Beyond the High: Exploring the Long-Term Health Effects of Cocaine Use FHE Health

Grams per week were estimated from participants’ reports of how much money was spent each week ($100/gram, 50% purity; Drug Enforcement Agency reports for the Baltimore area). All participants gave written informed consent, and this protocol was approved by the Institutional Review Board. This longitudinal study in patients with CUD who were followed for 12 years confirms the prognostic value of a comorbidity index in predicting the risk of hospitalization and death in patients seeking treatment for the disorder. VACS is a multiorgan system injury index validated in 2013 for HIV-positive patients, although it has been described as a reliable index for HIV-negative patients as well and as a predictor of health outcomes such as hospitalization (Tate et al., 2013; Barakat et al., 2015; Hotton et al., 2017). To the best of our knowledge, this is the first time that VACS Index was analyzed in a cohort of HIV-positive and HIV-negative patients with CUD.

  1. As with any disorder, treatment strategies need to assess the biological, social, emotional, and pharmacological aspects of the individual’s drug abuse.
  2. Less cocaine use in the 30 days prior to treatment entrance, fewer years of cocaine use, and a greater LDA were all predictive of higher abstinence and treatment retention rates [28, 31, 36]; these same variables were also predictors of a lower frequency and proportion of days of cocaine use [27].
  3. Sessions with a trained therapist can help you make changes to your behaviors and thought processes.
  4. Using cocaine can cause changes to the brain, such as in the reward system, resulting in a buildup of dopamine and making it difficult for someone to stop using the substance.

Short and Long-Term Effects of Cocaine

In accordance with these mechanisms, several pre-clinical studies have shown the effects of cocaine on food consumption and the nutritional status in animals [113,114,115]. For example, Balopole et al. [113] reported a decrease in cannabis marijuana drugfacts national institute on drug abuse nida food intake after cocaine administration to rats (10, 15, and 25 mg/kg). They found that the cocaine-induced anorexia was transient and dose-dependent. After an hour of anorexic effect, it was shown that animals overconsumed foods.

How is cocaine use disorder treated?

The first systematic review and meta-analysis on healthcare utilization in patients with SUD was published in 2019 and shows that hospitalization and ED admissions are 5 and 7 times more frequent, respectively, in this group than in the general population (Lewer et al., 2020). In Spain, 38.4% of drug-related ED admissions can be attributed to cocaine (Miró et al., 2019). Furthermore, a study reveals that 18% of those admitted to an ED for cocaine use are readmitted in the following year (Miro et al., 2010). Rates were calculated in p-y by dividing the number of observed events during the study period by the sum of all individual follow-up times. Cox regression models were used to analyze the risk factors of first hospitalization after discharge and mortality.

Pathophysiological Mechanisms of Cocaine on Cardiovascular Health

Furthermore, cocaine also increases the levels of other monoamines by blocking serotonin (5-HT) or norepinephrine (NE) transporters. Increased monoamine levels, specially DA, are thought to be involved in the euphoric effects of cocaine as well as explaining its motoric side effects [36]. Repeated use of cocaine may cause the brain to be more sensitive to the negative or toxic effects of cocaine, such as anxiety, at lower doses. If a person uses cocaine, it can have both short- and long-term effects on their brain. Some effects of cocaine are almost instantaneous and typically last from a few minutes to 1 hour. This article discusses the short- and long-term effects that cocaine can have on the brain, other health considerations, substance use disorder, and when to consider speaking with a doctor.

Short-term effects on the brain

For example, those who identify as LGBTQ are more than twice as likely to use illicit drugs as heterosexual people. LGBTQ adults are also more than twice as likely to have a substance use disorder. Cocaine has been found to trigger chaotic heart rhythms called ventricular fibrillation, accelerate heartbeat and breathing, and increase blood pressure and body temperature. Physical symptoms may include chest pain, nausea, blurred vision, fever, muscle spasms, convulsions, coma, and death. Long-term effects of cocaine use include addiction, irritability and mood disturbances, restlessness, paranoia, and auditory hallucinations.

Medications can treat the symptoms related to cocaine withdrawal, but there is no substitute drug that can effectively help a patient recover from a cocaine dependency. Research indicates that cocaine use many at risk for alcohol-medication interactions national institutes of health nih can significantly increase the risk of a heart attack or stroke. Scientists at the University of Cambridge in England identified abnormal brain structure in the frontal lobe of the brain of cocaine users.

A narrative review looking at 16 studies, nine of which included patients with CUD, found cumulative evidence supporting progesterone in its ability to decrease cravings and subjective positive effects of cocaine.215 Oxytocin may also play a role in modulating stress response. The treatment condition has emerged as a robust predictor of treatment outcomes, with four different trials finding that contingency management is predictive of long-term abstinence, higher treatment retention rates, and a higher proportion of negative urine samples [11, 32, 33, 35]. One RCT found that CM was especially beneficial in terms of treatment retention in cocaine users who also used marijuana because these patients tend to drop out of treatment relatively quickly without CM [11]. Another RCT found that treatment outcomes were better in patients who received individual and/or group drug counselling compared to patients randomized to other treatments, such as cognitive therapy or supportive-expressive therapy (a psychodynamic approach) [37]. This study determined that chronic heavy cocaine users have persistent decrements in neurobehavioral performance despite a 4-week abstinence.

In addition, this study was carried out in a single unit which limits the generalization of the findings. It was interesting to confirm that medical comorbidity was the only predictor of death in this cohort with a high prevalence of polysubstance use. Some studies on CUD indicate that the risk of death is higher in men, in those with a history of injected drugs, in those with an early onset of use, in those who drink alcohol, or in those with psychiatric comorbidity (Arendt et al., 2011; de la Fuente et al., 2014). However, there are hardly any studies on the medical comorbidity of CUD other than HIV infection and HCV infection. VACS Index analyzes kidney and liver function in addition to age, hemoglobin and HIV and HCV infections, thus reflecting the general health status.

From the neurobiological perspective, during adolescence, the brain is still under development, especially the prefrontal cortical regions responsible for emotion regulation and adult-level judgement. Consequently, impulsivity increases, placing youths at greater risk of engaging in drug and other risky behaviors [43, 44]. Referring to more years of cocaine use, the longer the duration of cocaine use, the higher the resistance to change. Moreover, the odds of submitting a negative long-term urine sample decreases with every year of cocaine use [31].

Evidence on the predictive capacity of genetic markers in CUD is scant and more research is warranted to investigate the impact of genetic markers on both treatment and prognosis. The tricky thing about cocaine, as is for any drug, is how subtly it can begin to dominate a person’s life, no matter why they started using it in the first place. Many fall into the trap of thinking they can keep their usage under control and avoid addiction, which is a widely held but dangerous belief. Dame Carol Black, a renowned professor and researcher, has pointed out that many people who use cocaine don’t even see themselves as addicts, which is a clear sign of how deceptive the drug can be. The FHE Health team is committed to providing accurate information that adheres to the highest standards of writing.

Another RCT showed that weak therapeutic alliance in patients receiving group drug counselling was a significant predictor of higher drug use (measured by urinalyses and self-report measures) at the next treatment session, and lower treatment retention rates [19]. Two RCTs found that gender was not a predictor of cocaine use at six months posttreatment [22, 24]. Interestingly, [22] observed significant differences between genders in the transition from abstinence to cocaine use, with men transitioning nearly two times as fast as women. In other words, women who use cocaine are more likely to keep using it while women who are abstinent are more likely to remain abstinent.

Concomitant AUD is frequent in CUD and has been described as an indicator of poor health outcomes (Timko et al., 2018). Specifically, cocaethylene, the metabolite resulting from the concomitant use of alcohol and cocaine, has a known toxicity (Jones, 2019). This potent stimulant is more toxic than cocaine itself and has a longer half-life. On the other hand, the increased risk of hospitalization mesclun vs mesculin everything you need to know for women with CUD requires an accurate evaluation of the continuum of care and care coordination after discharge. Kozor et al. [81] in Australia compared blood pressure, aortic stiffness, and LV mass in cocaine users with those in cocaine non-users. The authors recruited 20 regular cocaine users aged 37 ± 7 years (85% male) and 20 control subjects aged 33 ± 7 years (95% male).

Alpha-2 adrenergic receptors induce vasoconstriction of coronary arteries through contraction of vascular smooth muscle cells [34], leading to prothrombotic effects caused by increased von Willebrand factor [21]. Cocaine induces vasospasm through stimulation of adrenergic receptors on coronary arteries [69]. In addition, long-term use of cocaine induces endothelial injury, vascular fibrosis [73,74], and subsequent vessel wall weakening [75], resulting in apoptosis of vascular smooth muscle cells and cystic medial necrosis [76,77]. According to previous reports, cocaine sometimes induces coronary and carotid aortic dissections [78,79,80].

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