Instituition
Statement: Cocaine and amphetamines are highly dangerous,addictive drugs and available in various forms. There are very few treatment options for addicts and none of them is completely effective.
Cocaine is one of the most dangerous drugs known to man. When consumed through various ways it damages cardiovascular system. With increased usage the heart tissue is thickened and prevents the flow of blood to the heart muscle. Amphetamine is a strong artificial stimulant drug. Due to its effect the person is stimulated to higher wakefulness and energy. The drug bypasses the body’s normal pathways for creation of energy. Continuous abuse of amphetamines leads to the person staying awake and failing to eat for long periods, leading to disaster (cocaine health risk,amphetamine faq).
The different forms of cocaine are
1. Coca Leaves: The cocaine content in the coca leaf is between 0.1–0.8%. The leaves are smoked after rolling them within cigarettes or cigars. The leaves are blended with a liquid to form tea or they can be chewed.
2. Coca Paste: This is the intermediate product between the leaf and powder
cocaine. It can be burned and inhaled.
3. Powder Cocaine : This is developed by dissolving coca paste in hydrochloric acid. Snorting,injection or ingestion is possible with powder cocaine. It decomposes easily at temperatures above 198ºC or 388ºF and cannot be smoked.
4. Cocaine Base : Cocaine base is derived from powder form of cocaine. This is poorly absorbed in the body and its potency is less than powder cocaine.
5. Crack Cocaine : Baking soda when heated with cocaine powder forms crack cocaine. The user can smoke the cocaine. It has purity levels in the range 75–90% .(Freye,2009)
There are cocaine drug users who combine alcohol and cocaine for different reasons:to reduce the feeling of alcohol consumption,to increase the cocaine effect,to reduce the unwanted symptoms of decreasing effect of cocaine. The union of abuse of alcohol and dependence on cocaine has given rise to puzzling questions. Cocaine and alcohol combination produces a novel substance which threatens life. The compound is cocaethylene, a metabolite more toxic than cocaine and is active biologically and behaviorally. It is produced in the liver. The combination hastens death quickly than in the presence of only cocaine.(Concurrent Alcohol And Cocaine Abuse)
Initial Treatment for Cocaine Overdose : patients showing symptoms of altered mental status are to be treated with:
1. Airway, Breathing, Cardiovascular status.
2. Administration of dextrose for potential hypoglycemia.
3. Administration of thiamine for preventing Kosakoff’s Syndrome in potential
alcohol intoxication.
4. Administration of 2 milligram of Naloxone (Narcane®) for reversal of opioid overdose. (Freye,2009)
Thiamine helps in decreasing the risk and symptoms of a definite brain disorder called Wernicke-Korsakoff syndrome(WKS). This is linked to low levels of thiamine (thiamine deficiency) and is regularly observed in alcoholics. Thiamine deficiency occurs in 30% to 80% of alcoholics. Administering shots of thiamine helps reduce the risk of development of WKS and diminish the manifestations of WKS during alcohol disengagement (Thiamine (Vitamin B1),2016).
The Wernicke-Korsakoff syndrome appears in fewer than 5% of alcoholics. This syndrome is a outcome of deficiency of thiamine.There are many causes for thiamine deficiency which include starvation,malnutrition, renal dialysis, hyperemesis. In alcoholics, deficiency of thiamine may occur due to poor nutrition in food, malabsorption in the small bowel induced by alcohol and decrease in production of enzyme transkalose which is thiamine-dependent. The resultant malnutrition results in neurological syndrome, Wernicke-Korsakoff. Therfore the treatment always includes administration of thiamine( Galanter,1992).
Advanced treatment for cocaine overdose: Special attention must be focused on potential cardiac arrhythmias and includes treatment of tachy-arrhythmia,ventricular fibrillation, hypertension,hyperthermia. Due to the non availability of specific antidote, therapy consists of treatment of symptoms till the acute effects disappear. Vaccination,if available is considered as a treatment option for the cocoine addict (Freye,2009).
New research has revealed that topiramate, a drug used to treat epilepsy and migraine headaches can also be the first reliable medication in treating cocaine dependency. Earlier topiramate was found to be a safe and effective treatment for alcohol dependence. The research observed less side effects in the usage of topiramate for treatment (Study reveals first effective medicine to treat cocaine dependence,2013).
Amphetamine as a drug taken for mind altering effects, has the form of white, grey, yellow or pink powder. It also takes the form of base,a paste like substance. The pureness of powder is lower than 15%. Most of the powders have 10% amphetamine and the remaining composition includes sugar,purgative among others. Caffeine and other other narcotics acetaminophen or acetylsalicyclic acid are also added to powder. Other forms include capsules of different colors and ice in the form of crystal sheets or crystalline powder. Base is strong at around 50 % pureness or slightly more. Methamphetamine is a potent variant of the drug. This has the form of powder,crystals(ice) or tablet. The powder is used in the following ways: inhalation through nose, mixing in alcohol, injection. Usually base is swallowed but due to bad taste it is encased in tobacco paper and devoured. It is inhaled when properly dried. Methamphetamine can be consumed in different ways. Tablets are taken orally. In solid shape, it is comfortably burned and the resultant smoke is inhaled through the nostrils. Snorting or swallowing are the ways for the powder to get inside the body (Amphetamine-type Stimulants, Amphetamines) .
Amphetamine addiction treatment: combination of the following for treatment of addicts.
Hospitalization: If the person experiences strong drug cravings it is easier to withdraw from the drug in a hospital environment. This will also help if the person has negative mood changes,aggression and suicidal tendencies.
Therapy:Individual counseling, family therapy, and group therapy help in identification of reasons for the usage of drugs,resolution of problems that led to the usage of drugs,building healthy relationship with one's family,learning effective methods to avoid using the drug amphetamine use,discovering activities to replace drug usage.
In case of severe withdrawl symptoms the doctor may prescribe the following medicines
1.Methylphenidate: for severe intravenous amphetamine dependence.
2. Fluoxetine: to decrease cravings for the drug.
3. Imipramine: helps in sticking to treatment for amphetamine dependence.
Other general medications may be required to relieve symptoms of anxiety, depression, and aggression (Kivi & Yu,2015).
Conclusion:There are no medicines available as of today for effective and complete treatment of drug addicts. Therfore it is the top priority in medical research to find a cure for drug addiction. It may be a vaccine,pill or injection. All options must be pursued seriously. Present medicines are only partially effective in eradicating the problem. Other methods to cure the addicts should be considered. They include yoga,meditation,nature therapy, a strict vegetarian diet,developing religious inclination by going to places of worship. Considering the highly effective alternative systems of medicine like the Indian system of Ayurveda and others should be given a serious thought. Preventing the usage of drugs by proper education at the right age goes a long way in the eradication of the problem.
References
1. Freye, E., Dr. (2009). Pharmacology and Abuse of Cocaine, Amphetamines, Ecstasy and Related Designer Drugs. Springer Science Business Media B.V.
2. Amphetamine-type Stimulants.Retrieved from http://www.ceida.net.au/stimulants/amphetamine-type.asp)
3. Kivi, R., & Yu, W. (2015, November 30). Amphetamine Dependence (M. R. LaFlamme Dr., Ed.). Retrieved from http://www.healthline.com/health/amphetamine-dependence#Treatment6
4. Cocaine Health Risk. Retrieved from
http://www.narconon.org/drug-abuse/cocaine/health-risk.html
5 Amphetamine FAQ. (n.d.). Retrieved from http://www.narconon.org/drug-information/FAQ-amphetamine.html
6.Amphetamines. (n.d.). Retrieved from http://www.drugwise.org.uk/amphetamines/
7.University of Maryland School of Medicine. (2013, October 25). Study reveals first effective medicine to treat cocaine dependence. ScienceDaily. Retrieved June 18, 2016 from www.sciencedaily.com/releases/2013/10/131025113741.htm
8.Galanter, M. (Ed.). (1992). ALCOHOLISM-ALCOHOL AND COCAINE Similarities and Differences. (10th ed.). SPRINGER SCIENCE BUSINESS MEDIA, LLC.
9.Thiamine (Vitamin B1). (2016, March 15). Retrieved from https://www.nlm.nih.gov/medlineplus/druginfo/natural/965.html
10.Concurrent Alcohol And Cocaine Abuse. (2016). Retrieved from http://drugabuse.com/library/concurrent-alcohol-and-cocaine-abuse/
