The Use of Cocaine

Those who use this substance commonly experience rapid irregular rhythms of the heart, seizures, elevation of blood pressure, vasospasm of the coronary arteries, acute myocardial infarction or heart attack, stroke, and appetite suppression.  The suppression of appetite will, in many cases, result in malnutrition as they do not consume an adequate diet though the body still requires it [1, 2]. 

People who inhale or “snort” this illicit drug may experience sinusitis, irritation and bleeding of the nasal mucosa, and perforation of the nasal septum.  They sometimes also suffer from bronchitis, cough, bronchospasm, and collapse of the lung. 

Since many of these clients perform a maneuver to enhance the absorption of the agent in which they attempt to blow air out of their lungs while they seal the lips to prevent the release of air from the mouth, other medical complications of the heart and lung such as pneumomediastinum or pneumopericardium can occur [1].

Drug users, whether of cocaine or other illicit substances, experience impairment of judgment, and this may lead to promiscuous sex and unprotected intercourse.  This places them at risk for the acquisition of sexually transmitted diseases such as human immunodeficiency virus (HIV).  Additionally, they become at risk for transmission of viral hepatitis and HIV when they share needles and syringes with other people [1, 2].

Though medication to control cocaine-induced or withdrawal seizures is necessary, there may not be any benefit to the use of these agents for prevention of seizures.  Moreover, it is questionable whether psychotropic medication for depression, anxiety, bipolar disorder, or schizophrenia are effective in the management of these comorbid conditions [1]. 

Nevertheless, the clinician can prescribe lithium for cocaine users who also have manic-depressive illness, and antipsychotic agents will likely have some benefit for patients with schizophrenia who also use cocaine.  The essential element for those who use cocaine, however, is psychosocial treatment, and in many instances, this can take place on an outpatient basis [1, 2].

The use of illicit drugs such as cocaine continues to cause much morbidity and mortality across the globe.

1. Work Group on Substance Use Disorders, Kleber, H.D., Weiss, R.D., Anton, R.F., et al.:  APA Practice Guideline for the Treatment of Patients with Substance Use Disorders, Second Edition.  American Psychiatric Association, 2007.
2. National Institute on Drug Abuse.  (2013).  DrugFacts:  Cocaine.  Retrieved April 12, 2015.
3. The photo shows drug paraphernalia and is reprinted with permission from Centers for Disease Control and Prevention/Debora Cartagena.

The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.