| Cocaine: Harm Reduction Advice |
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Drug information - Cocaine Cocaine is a powerful stimulant which makes you feel very alert, confident, emotionally fulfilled and full of energy. It is an addictive drug and can be very harmful to health. It lasts about 15-30 minutes so is often taken repeatedly. It is manufactured from the coca plant which grows in regions of South America. It was formerly used (late 1800s) in medicines and ‘soft’ drinks like coca-cola but has been illegal in any form for many years. The international trade in cocaine has grown massively in the last 30 years and is now worth billions of dollars to organised crime. There is probably more violence and murder involved in the cocaine industry than any other drug. Every year there are many large seizures by customs and police in various countries but production remains high, driven by huge demand. Essentially, there are two varieties; cocaine hydrochloride, the powder form which is usually snorted in ‘lines’ or dabbed, and ‘crack’, a purer and more addictive, smoked form which is sold as small ‘rocks’ In the UK, like most western countries, powder cocaine has increased in use over the last few years and purity has fallen at the same time. Patterns of Use In the UK, there used to be very distinct groups who would use cocaine, such as those working in the music industry and city high-fliers. This restriction was down to the very high cost but the price has since fallen dramatically in recent years making it more accessible to a wide range of drug users. Last year in the UK, over 900,000 people took powdered cocaine at least once. It is much more popular among women than many other drugs. Ten years ago cocaine cost about £80 a gram and now it is about half that price. At the same time, purity has fallen to an average of 27% although it can be below 10%. There appears to be two markets of purity and price now for different types of drug user, with the more affluent getting the better quality. Cocaine is ‘cut’ with various other white powder products, some innocuous, some dangerous. Currently, a common adulterant is Levamisole, a worming drug that has caused serious illness and a few deaths among addicts who have consumed large quantities of it. Levamisole causes damage to the immune system and blood vessels. Effects Stimulants like coke, speed or mephedrone all get the heart racing. Cocaine is generally preferred as it also gives a greater sense of confidence and wellbeing than the others. It also suppresses the appetite very effectively. Many people can take it or leave it. They reserve it for special events and take it no more than a few times a year. So long as they do not change their level of consumption of the drug then these occasional users are unlikely to suffer from serious consequences of the drug. However, there is always some risk to the heart from taking any stimulant, particularly repeatedly. The problem is that it is easy to lose control of cocaine use. Users who take the drug more regularly will come to rely on the drug although they often deny it. Harms Cocaine works on the nervous system and makes the heart rate much faster so many of the health issues relate to the heart such as elevated blood pressure, risk of developing heart disease and risk of heart attack. Cocaine damages the membrane in the nose which over time can collapse completely. Cocaine especially crack is certainly one of the most addictive drugs available. It encourages repeat dosing where during one session users may take several lines to maintain their high. As a stimulant, it badly disrupts your sleep patterns and your ability to function with the routine of the rest of the world so puts pressure on family, friends, work and study. For every high there is a downside and cocaine users may feel depressed for a day or two after a big night. Taking a drug like alcohol or diazepam (valium) to combat these negative feelings is a bad move as it encourages you to think there is a chemical solution to every situation. Prolonged use can affect user’s mental capacity. They may become paranoid or delusional or in some extreme cases develop a kind of psychosis. Cocaine is often taken in conjunction with other drugs, there is often an associated high consumption of alcohol and tobacco which is harmful in other ways. Combining cocaine with alcohol can form a third substance, cocaethylene, which is even more damaging to the heart than cocaine alone. Longer term users may become a bit thinner, and their behaviour may become noticeably erratic. They may sniff a lot and scratch their skin. Long-term use of cocaine leads to some delusions and paranoia, full ‘coke psychosis’ is quite rare but psychotic episodes are not. Most deaths are heart related - in 2008, 235 people in UK died of cocaine use. Addiction and Treatment Developing addiction would seem a likely outcome if cocaine is used every weekend. It is hard to determine exactly when someone is getting dependent but when they start selling cocaine to friends to pay for some of their own use then they should be concerned how much they are taking. In any event they will find themselves buying it more frequently and it becoming central to their lives. Some dependent users turn to crime (shop-lifting, burglary) to fund their addiction so cause greater harms to their community and risk imprisonment themselves. Over 12,000 people sought treatment for cocaine last year. There is no substitute treatment for cocaine addiction like there is for heroin. Breaking an addiction can be very tough and relapse is common. Treatment is more like therapy and relies very much on will-power and group support. Often a change of lifestyle is needed to beat the addiction and prevent greater harms to the individual their family and friends. The Law Cocaine is illegal to possess and supply. It is a Class A drug and it is generally agreed that that status is fully deserved. Possession with a small amount may lead to a court appearance and a fine but prison is unlikely. The police may chose to offer to caution you which is still a criminal record. If you have enough to supply a few grams to friends you may be charged with ‘possession with intent to supply’ - it depends on the circumstances of the case but a conviction may lead to fine, community service or even imprisonment. If you are convicted of dealing the drug and making money out it, you will probably be imprisoned, depending on the amount, for two or more years. War on Drugs Drug enforcement agencies in North and South America have been trying to combat cocaine production and supply for many years. They have not been able to break up the big drug ‘cartels’ who run the industry and make vast profits. The organised gangs have enough weapons, money and influence to control officials in many levels of drug law enforcement. In Mexico the drug war has led to over 20,000 killings in the last 3-4 years. |