep. Also, cocaine can lower
seizure threshold. Tolerance and dependence: Some, but not all, of the central effects (eg, euphoria, anorexia,
hyperthermia) reveal tolerance. Tolerance may lead to the escalation of dose required to produce the same CNS effect.
Despite evidence of a recent overall decline in cocaine use, cocaine-related health and criminal justice problems …show more content…
Pregnancy and newborns
Women using cocaine have higher numbers of spontaneous abortions, premature births, and placenta previa than
nonusers. Babies born to these mothers exhibit significant depression in behavior and response to stimuli. Newborn
babies may develop cerebral infarcts. Intrauterine fetal growth may be retarded; microcephaly, small-for-date birth
weights, convulsions, infarcts, cerebral hemorrhages, hypertonicity, motor restlessness, and absence of saccadic
movements on oculovestibular stimuli are more common than in newborns of mothers who do not use the drug.
Congenital malformations are postulated to result from fetal ischemia during the first trimester, and occlusive stroke is a
consequence of ischemia during the third trimester.
Respiratory anomalies in newborns are more noticeable during sleep. Severe respiratory difficulty syndromes and failures
of the awakening mechanism have been documented. Sonography, CT scan, and MRI revealed cortical infarcts and
midline congenital malformations in 15% of infants born to mothers who used cocaine.
Prenatal exposure to cocaine is related to aggressive behavior at age 5