Addiction Treatment Blog

In 1954, Olds and Milner discovered that there appeared to be pleasure spots in the brain. Implanting electrodes in certain areas of the brain, through which a rat can give itself an electric current by pressing on a lever, produced in most brain areas nothing of note. In some areas, however, the rats seemed keen on the effects of self-stimulation and, in some cases, if left to their own devices would self-stimulate to the exclusion of all else – even food and drink.

As mentioned, noradrenaline was discovered in the brain in 1954. In 1959, a second catecolamine, dopamine, was identified, which was shown to be deficient in Parkinson’s disease.

The later mapping of dopamine-containing neurones has shown that they too, like noradrenergic neurones, tend to originate in a discrete area, the ventral tegmentum. Some of these neurones run to strictly motor areas of the brain and constitute the nigrostriatal system, and it is loss of nerve calls in this pathway that leads to Parkinson’s disease. Read more…

Illness is in part what the world as done to a victim but in a larger part is what the victim has done with his world, and with himself.

Karl Menninger, quoted in ‘Illness as Metaphor’ by Susan Sontag.

Drug abuse is a cause for many serious illnesses, including HIV (AIDS).

From time to time the healthcare professional will encounter an individual with a medical condition who abuses drugs. Although not condoning the taking of these substances, it is desirable that those in a position to advise are able to provide information on whether the drug is liable to exacerbate the condition. The sections below provide brief details which may be helpful in advising those with some of the more common medical conditions. The information given should be used as a guide only. The data available are sparse in most cases and while it is hoped that the details in this chapter will be useful, every patient’s particular circumstances will differ and one should be cautious about extrapolating limited information to all situations in which it could be applicable.

It is difficult to find data in the advisability of drug abuse in those suffering from concomitant medical conditions. The data given here are based upon details of side effects that have been reported in the medical literature and knowledge of drug handling by the body. This information is incomplete because none of the drugs of abuse have been subject to large-scale clinical trials at the doses abused. This is the main mechanism by which side effect profiles of therapeutic drugs are determined. This being the case, most of the data on adverse effects from street drugs are derived from small-scale studies, case reports, surveys and anecdotal evidence. Causality can also be difficult to ascertain because many users employ a variety of drugs simultaneously. Many drug abusers have a poor quality of life due to bad living conditions and/or inadequate nutrition; this may make them more susceptible to various diseases. Read more…

Save for the occasional use of Cocaine he had no vices, and he only turned to the drug as a protest against the monotony of existence.

Dr. Watson describing Sherlock Holmes in ‘The Adventure of the Yellow Face’, Sir Arthur Conan Doyle, 1893.

When cocaine is taken, users hope to experience a 'rush' of exhilaration as the drug reaches the brain.

History

Cocaine occurs naturally in the leaves of the coca plant, Erythroxylum coca, and certain related species which originate from South America, especially Peru, Bolivia and Columbia. The Incas considered the plant a divine gift and reserved its use for the higher echelons of society. Conversely, all levels of society amongst the Andean Indians have used the leaves as a masticatory for thousands of years. The leaves are combined with slaked lime or plant ash to produce an alkaline medium which enables the cocaine base to form a solution in saliva and thus and the circulation. Chewing the leaves helps the Indians tolerate hunger, exposure and fatigue at high altitudes where the working environment can be hostile. Cocaine provides a stimulus to manual labour, therefore, as well as inducing feelings of pleasure. The leaves contain about 1 per cent cocaine.

In about 1860, cocaine was isolated and identified as the active constituent of the coca plant. It was subsequently employed medicinally as a local anaesthetic. Karl Koller was probably the first to use it in humans, when he performed eye surgery in 1884.

When recreational use of cocaine developed outside South America the form developed was a water-soluble extract: crystalline cocaine hydrochloride. This is still probably the form of drug most widely used; it is often mixed with a diluent powder on the street and in the UK is usually known as coke, snow or blow.

Until relatively recently, cocaine was viewed in the UK as an expensive drug, used more by the wealthier sections of the populations. However, the number of abusers at all levels of society has increased. This is probably because cocaine has a reputation as a ‘clean’ drug and the street price has decreased considerably. Other factors influencing the greater demand for the drug may include the increased availability of very pure forms of cocaine such as ‘crack’ and the fact that various forms of the drug can produce rapid-onset, short-lived but intense effects without the need for injection.

‘Crack‘ is a highly pure form of the free base of cocaine (i.e. it is not a salt of cocaine like cocaine hydrochloride). The name is thought to originate from the cracking noises that lumps of free base make when heated up. This noise is probably caused by impurities in the cocaine remaining from the extraction process (e.g. sodium bicarbonate, sodium chloride). ‘Crack’ began to be available on a large scale in the USA in the mid-1980s. Read more…