PSYCHOSTIMULANTS—PHARMACOKINETICS/PHARMACODYNAMICS, NEUROBIOLOGY, AND EPIDEMIOLOGY

PSYCHOSTIMULANTS—PHARMACOKINETICS/PHARMACODYNAMICS, NEUROBIOLOGY, AND EPIDEMIOLOGY is a topic covered in the Harrison's Manual of Medicine.

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Cocaine

  • A powerful stimulant drug made from the cocoa plant.
  • Local anaesthetic, vasoconstrictor, and stimulant properties.
  • A Schedule II drug, which means that it has high potential for abuse but can be administered by a physician for legitimate medical uses.

Cocaine salt is an acidic, water-soluble powder with a high melting point, used by snorting or sniffing intranasally or by dissolving it in water and injecting it intravenously. Freebase cocaine can be vaporized and inhaled, or crystallized and sold as crack or rock, which is also smoked or inhaled. Street dealers often dilute (or “cut”) cocaine with nonpsychoactive substances such as cornstarch, talcum powder, flour, or baking soda, or adulterate it to increase profits.

Smoked or inhaled cocaine reaches the brain quickly and produces a rapid and intense (yet transient) high, which enhances its addictive potential. Cocaine binds to the dopamine (DA) transporter and blocks DA reuptake, which increases synaptic levels of the monoamine neurotransmitters DA, norepinephrine (NE), and serotonin.

The National Survey on Drug Use and Health (NSDUH), in 2015 estimated that 1.9 million people (approximately 0.7% of the population) were current users of cocaine.

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Cocaine

  • A powerful stimulant drug made from the cocoa plant.
  • Local anaesthetic, vasoconstrictor, and stimulant properties.
  • A Schedule II drug, which means that it has high potential for abuse but can be administered by a physician for legitimate medical uses.

Cocaine salt is an acidic, water-soluble powder with a high melting point, used by snorting or sniffing intranasally or by dissolving it in water and injecting it intravenously. Freebase cocaine can be vaporized and inhaled, or crystallized and sold as crack or rock, which is also smoked or inhaled. Street dealers often dilute (or “cut”) cocaine with nonpsychoactive substances such as cornstarch, talcum powder, flour, or baking soda, or adulterate it to increase profits.

Smoked or inhaled cocaine reaches the brain quickly and produces a rapid and intense (yet transient) high, which enhances its addictive potential. Cocaine binds to the dopamine (DA) transporter and blocks DA reuptake, which increases synaptic levels of the monoamine neurotransmitters DA, norepinephrine (NE), and serotonin.

The National Survey on Drug Use and Health (NSDUH), in 2015 estimated that 1.9 million people (approximately 0.7% of the population) were current users of cocaine.

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