The Routes of Cocaine Administration and Their Effects

Introduction

Cocaine, a potent stimulant derived from the coca plant, has been used for centuries for its euphoric and anesthetic properties. The way cocaine is administered significantly impacts its absorption into the bloodstream and its subsequent effects on the body and brain. In this blog post, we will explore the different routes of cocaine administration, their effects, and the potential risks associated with each (Rosenthal,2022):

1)Topical:

1. Medical Use: Cocaine is occasionally used in medical settings as a local anesthetic, typically applied to the mucous membranes of the nose, mouth, or throat.
2. Absorption: Quickly absorbed into the bloodstream, providing rapid anesthetic effects.
3. Risks: While topical applications minimize systemic effects, absorption, and potential adverse reactions are risky.

2)Oral:

1. Absorption: Poorly absorbed due to vasoconstriction and breakdown in the stomach.
2. First-Pass Effect: A significant portion of orally ingested cocaine is metabolized by the liver before reaching the brain.
3. Alkaline Substances: Mixing cocaine with an alkaline substance can improve oral absorption.

3)Snorting (Insufflation):

• Absorption: Absorbed through the nasal mucous membranes, reaching the brain within minutes.
• Vasoconstriction: Cocaine's vasoconstrictor properties limit absorption.
• Risks: Nasal irritation, nosebleeds, and potential for nasal septum perforation.

4)Smoking:

• Crack Cocaine: The freebase form of cocaine, which can be smoked.
• Absorption: Rapidly absorbed into the bloodstream through the lungs, reaching the brain quickly.
• Risks: Lung damage, respiratory problems, and increased risk of cardiovascular complications.

5)Injection:

1. Absorption: Directly into the bloodstream, leading to the highest blood levels and the fastest onset of effects.
2. Risks: Increased risk of infection, blood-borne diseases, and overdose.

6)Distribution, Metabolism, and Elimination

1. Distribution: Cocaine is widely distributed throughout the body tissues.
2. Metabolism: Primarily metabolized by the liver enzymes.
3. Elimination: Excreted through urine, sweat, saliva, and breast milk.

7)Effects of Cocaine

• Neurotransmitter Effects: Cocaine blocks the reuptake of dopamine, norepinephrine, and serotonin, leading to increased levels in the brain.
• Physiological Effects: Increased heart rate, blood pressure, respiratory rate, and body temperature; constricted blood vessels; dilated pupils; and decreased appetite.
• Physiological Effects: Increased heart rate, blood pressure, respiratory rate, and body temperature; constricted blood vessels; dilated pupils; and decreased appetite.
• Negative Effects: Anxiety, paranoia, aggression, hallucinations, and potential for psychosis.

8)Medical and Therapeutic Uses

• Local Anesthetic: Used in oral and eye surgeries due to its vasoconstrictor properties.

9)Adverse Effects

1. Cardiovascular Risks: Increased risk of heart attack, stroke, arrhythmias, and sudden death.
2. Respiratory Problems: Lung damage, difficulty breathing, and pulmonary edema.
3. Neurological Effects: Seizures, headaches, and cognitive impairments.
4. Psychological Effects: Anxiety, depression, paranoia, and psychosis.
5. Drug Interactions: Dangerous interactions with alcohol, other drugs, and certain medications.

Overdose: This can be fatal, especially when combined with other substances.

Conclusion

The route of cocaine administration significantly influences its effects and the associated risks. Understanding these routes is crucial for individuals seeking information about cocaine abuse and its consequence

s. If you or someone you know is struggling with cocaine addiction, please reach out to a healthcare professional or a substance abuse treatment facility for help.

References

•  Rosenthal, M. S. (2022). Drugs: Mind, Body, and Society (2nd ed.). Oxford University Press Academic US. https://bookshelf.vitalsource.com/books/9780197585313

A History of Cocaine: From Sacred Leaf to Street Drug

 

For millennia, the coca plant played a central role in the lives of Andean people. Native South Americans chewed the leaves to combat altitude sickness, increase energy, and aid digestion (Rosenthal, 2022). It was also deeply intertwined with religious and ceremonial practices. When Spanish conquistadors arrived in the 16th century, they attempted to suppress coca use, deeming it idolatrous; however, according to Rosenthal (2022), they soon realized the plant's practical importance in maintaining productivity among the indigenous population.

The Rise of Cocaine

Rosenthal (2022), explains the rise of cocaine:

• In the 19th century, scientists isolated the active ingredient in coca leaves: cocaine.
• Cocaine was used to treat a variety of ailments, from pain to depression, and was initially hailed as a medical miracle.
• Sigmund Freud, a prominent figure in psychology, was an early proponent of cocaine, though his enthusiasm waned after a friend died of an overdose.

The Dark Side of Cocaine

Despite its initial promise, cocaine's popularity soon began to decline as its addictive properties became apparent. The drug's association with crime and marginalized communities further fueled negative perceptions. In the early 20th century, laws were enacted to restrict the production and distribution of cocaine.

The Crack Cocaine Epidemic

Cocaine's resurgence in the 1970s and 80s was marked by the emergence of crack cocaine, a more potent and addictive form of the drug. The crack epidemic disproportionately affected marginalized communities, particularly Black urban populations. This led to harsh sentencing laws that further exacerbated racial disparities in the criminal justice system.

A Complex History

The history of cocaine is a complex one, filled with both promise and peril. From its sacred origins in the Andes to its role as a popular recreational drug, cocaine has had a profound impact on societies around the world. Understanding its history is essential for developing effective strategies to address the ongoing challenges associated with substance abuse.

References

1.  Rosenthal, M. S. (2022). Drugs: Mind, Body, and Society (2nd ed.). Oxford University Press Academic US. https://mbsdirect.vitalsource.com/books/9780197585313

The Evolving Landscape of Addiction: The Impact of Synthetic Drugs

The field of addiction treatment is constantly evolving, and one of the most significant challenges in recent years has been the rise of novel synthetic drugs. These substances, such as cathinones and synthetic cannabinoids, pose serious health risks due to their severe side effects, unpredictable interactions, and ability to evade routine drug screenings. 

A Case Study

A recent case study published in Cureus highlights the complexities of treating patients who are using synthetic drugs. A patient on buprenorphine/naloxone therapy for opioid dependence was experiencing symptoms of sedation, agitation, and paranoia. Despite negative results from initial screenings, subsequent analysis revealed the presence of synthetic cannabinoids and cathinones. This case underscores the importance of vigilant monitoring and specialized toxicology testing in addiction treatment.

The Impact of Synthetic Drugs

The emergence of synthetic drugs has had a profound impact on the field of addiction (Awasthi, 2023) :

• Increased Complexity in Treatment: The unpredictable nature of these substances makes it difficult to manage patients using them.
• Evasion of Routine Screening: These drugs often evade standard screenings, making it harder to identify and address their use.
• The strain on Healthcare Systems: The rise in synthetic drug use has put a strain on healthcare resources.
• Need for Enhanced Toxicology Testing: More advanced testing methods are required to identify and monitor these substances.
• 
  Public Health Education: Increased education is needed to raise awareness about the dangers of synthetic drugs.

Addressing the Challenges

To address the challenges posed by synthetic drugs, addiction treatment providers must (Awasthi, 2023):

• Stay Informed: Keep current on the latest information about synthetic drugs and their potential effects.
• Utilize Specialized Toxicology Testing: Invest in advanced testing methods to identify these substances.
• Enhance Patient Education: Educate patients about the risks of synthetic drugs and encourage them to be honest about their substance use.
• Collaborate with Other Healthcare Professionals: Work with other specialists to provide comprehensive care for patients who are using synthetic drugs.

As the landscape of addiction continues to evolve, healthcare providers need to adapt

their approaches and stay informed about emerging trends. By understanding the challenges posed by synthetic drugs and implementing effective strategies, we can improve outcomes for individuals struggling with addiction.

 References

• Awasthi, Harshal. (​2023). Abuse of Synthetic Cannabinoids and Cathinones in a​ ​Patient on Buprenorphine-Naloxone Treatment: A Case Report. Cureus. 15​. 10.7759/cureus.48386. 

The Intersection of Mental Illness and Homelessness: A Perilous Combination

 The intersection of mental illness and homelessness is a complex and often overlooked issue. When individuals struggling with mental health disorders find themselves without a stable place to live, the consequences can be devastating. Isolation within the homeless communities can exacerbate mental health symptoms, leading to a vicious cycle that is difficult to break.

The Challenges of Mental Illness in the Homeless Community

• Stigma and Discrimination: People experiencing homelessness often face stigma and discrimination, and those with mental illnesses may be particularly vulnerable to prejudice. This can lead to feelings of isolation, shame, and a lack of social support.
  
• Limited Access to Care: Homeless individuals may have limited access to mental health services due to financial constraints, lack of transportation, or difficulty navigating the healthcare system. This can result in untreated or undertreated mental health conditions.
• Trauma and Stress: Many homeless individuals have experienced traumatic events, such as abuse, violence, or loss. These experiences can contribute to the development or exacerbation of mental health disorders. 
• Substance abuse: The rates of substance abuse are higher among homeless individuals, and the combination of mental; illness and substance abuse can create a particularly challenging situation.
• Lack of Social Support - Isolation within the homeless community can lead to a lack of social support, which can exacerbate mental health symptoms and make it difficult to cope with life's challenges.

The Consequences of Isolation

1. Increased Risk of Self-harm - Individuals with untreated mental health conditions who are isolated within the homeless community may be at increased risk of self-harm or suicide.
2. Difficulty Reintegrating into Society: The challenges of homelessness, combined with the stigma and discrimination associated with mental illness, can make it difficult for individuals to reintegrate into society.
3. Criminal Justice Involvement: Untreated mental health conditions can contribute to criminal justice involvement, as individuals may engage in behaviors that are driven my their mental health.

Addressing the Issue

To address the challenges faced by individuals with mental illness who are homeless, it is essential to implement comprehensive strategies that focus on:

1. Affordable Housing: Providing affordable housing options can help individuals with mental illness escape the cycle of homelessness and improve their overall well-being.
2. Mental Health Services: Expanding access to mental health services, including crisis intervention, medication management, and therapy, can help individuals manage their symptoms and improve their quality of life.Support Services: Offering supportive services, such as job training, life skills development, and case management, can help individuals with mental illness develop the skills they need to succeed.
3. Stigma Reduction: Raising awareness about mental illness and challenging negative stereotypes can help reduce stigma and discrimination.
4. Community Partnerships: Collaborating with community organizations, healthcare providers, and government agencies can help create a more supportive environment for individuals with mental illness who are homeless.
5. By addressing these issues, we can help individuals with mental illness who are homeless break free from the cycle of isolation and build a more fulfilling life.

A Night on the Streets: A Homeless-ish Experience

 Saturday, August 17, 2024

Last night, I found myself sleeping on the concrete patio of a church alley. My two companions, or "posse" as I called them, were just across the way in the grass. It wasn't the most comfortable resting place but surprisingly safe. Cars passed by occasionally, and a few other homeless folks wandered through without incident.

Saturday was a quiet day, but it was tough on me psychologically. Addiction is a major challenge for homeless people, and it can be difficult to stay clean on the streets. I've had my fair share of struggles with substance abuse, but I'm trying to stay strong. Avoiding drugs and alcohol is crucial, not just for personal well-being, but also to avoid dangerous situations.

Many places that serve free meals were closed for the weekend, but I'm grateful for the organizations that provide these services. They're doing incredible work, and I'm amazed by their dedication. The volunteers put up with a lot, from verbal abuse to long hours.

I had to work a night shift, so I had to figure out how to get clean. I ended up taking a quick wash in a hospital bathroom before my shift. It wasn't ideal, but it was better than nothing.

As I sat in the nursing lounge, trying to rest before my shift, I couldn't help but think about the challenges I was facing. The constant fear of not having enough food, the uncertainty of where would sleep, and the constant struggle to stay clean were all weighing heavily on me. 

Loneliness was also a significant factor. Being homeless can be isolating, and it can be difficult to connect with others. I missed having a stable place to call home and the comfort of familiar surroundings.

Despite the difficulties, I was determined to persevere. I knew that giving up wasn't an option. With each passing day, I was learning more about survival on the streets and developing a stronger sense of resilience.

I was also beginning to appreciate the small things in life that I had taken for granted. A warm meal, a comfortable bed, and a sense of security were all things that I had once taken for granted. Now, I realized how precious these things were. 

The experience of being homeless has also taught me the importance of human connection. The kindness and compassion that I have encountered from strangers have been a source of strength and hope. I have learned that even in the darkest of times, there is always someone willing to help.

I'm still learning the ropes of being homeless, but I'm determined to make it through. I'll share more about my experiences in future posts. 

Additional Thoughts

• The importance of community: Being homeless can be isolating, but it's important to find a community of people who understand what you're going through.
• The value of hope: Even in the darkest of times, it's important to hold onto hope. Hope can give you the strength to keep going, even when things seem impossible.
• The importance of self-care: Taking care of yourself is essential when you're homeless. This includes eating healthy food, getting enough sleep, and staying active. 
• The power of gratitude: practicing gratitude can help you to focus on the positive things in your life, even when things are tough. 

This post was pretty boring but my next ones will be more exciting.  I will add that my morale was pretty low Sat and I was also dealing with the self-doubt voices that plagued my mind with phrases like You’ll never make it. You're going to start using again and show up to work fucked up and get your contract terminated. And then of course there is the frequent phrase that you are not even physically strong enough to make it through the sweltering heat and physical exhaustion of constantly moving. Another one kept focusing in on my previous addiction and how I knew that meth was everywhere and accessible. All of these voices and phrases turned out to be wrong in the end. And spoiler alert this whole experience was just what I needed. I was getting weak in my fight with the addiction and this experience broke me down a little It was necessary for the reset to fuel my victory. Anyway take care and until I post again – take care of yourself. 

Day One: Unexpected Journey

I never thought I’d be writing this. On the night of August 15th, 2024, my world imploded. The money I’d scraped together to escape a toxic situation and start anew had vanished. A week of work, and the promise of daily pay, became an unattainable dream. Without my old phone number, access to that money was weeks away. Panic set in. Motel rent, bus fares, and Lyft rides had devoured my last dollars. A generous friend had already loaned me $200. The stark reality of homelessness loomed, a week away. Tears fell as I faced the terrifying unknown. But then, something unexpected happened. A flicker of determination ignited. I refused to be a victim. I started planning, researching, and preparing. Armed with an older Android, Google Maps, and a relentless spirit, I faced the day with a newfound sense of purpose. 

The morning was a blur of packing and farewells. The bus ride to the city center was a sweaty ordeal, filled with fear and uncertainty. Yet, I followed my plan, arriving at the first homeless shelter. Inside, I found air conditioning, food, water, and a sense of relief. As the day wore on, I explored the city, meeting others who shared my plight. There was a camaraderie, a sense of community that surprised me. And amidst the struggle, I discovered an unexpected source of support: religious organizations. I’ve never been particularly religious, but the kindness and compassion I witnessed from these groups was overwhelming. They provided food, water, and a safe place to rest. Their actions spoke volumes about their faith, and I found myself developing a newfound respect for their work. As the sun began to set, I found a safe spot to sleep. Exhausted but determined, I drifted off, filled with a strange sense of peace. I had survived the first day. Tomorrow is a new day, and I'll face it with courage and resilience. I’ve learned that even in the darkest of times, there is hope, strength, and a surprising amount of human kindness.

What Would You Keep? A Journey of Loss and Discovery

Have you ever considered the possessions you'd cling to in sudden upheaval? This thought experiment invites you to confront the fragility of material things and the enduring power of what truly matters.

Imagine a world turned upside down. You must flee your home, grasping only what you can carry. The challenge? Limiting yourself to just three items. These could be tangible objects, digital treasures, or even abstract concepts. Take a moment to envision your choices.

Now, a cruel twist of fate: one item must be left behind. Which one? The decision is yours to make. As you relinquish this possession, explore the emotions that arise. What does this item symbolize? How does it contribute to your sense of self?

The journey continues, fraught with adversity. You find refuge, lose it, and face the elements alone. A storm rages, claiming one of your remaining items. The final blow comes in the form of theft, leaving you with nothing.

This exercise is a stark portrayal of life's unpredictability. It challenges us to question our priorities and reevaluate what truly enriches our lives. Material possessions, while comforting, are ultimately impermanent. Perhaps it's time to invest in experiences, relationships, and personal growth – elements that withstand the test of time.

As you reflect on this thought experiment, consider the items you chose and the emotions they evoked. Did you find it difficult to let go? What did this exercise reveal about your values and priorities? Sharing your insights can spark meaningful conversations and deepen your understanding of what truly matters.

Remember, while possessions can bring joy, it's the intangible aspects of life that create lasting fulfillment. By confronting the possibility of loss, we gain a profound appreciation for the richness that exists beyond the material world.

 References

https://www.humankindwichita.org/wp-content/uploads/2023/06/Sleep-Out-ICTToolkit.pdf