Cocaine

Originally located in South and Latin America. Cultivated mainly in Colombia, Peru and Bolivia.

Cultivation: area under cultivation in Peru 1978: 17,800 ha, 1984: 63,000 ha, 1988: 190,000 ha, 1989: 250,000 ha, and the trend is still rising. Bolivia: increase in the area under cultivation from 70,000 ha in 1980 to 120,000 ha in 1986 (80% of the gross national product).

Raw material: Erythoxylon coca leaves, 3-4 harvests/year with 300 g of fresh leaves/harvest. Annual yield: about 1 tonne/hectare.

Preparation: Raw leaves are soaked in water and soda/lime, the cocaine is extracted with mineral oil and re-extracted with sulphuric acid: 1000 kg coca leaves make 5 kg "coca paste". Further, partly quite complex cleaning leads to cocaine hydrochloride with 90% active ingredient. 2 kg coca paste provide 1 kg pure cocaine.

After application and absorption through the nasal mucosa, the effect begins to take effect after 3 minutes, and after about 6 seconds in the case of i.v. injections or smoking. The effect lasts about 30 minutes.

Centrally arousing and euphoric, "making the unbearable bearable". Physical power reserves can be exploited to the point of exhaustion.

Initial stage: Depressions are driven away, urge to be active, fantasies of omnipotence, reduction of inhibitions, urge to speak increases.

After the initial stage of intoxication with fear-sounding experiences, tactile sensory illusions (skin tingling "cocaine animals"), flashes of light ("snow lights").

The intoxication ends after 1-2 hours in a depressive stage with headaches, vomiting and the need to sleep with simultaneous sleeping ability. Need for a new dose to escape this state.

First important local anaesthetic, which is used in salt form, as Cocainum hydrochloricum, according to BtMVV only as a local anaesthetic on the eye (simultaneously causes mydriasis).

• Crack, as practically pure cocaine, only works for 2-20 minutes, immediately followed by the post office rush, thus rapid repetition danger by psychological dependence.
• By strong acute effect: hyperhidrosis, heart failure, respiratory arrest, cerebral hemorrhages, stroke.
• Long-term effects: exhaustion, loss of vision, paranoid and schizophrenic states, personality aging.
• Long-term abuse can lead to scleroderma-like skin changes, especially middle facial necrosis.
• Other undesirable side effects: eosinophilia, urticaria, vasculitis, livedo racemosa, supraglottitis, priapism, Raynaud's symptoms, focal necrosis (ulcer) of the extremities.

History: 5000 years ago "holy plant" of the Inca, at the time of the Spanish, miners and slaves were paid with coca leaves. From 1884 used for local anaesthesia, especially for minor eye operations (ophthalmologist Carl Koller), from 1899 also used for conduction anaesthesia; from 1905 replaced by fully synthetic products like procaine.

Since 1886 part of "Coca-Cola", from 1906 no cocaine is added.

In Germany until well into the 20th century it was used as a legal party drug, especially by artists.

1. Attoussi S et al (1998) Cocaine-induced scleroderma and scleroderma renal crisis. South Med J 91: 961-963
2. Castro-Villamor MA et al (1999) Cocaine-induced severe angioedema and urticaria. Ann Emerg Med 34: 296-297
3. Di Paolo N et al (1997) Kidney vascular damage and cocaine. Clin Nephrol 47: 298-303
4. Haustein UF, Ziegler V (1986) Scleroderma and scleroderma-like diseases caused by environmental pollutants. Derm profession environment 34: 61-67
5. Hofbauer GF (1999) Urticarial vasculitis following cocaine use. Br J Dermatol 141: 600-601
6. Nelson LM (1995) Fixed drug eruptions; a report of two cases, one caused by niacin, the other by cocaine. Calif Med 82: 127-128
7. Paraiso PG et al (2003) Middle facial necrosis secondary to cocaine abuse. An otorrinolaringol Ibero Am 30: 389-396
8. Strong DH et al (2003) Eosinophilic "empyema" associated with crack cocaine use. Chest 58: 823-824