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Monday, June 27, 2022

Coke (cocaine): the high and… the harder the fall 

Christian Mirre
Christian Mirre
PhD. in Sciences, holds a Doctorat d'Etat ès Sciences from the University of Marseille-Luminy and has been a long term biologist at the French CNRS's Section of Life Sciences. Currently, representative of the Foundation for a Drug Free Europe.

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Coke: the high and… the harder the fall

The beginning

Cocaine named from the Quechua “kúka” is a natural alkaloid synthezised by the coca plant (family of Erythroxylaceae) as a secondary metabolitefor its protection. It is extracted from the leaves to an amount of 0.3 to 1.5%. The use of the coca for religious, medicinal and stimulant purposes has been known since pre-Inca times. The people used to chew coca leaves for at least 8000 years to relieve hunger, to alleviate strenuous activities and also as a stimulant.

Dry leaves are also used for tea: the “mate de coca”. Initially starting on the Andean ridge (South America), the use of coca leaves has then spread to neighbour countries as Chile, Uruguay, Argentina and Brazil. From the 16th Century it started to be exported and from the 19th Century with its chemical extraction as the psychoactive cocaine powder form it reached the whole world with the development of the routes of communication. Nevertheless, Evo Morales, the President of Bolivia (2006 to 2019) used to say: “la coca no es cocaina” (the coca is not cocaine). 

Nowadays, the cocaine use although under the control of international Conventions, is a matter of public health due to its great addictive potential and toxicity. This is resulting in great psychological dependence, physical disorders  and side effects, producing harming impacts on the individual, the familial cell, the workplace, the society, and finally on the economy of the country. Usually available as an hydrochloride salt (formula: C17H22ClNO4) cocaine has limited medical use as an anaesthetic and vasoconstrictor. This contrasts with the increasing misuse of the cocaine as a central nervous system stimulant since the early years of the twentieth century. The cocaine became popular in the sixties through artists and mass media.

In illicit use and search of the “high”, the cocaine powder (Coke, Snow, etc.) is ritually sniffed/snorted by 69% of the users, from “lines” and absorbed through the nasal mucosa and less commonly (for 2%) intraveinuously injected. The free base, sometimes known as crack, a crystal form, is smokable or heated and inhalated as fumes (for 26%). The ingestion (2% of the users) leads to a loss of psychoactive activity due to enzymatic hydrolysis in the gut.

A typical dose of cocaine or crack for a shoot is 100–200 mg.

Historical points…

  • In 1859, Dr. Paolo Mantegazza, (Italy) back from Peru, described the use of coca as medicine;
  • In 1860, the chemist Albert Niemann (Germany) isolated and coined the name “cocaine”; 
  • In 1863, Angelo Mariani French pharmacist, using coca leaves macerated in Bordeaux wine created the tonic drink “Vin Mariani”;
  • In 1885, the U.S. manufacturer Parke-Davis sold cocaine in various forms, stating that cocaine products “supply the place of food, make the coward brave, the silent eloquent and render the sufferer insensitive to pain.”
  • In 1886, John S. Pemberton (USA), pharmacist veteran of the Secession war and morphine user  changed his Pemberton’s French Wine Coca in a non-alcoholic then non-cocaine (replaced by caffeine) tonic beverage, inventing the famous “Coca-Cola”.

In Europe

Most of the cocaine available in Europe, using well-organized networks, continues to be smuggled into the largest container ports of the European Union (EU) located in Belgium (Antwerp), the Netherlands (Rotterdam) and Spain (Valencia and Algeciras). In addition to Hamburg (Germany), ports in France (Le Havre, Dunkerque, Marseille), Romania (Constanta), and Italy (Gioia Tauro) have also become significant cocaine entry points. The German authorities have attributed the recent increase in seizures in the port of Hamburg to the activities of Balkan and Albanian-speaking organised crime networks (BundesKriminalAmt, 2021). 

The Southeast European Law Enforcement Center (SELEC) reported that in this part of Europe alone, the cocaine seized in 2020 amounts to 5,821.9 kg, representing a 22.3% increase. The total estimated value (street price) in 2020 is more than 281 million EUR.                                                                                     

According to the European Monitoring Center for Drugs and Drug Addiction (EMCDDA), the cocaine retail market concerns about 14.0 million adults in the European Union (aged 15-64), about 5 % of this age group. This market was worth at least EUR 10.5 billion in 2020; this represents about a third of the illicit market in all drugs and makes cocaine the second-largest market after cannabis. Since the mid-1990s the drug is more affordable for consumers than in the past so the overall cocaine usage in Europe has been on the rise.

Corruption at all levels is broadly used as a facilitator of drug trafficking activities and is a key threat in the EU according to the last EU Serious and Organised Crime Threat Assessment (SOCTA) report (Europol, 2021a).

In addition, the cocaine gotten from the streets could be prepared with variable proportions of caffeine, ammonia, solvents, industrial products such as battery acid, and even gasoline, kerosene and quicklime, increasing their toxicity but a greater profit.

EMCDDA report that cocaine seized at or destined for EU ports in 2020 (378 seizures) was smuggled within legitimate goods (132 tonnes), followed by the rip-on/rip-off method (108 tonnes). 

Cocaine trafficking concerns all EU Member States (Europol, 2021a) via diversified smuggling routes: roads for private cars and lorries, railways, maritime transports, commercial or passengers and light aircraft, and increasingly the post services (Council of Europe, 2021).

Effects and Risks

The cocaine psychoactive substance is a tropane alkaloid as for scopolamine used in World War II,  when the THC of the cannabis is a terpene.  Alkaloids are also present in the pine, citrus, lavender, poppy, etc. About a fifth of the total plant species is synthesizing alkaloids as secondary metabolites such as in plant families from the nightshade (Solanaceae), coca (Erythroxylaceae), bindweed (Convolvulaceae), cabbage/broccoli (Brassicaceae). Not all are psychoactive.    

As for the psychoactive substances, the liposoluble cocaine passes easily through the blood-brain barrier, reaching via the bloodstream and the Central nervous system (CNS) in about five seconds to produce the euphoric effect sought by the user.

In the mid-brain, the target of the cocaine is the Nucleus Accumbens located in the limbic system and  known to be the pleasure center or reward system (Lopez Hill et al. 2011).  In this area the cocaine inhibits the re-uptake from the synaptic cleft of the neurotransmitter dopamine by the presynaptic neurons by blocking their dopamine transporters. Thus, the artificial accumulation of dopamine in the synaptic cleft continuing to stimulate the receptors and the newly synthezised ones on the post-synaptic neurons is creating the lasting euphoric effects: the “high” from snorting may last about 15 to 30 minutes and from smoking 5 to 10 minutes. Injecting provides a quick, strong but short result.

When the use is stopped,  the mechanisms of re-uptake of dopamine are re-activated so the stimulating effect disappears  giving the manifestations of anxiety, feeling of lack and depression. Cocaine interfers also with the activities of the receptors of serotonin (regulation of behaviors, anxiety, learning, etc.) and noradrenaline (alertness, excitment, attention, etc.).

Considering that the nerves of the limbic area (emotions and reward system) are in relation to the cortex pre-frontal (judgement and decision) this explains the compulsive urge for the user to seek for more drug to continue the “high”. This is explaining the overall and powerful addictive effect of cocaine.

Mental effects of cocaine use include an intense feeling of happiness, sexual arousal, loss of contact with reality, paranoia, and agitation (Pomara C., et al. 2012). But also it increases the physical risks of stroke, cardiac arrhythmia, lung injury for smokers, sweating, high blood pressure, body temperature, dilated pupils and sudden cardiac death. The withdrawal symptoms include depression, decreased libido and ability to feel pleasure and increased fatigue feeling.

Based on data from 20 European countries there were an estimated 473 cocaine-related deaths in 2020 or about 13.5 % of all drug-induced deaths. These results are underestimated.

In Fine…

At a time whenthe governmental debates on eventual drug decriminalization or legalization are gaining all the countries and neglecting the health consequences for their peoples, when the profits and corruption at high levels are taking over the population and youth safety, it is more than ever vital to remind the words of Ms. Johansson of the European Commission (31.3.2022): “The new EU Drugs Strategy 2020-2025 …[has] the aims to ensure a high level of health promotion, social stability and security and contribute to awareness raising”.

The “awareness raising” can be easily achieved through education. Indeed, as for any other subject,

“Education is the progressive discovery of our own ignorance” said William Durant (1885-1981). This ignorance of the drug effects is life endangering when not fatal for the cocaine and drug users!

To contribute to this drug preventive education of the youth (and parents) the Foundation for a Drug Free Europe and its hundred of associations and groups across Europe are delivering lectures, distributing informative booklets (14 booklets on most used drugs of 24 pages, in 17 languages, including on cocaine), educative audiovisual materials and a guide for lessons as part of the Foundation for a Drug-Free World campaign The Truth About Drugs.

Witness to the harming effects of drug use, let’s preventively educate the youth and people so they will be able to realize their full life potentials in a safer society and in a better world!

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