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Toxins Apr 2022Cocaine is one of the most consumed stimulants throughout the world, as official sources report. It is a naturally occurring sympathomimetic tropane alkaloid derived... (Review)
Review
Cocaine is one of the most consumed stimulants throughout the world, as official sources report. It is a naturally occurring sympathomimetic tropane alkaloid derived from the leaves of , which has been used by South American locals for millennia. Cocaine can usually be found in two forms, cocaine hydrochloride, a white powder, or 'crack' cocaine, the free base. While the first is commonly administered by insufflation ('snorting') or intravenously, the second is adapted for inhalation (smoking). Cocaine can exert local anaesthetic action by inhibiting voltage-gated sodium channels, thus halting electrical impulse propagation; cocaine also impacts neurotransmission by hindering monoamine reuptake, particularly dopamine, from the synaptic cleft. The excess of available dopamine for postsynaptic activation mediates the pleasurable effects reported by users and contributes to the addictive potential and toxic effects of the drug. Cocaine is metabolised (mostly hepatically) into two main metabolites, ecgonine methyl ester and benzoylecgonine. Other metabolites include, for example, norcocaine and cocaethylene, both displaying pharmacological action, and the last one constituting a biomarker for co-consumption of cocaine with alcohol. This review provides a brief overview of cocaine's prevalence and patterns of use, its physical-chemical properties and methods for analysis, pharmacokinetics, pharmacodynamics, and multi-level toxicity.
Topics: Cocaine; Dopamine; Ethanol
PubMed: 35448887
DOI: 10.3390/toxins14040278 -
ACS Chemical Neuroscience Oct 2018In this Review, we consider the story of cocaine from its humble origins in South America to its status as one of the most abused substances in 21st century society. The... (Review)
Review
In this Review, we consider the story of cocaine from its humble origins in South America to its status as one of the most abused substances in 21st century society. The synthesis and biosynthesis of cocaine are discussed, as well as its pharmacokinetics, metabolism, pharmacology, and importance in modern neuroscience and molecular imaging.
Topics: Cocaine; Crack Cocaine; Dopamine Uptake Inhibitors; History, 19th Century; History, 20th Century; History, 21st Century; Humans
PubMed: 29630337
DOI: 10.1021/acschemneuro.8b00117 -
Annals of Burns and Fire Disasters Jun 2020The paper describes the presentation and management of patients presenting with crack cocaine induced upper airway injury. The study involved a retrospective clinical...
The paper describes the presentation and management of patients presenting with crack cocaine induced upper airway injury. The study involved a retrospective clinical series of six patients with crack cocaine induced upper airway injury. Demographics, symptoms, physical exam, flexible laryngoscopy findings, treatment and intervention were recorded. All patients with crack cocaine induced thermal injury presented with mouth or throat pain plus at least one other laryngeal symptom, such as globus sensation, dysphagia or throat tightness. On physical exam, the supraglottis was the most common subsite of endolaryngeal injury. The only statistically significant finding was the number of subsites on initial physical exam and flexible laryngoscopy and need for airway intervention (p = 0.001). Airway intervention was required in one patient, while the remaining patients were closely observed until resolution of symptoms. Upper airway injury should be suspected in patients who present with pain and laryngeal symptoms after smoking crack cocaine.
PubMed: 32913433
DOI: No ID Found -
Trends in Psychiatry and Psychotherapy 2017Impairments involving inhibitory control have been considered central deficits in drug users, but it appears that dysfunctions may be specific to users' drug of choice.... (Review)
Review
OBJECTIVE
Impairments involving inhibitory control have been considered central deficits in drug users, but it appears that dysfunctions may be specific to users' drug of choice. This article aims to review recent findings on inhibitory control impairment in samples of crack and/or cocaine users.
METHODS
Searches were conducted on the PubMed, PsycINFO, and Web of Knowledge databases in two stages according to eligibility criteria. Initially, databases were searched and the titles and abstracts of results were analyzed and then selected articles were read in full. Inclusion criteria were: empirical articles written in English, Portuguese, or Spanish, published in the last ten years and involving the assessment of inhibitory control in crack and/or cocaine users.
RESULTS
The database searches returned a total of 3,796 titles, 56 of them were selected initially and then a further 20 were excluded. Thirty-six articles were included in this review. In 90% of the studies reviewed the presence of inhibitory control deficits was reported, verified by impaired cognitive processing and response monitoring, as well as high levels of impulsiveness, regardless of the pattern of crack and/or cocaine consumption (recreational or chronic). Former users showed high levels of impulsiveness even after long periods of abstinence.
CONCLUSIONS
Crack and/or cocaine users may have inhibitory control deficits, irrespective of different consumption patterns. High levels of impulsiveness can represent a factor of vulnerability to drug use and relapse.
Topics: Cocaine-Related Disorders; Cognition; Crack Cocaine; Drug Users; Executive Function; Humans; Inhibition, Psychological
PubMed: 28813109
DOI: 10.1590/2237-6089-2016-0043 -
Revista de Neurologia Apr 2019Cognitive effects caused by cocaine and crack consumption, especially deficits in executive functions may increase the likelihood of drug-seeking behaviour and interfere... (Comparative Study)
Comparative Study Review
INTRODUCTION
Cognitive effects caused by cocaine and crack consumption, especially deficits in executive functions may increase the likelihood of drug-seeking behaviour and interfere with the ability of users to assimilate and participate in rehabilitation programs.
AIM
To determine in early abstinence the state of executive functions, the impulsiveness and craving in cocaine and crack consumers.
SUBJECTS AND METHODS
This cross-sectional study functions, with a sample of 60 male aged between 31.38 ± 7.26 years old, distributed in three groups: inhaled cocaine users (CDP-I; n = 15), with 23.13 ± 7.2 age of onset of consumption; crack cocaine users (CDP-C; n = 26), with 20.81 ± 4.21 age of onset of consumption, and a control groups of no-addiction individuals (n = 19). Sociodemographic, clinical and cognitive assessments were applied.
RESULTS
The data showed that significant differences in socioeconomic level score and impulsiveness. Consumer groups have with lower scores with respect the control group. CDP-C group showed poor performances compared to the CDP-I and control groups, in the Berg Test, Tower of London, numbers in the direct order and subtraction. CDP-I group showed less score in planning compare with the other two groups.
CONCLUSIONS
In early abstinence crack users manifest a greater number of deficits, mainly in working memory, planning and cognitive flexibility.
Topics: Adult; Alcoholism; Cocaine-Related Disorders; Cognition; Cognition Disorders; Crack Cocaine; Craving; Cross-Sectional Studies; Executive Function; Female; Gambling; Humans; Impulsive Behavior; Male; Memory, Short-Term; Mexico; Neuropsychological Tests; Socioeconomic Factors; Substance Withdrawal Syndrome; Theory of Mind
PubMed: 30906976
DOI: 10.33588/rn.6807.2018119 -
International Journal of Environmental... Mar 2023The aim of this manuscript is to understand the impact of childhood sexual abuse on the development of Post-Traumatic Stress Disorder (PTSD), Human Immunodeficiency...
The aim of this manuscript is to understand the impact of childhood sexual abuse on the development of Post-Traumatic Stress Disorder (PTSD), Human Immunodeficiency Virus (HIV) exposure. and parental neglect in crack cocaine users, considering the role of gender. This study is a secondary database analysis of a sample from a multicenter cross-sectional study with 715 crack cocaine users receiving outpatient treatment in public mental health networks in six Brazilian capitals. Prevalence ratios were estimated by Poisson regression. In crack cocaine users with childhood sexual abuse, traumatic experiences seem to remain fixed through the development of Post Traumatic Stress Disorder (PTSD) in adulthood. Crack cocaine users with childhood abuse and PTSD in adulthood showed more sexual risk behaviors, including outcomes such as HIV (PR = 3.6 < 0.001 for childhood abuse and PR = 3.7 < 0.001 for PTSD). Furthermore, this traumatic trajectory affects the functional ability of crack cocaine users, especially women, to work thus impacting their inclusion and sense of social belonging. Such a chain seems to be reflected in the establishment of a circle of transgenerational transmission, to the extent that subjects with a history of abuse and PTSD reported more parental neglect towards their children. This study reinforces the importance of preventive public policies regarding early socio-emotional vulnerabilities and the need to support families, especially women, to avoid HIV and self-destructive outcomes such as crack cocaine use.
Topics: Humans; Female; Child; Crack Cocaine; HIV; Cross-Sectional Studies; Sexual Behavior; Cocaine-Related Disorders; HIV Infections
PubMed: 37047901
DOI: 10.3390/ijerph20075285 -
Gender differences in progression to crack-cocaine use and the role of sexual and physical violence.Revista Brasileira de Psiquiatria (Sao... Nov 2022This study aimed to evaluate whether progression from first drug use to crack-cocaine use differs according to gender, and whether the report of sexual or physical...
OBJECTIVE
This study aimed to evaluate whether progression from first drug use to crack-cocaine use differs according to gender, and whether the report of sexual or physical violence impacts the time of progression.
METHODS
We interviewed 896 crack-cocaine users (548 men; 348 women) from addiction treatment units. Cox regression models evaluated the time of progression from first drug use to crack use. We analyzed gender differences according to the absence or presence of sexual or physical violence, also considering whether violence, when present, had occurred before or after the onset of crack use.
RESULTS
Women presented a faster progression to crack use regardless of exposure to sexual or physical violence (p < 0.05). Compared to unexposed men, there was a similar progression for men exposed to sexual or physical violence before the first use of crack (p = 0.167 and p = 0.393, respectively). In both genders, we observed a faster progression among individuals exposed to these types of violence after the onset of crack use (p < 0.01).
CONCLUSIONS
We found a faster progression to crack use among women and among individuals exposed to sexual and physical violence after the onset of crack use. These results encourage differentiated treatment strategies, focused on gender and individual characteristics.
Topics: Female; Humans; Male; Crack Cocaine; Physical Abuse; Sex Factors; Sexual Behavior; Cocaine-Related Disorders; Substance-Related Disorders
PubMed: 36409555
DOI: 10.47626/1516-4446-2021-2248 -
Brazilian Oral Research Jun 2017Crack cocaine use appears to have an impact on oral conditions. However, changes in the salivary flow among crack users have not been fully clarified. The aim of this...
Crack cocaine use appears to have an impact on oral conditions. However, changes in the salivary flow among crack users have not been fully clarified. The aim of this study was to compare stimulated salivary flow and the occurrence of hyposalivation between crack users and non-users. A cross-sectional study was conducted involving 40 crack users and 40 controls matched for sex, age, and smoking habits. Interviews were conducted to acquire data on the perception of dry mouth (xerostomia) and drug use. Stimulated salivary flow was determined using the spitting method. A significant reduction in stimulated salivary flow was found among crack users in comparison to non-users (1.02 vs. 1.59 ml/min). A total of 42.5% and 15% of crack users had very low and low stimulated salivary flow, respectively. Moreover, 65% of users reported xerostomia in comparison to 37.5% non-users (p < 0.012). No significant association was found between xerostomia and hyposalivation (p = 0.384). A multivariate analysis revealed that individuals older than 26 years of age, those with a low household income, and crack users (prevalence ratio: 2.59) had a significant association with the occurrence of hyposalivation. A significant association was found between the use of crack and reduced salivary flow. The use of crack was associated with the occurrence of hyposalivation in the multivariate analysis.
Topics: Adolescent; Adult; Case-Control Studies; Cocaine-Related Disorders; Crack Cocaine; Cross-Sectional Studies; DMF Index; Female; Humans; Male; Middle Aged; Multivariate Analysis; Salivation; Secretory Rate; Statistics, Nonparametric; Surveys and Questionnaires; Tobacco Use; Xerostomia; Young Adult
PubMed: 28591239
DOI: 10.1590/1807-3107BOR-2017.vol31.0042 -
European Neuropsychopharmacology : the... Oct 2021Cocaine use entails severe health- and social-related harms globally. Treatment options for cocaine dependence are highly limited. Benefits of cannabinoids for addiction... (Review)
Review
Co-exposure of cocaine and cannabinoids and its association with select biological, behavioural and health outcomes: A systematic scoping review of multi-disciplinary studies.
Cocaine use entails severe health- and social-related harms globally. Treatment options for cocaine dependence are highly limited. Benefits of cannabinoids for addiction have been documented, making it opportune to examine existing data on the possible outcomes associated with cannabinoids and cocaine co-use. We conducted a systematic scoping review following the PRISMA guidelines of peer-reviewed, English-language studies published from 2000 to 2021 in four databases (Medline, Web-of-Science, CINAHL Plus, and PsycInfo), assessing the co-exposure of cannabis/cannabinoids with cocaine on behavioural, biological or health outcomes. Both quantitative and qualitative, as well as humans and pre-clinical animals' studies (n=46) were included. Pre-clinical studies (n=19) showed mostly protective effects of cannabidiol (CBD) administration on animal models of addiction (e.g., cocaine-craving, -relapse, and -withdrawal) and cocaine-toxicity. Tetrahydrocannabinol (THC) had more inconsistent results, with both protective and counter-protective effects. Human studies (n=27) were more heterogeneous and assessed natural ongoing cannabis and cocaine use or dependence. Quantitative-based studies showed mostly enhanced harms in several outcomes (e.g., cocaine use, mental health); two available clinical trials found no effect upon CBD administration on cocaine-related treatment outcomes. Qualitative data-based studies reported cannabis use as a substitute for or to alleviate harms of crack-cocaine use. While pre-clinical studies suggest a potential of cannabinoids, especially CBD, to treat cocaine addiction, the few trials conducted in humans found no benefits. Cannabis co-use by cocaine users commonly presents a risk factor, entailing enhanced harms for users. More rigorous, controlled trials are still necessary to investigate cannabinoids' potential considering pre-clinical findings and reported benefits from specific drug users.
Topics: Animals; Cannabidiol; Cannabinoids; Cannabis; Cocaine-Related Disorders; Crack Cocaine; Dronabinol; Hallucinogens
PubMed: 34273801
DOI: 10.1016/j.euroneuro.2021.06.002 -
Ciencia & Saude Coletiva Mar 2019This paper aims to describe the dream content of crack cocaine users as per their view and analyze its interference in the drug withdrawal process. This is a qualitative...
This paper aims to describe the dream content of crack cocaine users as per their view and analyze its interference in the drug withdrawal process. This is a qualitative research with 21 crack cocaine users. Consuming crack cocaine during the dream meant a proof of failure or compensatory pleasure or warning of potential relapse; not consuming the crack cocaine meant the emergence of withdrawal symptoms or the success at overcoming drug dependence. Dream interpretation may lead users to craving and relapse. The outcomes may contribute to effective therapeutic interventions.
Topics: Adult; Cocaine-Related Disorders; Crack Cocaine; Craving; Dreams; Female; Humans; Male; Middle Aged; Recurrence
PubMed: 30892529
DOI: 10.1590/1413-81232018243.05072017