Chemistry

There are various chemicals known for having negative effects on human beings if these are misused and these include recreational drugs and alcohol. These recreational drugs include many types as heroine, cocaine, methamphetamines and many more.  This paper shall cover negative effects of exposure to cocaine along with risk assessments and highly vulnerable groups.

Section One Recreational DrugsBeverages
What is Cocaine
Cocaine is known among extremely addictive brain stimulants also known as drug of the 80s and 90s as it was most popular in that era. Cocaine is one of the oldest addictive drugs known. Source, coca leave have been chewed and ingested for brain stimulation since thousands of decades. Cocaine hydrochloride is purified form of cocaine.  Source of pure cocaine used to be Erythroxylon coca bush but it became a luxury after crop reduction scheme started in major growing countries as Peru and Bolivia. Today one of the largest cocaine producer is California. Cocaine is also referred to as schedule II drug as it is used as a recreational drug and as a medication or legitimate uses as local anesthesia of eye and ear or for surgical purposes.  Sold on streets as fine crystalline powder, cocaine has many names as coke, C, snow, flake, or blow.

Chemical Forms of Cocaine
Two forms of cocaine are usually abused, water-soluble hydrochloride salt and water insoluble cocaine base also known as freebase.  Hydrochloride salt of cocaine is also referred to as active form of cocaine and it can be injected as well as snorted. On the other hand, base form of cocaine has been originally interacted with ammonia or sodium bicarbonate and water. Afterwards this mixture is heated in order to remove the hydrochloride that produces a smoke able substance and this is referred to as crack referring to cracking sound when this mixture is heated (NIDA InfoFacts Cocaine, 2010).

Section Two Consequences of Cocaine Misuse
Organs Affected
Main organ affected after usage of cocaine is brain, specifically reward areas, the base ganglia. Studied included in the following sections will focus on these consequences. In addition to this, immune system and heart impairment is also observed.

Affect On Brain Cocaine Addiction Mechanism
Research has been carried out by Dr. Michael Nader and colleagues at Wake Forest University showing that initial use of cocaine lowers dopamine receptors availability in base ganglia that functions in reward system. This reduction in receptors further increases addiction and causes changes in decision making as well as cognitive functioning. Dopamine receptors are important for their functioning in thought, emotions, motivations and mobility. Thereby a gradual use of cocaine reduces the availability of dopamine receptors in human beings. Studies have suggested that lower the dopamine receptors higher is the addiction for cocaine. Main mechanism involved in cocaine usage is release of dopamine and attachment with the receptors thereby producing feelings and emotions associated with usual dopamine as happiness and feeling of being rewarded. It has been suggested that brain cells in individuals are stimulated to release dopamine in a sufficient amount that can fill up all dopamine receptors.

Brain activity in rewarding areas is thereby strongly reduced as a result of cocaine usage. Several studies have been carried out on monkeys and it has been shown that prolonged use of cocaine impairs functioning of brain beyond pleasure and motivation centers, and penetrates into memory and information processing areas. 

In this case one of the most important findings suggest that as compared to non abusers of cocaine, chronic cocaine abusers have lesser cerebral blood flow  in their brains and these studies  have tested any other factors that might be playing roles in reducing blood flow  thereby confirming  that chronic cocaine abuse is related with reduced blood flow.  Further brain areas and effects of cocaine on these areas are summarized as below (NIDA, 2009).

Effects On Heart
It has been studied by Dr. Shenghan Lai and colleagues at The Johns Hopkins Medical Institutions that left ventricular function in heart is reduced in chronic cocaine abusers. These studies have included evidences from MRI on various patients showing that pumping efficiency in left ventricular wall in the heart is greatly reduced.

Other than this studied have suggested that chances of heart attacks and stroke are highly increased because of chronic cocaine abuse. This is because chronic cocaine abuse causing a narrowing of blood vessels increases in blood pressure and increased heart rate causing cardiac arrhythmias. As a response to inflammation, some blood factors respond by increasing clotting to increase repair against inflammation. One of these blood factors is known as von Willebrand factor (vWF) and it remains elevated in blood after a single exposure to cocaine. Other proteins that are observed to remain elevated in blood after cocaine usage include fibrinogen and C-reactive protein thereby higher the concentration of these clotting factors, higher is the risk of heart attack (Zickle, 2003).

Effects On Sleep
Studies were carried out by scientists belonging to Yale and Harvard Schools of Medicine whereas study was funded by NIDA.  Studies also focused on focus and attention deficits in abusers. Studies suggest that cocaine abuse disturbs the need of sleep which is sometimes incorrectly calculated by brain under effects of cocaine. It has been added that abusers coming in for treatment get dropped out from the treatments because of lack of attention.

Chronic cocaine users thereby face problems in their sleep time as compared to non-abusers. It is seen that lower time is needed by non-abusers to sleep but cocaine abusers thereby reducing their sleep time require much greater time. In addition to this, another problem associated with these abusers is that they are not aware of theory lack of sleep, as they perceive that they are sleeping right. Thereby during treatment, they do not highlight sleep issue to doctors (NIDA, 2008).

Remedial Actions against Cocaine
Blocking Brain Receptors
It has been mentioned that one of the main issues being faced in case of cocaine abusers treatments is their lack of attention as brain centers are severely affected in chronic cocaine abuse. Links of these abusers is a group of people who already are drug abusers thereby leaving these abusers at a higher risk of abusing drugs even after treatments. Thereby keeping these issues in minds, studies have been carried out by researchers at Vrije Universiteit Medical Center in Netherlands and NIDAs Intramural Research Program suggesting that relapses in chronic drug abusers can be reduced by blocking specific receptors in brain activated by cocaine misuse. Thereby if these receptors are blocked by engineered drugs than administration of cocaine will have no effects on brain leaving the abuser feel nothing out of cocaine (Mann, 2004).

Epileptic Medicine As A Treatment Against Cocaine Usage
Since the last twenty years, in United States, epilepsy has been treated by using vigabatrin and it has been a promising medication and these days researchers have taken into account this medication that has been thought to have promising effects on chronic cocaine abuse. Studies have been carried out since the 80s by Dr. Stephen L. Dewey of Brookhaven National Laboratory, New York, and Dr. Jonathan D. Brodie from New York University School of Medicine showing that this medication reduces dopamine levels in the brain. The following figure shows the difference in dopamine levels after use of cocaine.

Thereby it has been shown that by using GVG, effects of drugs as methamphetamine and cocaine are blocked along with blocking the release of dopamine.

Chemical Interactions Of Cocaine With Other Drugs
It has been seen that street dealers observed selling out drugs mix cocaine with some inert substances as cornstarch, talcum powder, or sugar. In order to increase addiction to this powder, additional drugs that are added and mixed with cocaine include procaine which is often known as a local anesthetic, amphetamine which is a well known stimulant. Some dealers as well as cocaine users also mix cocaine with heroine termed as speedball.

Cocaine And Alcohol
As compared to alcohol and cocaine addiction in an independent manner, studies suggest that cocaine and alcohol addiction together can cause much more damage to brain. Effects of these two include impulsive decision-making and much poor memory and performance in tests. It has been suggested by NIDA Director Dr. Alan I. Leshner that the way these two chemicals interact has important implications in drug abuse treatment.  It has been seen that these two chemicals make it hard for abusers to remember and learn concepts thereby reducing any chances of better treatment. Major effects on brain are compounded by the use of alcohol and cocaine together (NIH, 2000).


Section Three Risk Assessment of the Threat
It was estimated in 2005 by the help of National Survey on Drug Use and Health (NSDUH) that at least 5 million current cocaine abusers in United States. Moreover, most distinguishing fact that has been observed in this case is that highest number of people belong to the age group of  18 to 25 as compared to adults thereby the teenagers are considered as the most vulnerable group.  Similarly, as compared to women, men consume cocaine at higher rates as compared to women.

Moreover since the late 1990s, it has been seen that use of cocaine has reduced in teenagers belonging to 10th, 11th and the 12th graders. In addition to this the survey has suggested that almost 2 million Americans have met  Diagnostic and Statistical Manual of Mental Disorders criteria after depending and abusing cocaine (NIDA InfoFacts Cocaine, 2010). 

Conclusion
Cocaine has been now regarded as one of the most addictive drugs as it is one of the most challenging. It is observed that treating cocaine abusers is difficult because of lack of concentration and attention deficit and these abusers add up to higher number of treatment dropouts. Thereby studies carried out in order to look into this and it has been seen that drugs and compounds that can block dopamine receptors in brain are more efficient in cocaine treatment thereby increasing memory response thereby increasing efficiency in treatments.