Lecture 13 - Cocaine Flashcards
1
Q
What is cocaine?
A
- White, crystalline powder derived from coca leaves
- Cocaine base (crack) looks like small, irregularly shaped white rocks
- Cocaine is an intense, euphoria-producing psychomotor stimulant drug with strong addictive potential (induces motor tics, anxiety, arousal etc.)
2
Q
Where can you get cocaine?
A
- Map of principal coca-growing regions of South America (culture/economic success driven by growth of cocaine)
- Distributed and used worldwide
3
Q
Costa Rica in the news Feb 2020
A
- Biggest seizure in history more than five tonnes in a shipping container
- Hidden in 202 suitcases in a consignment of flowers headed for the Netherlands
- Estimated street value 126 million euros
- The driver of the shipment was arrested
4
Q
Australia in the news March 2023
A
- $677 million worth of cocaine seized in Australia’s biggest ever drug bust
- One shipment (2.4 tonnes) was equivalent to half Australia’s estimated annual consumption
- Joint US and Australian operation intercepted shipment off Ecuador
- Seizure was kept quiet and syndicate baited with fake drug off the coast of Perth
- 12 arrests made, with alleged links to Mexican drug cartel
5
Q
What are the origins of cocaine consumption?
A
- Miners
- Traditional use: Bolivian miners chew coca leaves to reduce hunger, fatigue, and pain, helping them endure harsh working conditions
- Economic impact: the global demand for cocaine has led to illegal coca cultivation and drug trafficking, affecting miners’ livelihoods and communities (supplemented economic loss when metal prices fell)
- Cultural significance: coca leaves are deeply ingrained in Bolivian culture, and efforts to support miners should focus on sustainable economic development and alternative livelihoods
6
Q
Describe the major international row over Bolivia’s indigenous Indians rights to chew coca leaves
A
- Major international row with wide-ranging implications for global drugs policy over the right of Bolivia’s indigenous Indians to chew coca leaves, principal ingredient in cocaine
- Bolivia obtained special exemption from the (1961) global drugs convention on narcotic drugs that governs international drugs policy, despite international opposition…
- Bolivia had argued that the convention was in opposition to its new constitution, adopted in 2009, which obliges it to “protect native and ancestral coca as cultural patrimony” and maintains that coca “in its natural state … is not a narcotic”
7
Q
What are the methods of ingestion of cocaine?
A
- Snorting: leads to a high lasting 15-30 minutes but can cause severe nasal damage, including loss of smell and chronic nosebleeds (lead to binges)
- Smoking: results in a rapid, intense high lasting 5-10 minutes, with risks of severe respiratory issues and higher addiction potential
- Injecting: produces an immediate, intense high but carries risks of overdose, infections, and disease transmission through needle sharing
8
Q
What are the behavioural effects of cocaine?
A
- Short term = major euphoria and joy (reward sensation – develop enjoyment/addiction)
- Negative effects when euphoria wears off e.g. insomnia, restlessness, mild depression
- Compulsive motor behaviours
- Can lead to eating disorders because it is an appetite suppressant
- Social/financial implications to user and those around them
- Affects STM and decision making abilities
(Table in notes with more)
9
Q
What is the link between psychology and cocaine?
A
- “The psychic effect … consists of exhilaration and lasting euphoria, which does not differ in any way from the normal euphoria of a healthy person … One senses an increase of self-control and feels more vigorous and more capable of work …” (Freud)
- Freud was high on cocaine for most of his work and prescribed it to many patients
- Saw long-term effects in himself/patients, and moved away from it as a treatment
10
Q
What are the origins of consumption (Coca-Cola)?
A
- Coca-Cola (1906)
- Original formula: Coca-Cola originally contained cocaine derived from coca leaves, marketed as a medicinal tonic in the late 19th century
- Removal of cocaine: by 1904, Coca-Cola began using “de-cocainized” coca leaves, effectively eliminating cocaine from the formula due to growing health concerns and changing societal attitudes
- Cultural evolution: Coca-Cola successfully transitioned to a non-cocaine formula, maintaining its reputation and becoming one of the world’s most popular soft drinks
11
Q
Which neurotransmitters are involved with cocaine action?
A
- Dopamine naturally released into synaptic cleft when doing something that makes us happy
- Cocaine inhibits transporter to increase synaptic levels (inhibits reuptake of dopamine) – higher dopamine in synaptic cleft, leading to highs and symptoms
- DA, NA, 5-HT
- Can also block nerve conduction by inhibition Na+ channels, local anaesthetic
- Dopamine reuptake transporters are blocked by cocaine, resulting in increased dopamine in the synaptic cleft, leading to behavioural symptoms of cocaine use
- Greater interaction with dopamine receptors
12
Q
Describe the relationship between neurotransmitters and behaviour
A
- Rapid high and low
- As increased dopamine in synaptic cleft during cocaine use, leads to euphoria
- As cocaine leaves system and stops blocking reuptake, less dopamine in synaptic cleft, leading to dysphoria (low mood, anxiety etc.) and drives craving
13
Q
Describe the sympathetic nervous system (SNS) activation by cocaine
A
- Activates sympathetic branch
- High and ‘rush’
- But also vasoconstriction, hypertension
- So possibly stroke or intracranial haemorrhage
- Can lead to anxiety as ‘fight or flight’ pathway constantly activated
14
Q
What are the mechanisms of cocaine action?
A
- DA is key
- Microinjections to nucleus accumbens increase locomotor activity (Staton & Solomon, 1984)
- The nucleus accumbens (NAc) is a brain structure that plays a key role in motivation, reward, and decision-making. It’s also involved in addiction, anxiety and depression
15
Q
What are the mechanisms of cocaine action in animals?
A
- Striatum and nucleus accumbens critical in reinforcing effects
(more in table in notes)
16
Q
What are some behavioural effects of cocaine?
A
- Restlessness: users often appear unable to sit still and may seem overly energetic or agitated
- Confusion and disorientation: chronic use can impair cognitive functions, making it difficult for users to recall facts or events
- Paranoia and irritability: long-term use can lead to heightened paranoia and irritability, sometimes escalating to full-blown psychosis
- Insomnia: difficulty sleeping is a common symptom, often leading to exhaustion
- Social withdrawal: users may become isolated, withdrawing from family and friends
17
Q
What are some anatomical/physical effects of cocaine?
A
- Heart damage: cocaine can cause chronic high blood pressure, irregular heartbeats, and increase the risk of heart attacks
- Blood clots: it can lead to blood clots, which may result in strokes or pulmonary embolisms
- Lung diseases: chronic use can lead to lung diseases like chronic bronchitis or pneumonia
- Sinus damage: snorting cocaine damages the mucous membranes in the nose, potentially leading to septal perforations
- Organ stress: cocaine puts significant stress on the liver and kidneys, which can eventually lead to organ failure
18
Q
What are some neurological effects of cocaine?
A
- Dopamine system disruption: cocaine increases dopamine levels in the brain, leading to feelings of euphoria. Over time, this can disrupt the brain’s reward system, making it difficult to experience pleasure without the drug and contributing to addiction
- Cognitive decline: users may experience problems with attention, memory, and executive functions, which can persist even after stopping cocaine use
- Reduced grey matter volume: chronic cocaine use can lead to a reduction in gray matter volume, affecting areas involved in decision-making, emotion regulation, and memory (risky decision making)
- White matter damage: white matter is crucial for communication between different brain regions. Damage to white matter can result in impaired coordination and slower cognitive processing
- Shrinkage of the prefrontal cortex: this part of the brain is responsible for higher-order cognitive functions and emotional regulation. Long-term cocaine use can cause shrinkage in this area (reduce area responsible for making good decisions, reduce impulse control)
19
Q
What did the study by Inada et al. (1992) show?
A
- 11 days continuously iv infusion (to total 60 mg/kg/day)
- 20 mg/kg cocaine challenge
- Schedule produced tolerance
20
Q
What happens to dopamine receptors in cocaine addicts?
A
- Dopamine D2 receptors are lower in addiction (cocaine)
21
Q
What are some pharmacological treatment strategies?
A
- Tricyclic antidepressants most commonly prescribed to treat cocaine addiction
- Dopamine based substances that can reduce the euphoric effects of cocaine or reduce cravings during withdrawal
- Immunisation against cocaine (Carrera et al, 2002; Kosten et al., 2002) – drugs acts in a similar way to cocaine, so that when someone does ingest cocaine it has no effects, so people stop using it if it has no effect
22
Q
What are some behavioural treatment strategies?
A
- Contingency Management (CM): uses a reward-based system to encourage abstinence from cocaine by providing incentives for drug-free urine tests
- Cognitive-Behavioural Therapy (CBT): helps patients develop skills to recognize and avoid triggers, and teaches coping mechanisms to deal with problems associated with drug use
- Therapeutic Communities (TCs): drug-free residences where individuals support each other in understanding and changing their behaviours, fostering long-term recovery
