Dopamine and Norepinephrine Transporter Inhibition in Cocaine Addiction: Using Mice

Total Page:16

File Type:pdf, Size:1020Kb

Dopamine and Norepinephrine Transporter Inhibition in Cocaine Addiction: Using Mice Dopamine and Norepinephrine Transporter Inhibition in Cocaine Addiction: Using Mice Expressing Cocaine-Insensitive Transporters DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Bradley Joseph Martin, B.S. Neuroscience Graduate Studies Program The Ohio State University 2011 Dissertation Committee: Howard Haogang Gu, PhD., Advisor Gary L. Wenk, PhD Lane J. Wallace, PhD Robert L. Stephens, Jr., PhD Copyright by Bradley Joseph Martin 2011 Abstract Cocaine’s effects are predominately mediated by inhibiting the reuptake transporters for dopamine, serotonin, and norepinephrine. How each of these transporters contributes to cocaine’s effects is unclear, but such knowledge would aid in efforts to design rational treatments for cocaine addiction. To directly test the contribution of each of these transporters in cocaine’s effects, three transgenic knockout mouse lines were previously created wherein each transporter gene was individually deleted. These knockout mice studies suggest that no single transporter is critical for mediating cocaine’s rewarding effects. However, this hypothesis contradicts pharmacological studies which indicate that the dopamine transporter (DAT) is critical for cocaine’s rewarding effects. Our lab hypothesized that the compensatory adaptations of knockout mice were responsible for this discrepancy. To avoid compensatory adaptations, our lab developed transporter knockin mice expressing a mutated, yet functional, transporter that is insensitive to cocaine inhibition. Unlike transporter knockout mice, these cocaine-insensitive transporter mice retain functioning neurotransmitter systems. We have previously used cocaine-insensitive dopamine transporter mice to reestablish the hypothesis that inhibiting the dopamine transporter is critical for cocaine’s rewarding effects. ii In this dissertation, I will utilize two knockin mouse lines to further elucidate how inhibiting DAT and norepinephrine transporter (NET) contribute to cocaine’s effects. First, I used Golgi-Cox techniques to demonstrate that dopamine transporter cocaine insensitive (DAT-CI) mice do not show chronic cocaine-induced increases in spine density on the dendrites of neurons in the nucleus accumbens relative to wild-type mice. These data suggest that DAT inhibition is critical for cocaine’s ability to produce long- lasting neural adaptations that have been associated with addiction. Second, I performed various molecular, biochemical, and neurochemical techniques to show NET-CI mice are valid tools for studying cocaine addiction. Third, by characterizing the behaviors of NET- CI mice, I found that NET-CI mice have lower levels of basal locomotion, higher levels of locomotor activity in response to cocaine, and similar reward-related behaviors. These data suggest that NET inhibition influences cocaine’s stimulating but not its rewarding effects. Collectively, these studies further our understanding of how the inhibition of DAT and NET contributes to cocaine’s many effects. In addition, our data clarify the literature by demonstrating that NET does not play a major role in cocaine reward. iii Dedication To my wife, Amanda, and my mother, Jeannie. iv Acknowledgments I would like to thank my advisor, Dr. Howard Gu, for adopting me into his lab, for being patient and supportive, and for taking on the Sisyphean task of trying to teach molecular biology to a psychology student. I would also like to thank the professors who served on my committees, Drs. Gary Wenk, Lane Wallace, Robert Stephens, Georgia Bishop, and David Saffeen, for their encouragement and feedback - a special thanks to Dr. Wallace for giving me plenty of guidance and opportunities to teach. I would also like to thank my labmates: Drs. Erik Hill, Hua Wei and Michael Tilley; Keerthi Thirtamara, Bartholomew Naughton, Pauline Chen, Dawn Han, Aravand Menon, Daniel Yoon, and Brian O’Neill. A special thanks to Brian for always challenging me and to Hua for creating the cocaine-insensitive norepinephrine transporter mice. I would also like to thank my collaborators Drs. A. Courtney Devries, and Dr. Maria Hadjiconstantinou Neff. I would like to thank my family and friends; my mother for managing to provide for my brother and I as a single mother; my brother, Alex; my grandparents, Frank and Bryan Wool, for showing me the value of an education; my dad, Jon Hackett, and my step father, Rusty Van Leuven, for always being proud of me; my wife’s grandparents, Dr. Bill and Helen Swank and Frank and Marcy Webster, and parents, Dr. Douglas and Theresa Webster for making Columbus a wonderful place to live and for doting on our v children; my friends Daniel Hendrix, Leonard Greco, Joe Piasick, Dr. Ryan Smith, and Dr. Michael Stone. I would like to thank my wife, Amanda Martin, for being so supportive and not judging me too much during the ups and downs of this endeavor. vi Vita January 22nd, 1982 .........................................Born, Jacksonville, Florida 2000................................................................Cornwall Central High School 2004................................................................Colorado State University 2005 ...............................................................Postbac Intramural Research Training Award (IRTA) recipients 2006 to Present ..............................................Graduate Research Associate, Department of Psychiatry and Pharmacology, The Ohio State University Publications Martin BJ, Wei H., Gu HH. Characterizing cocaine reward and stimulation in mice expressing cocaine-insensitive norepinephrine transporter. (in prep) Martin BJ, Naughton BJ., Thirthamar, KK. Devries AC., Gu. HH. Dopamine transporter inhibition is necessary for cocaine’s ability to increase dendritic spine density in the nucleus accumbens. Synapse. 2011 Jun; 65(6):490-6. vii Bruno JP, Gash C, Martin B, Zmarowski A, Pomerleau F, Burmeister J, Huettl P, Gerhardt GA. Second-by-second measurement of acetylcholine release in prefrontal cortex. European Journal of Neuroscience. 24(10), 2749-57, 2006 Wendland JR, Martin BJ, Kruse MR, Lesch KP, Murphy DL. Simultaneous genotyping of four functional loci of human SLC6A4, with a reappraisal of 5-HTTLPR and rs25531. Mol Psychiatry 11(3), 2006. Kim DK, Tolliver TJ, Huang SJ, Martin BJ, Andrews AM, Wichems C, Holmes A, Lesch KP, Murphy, DL. Altered serotonin synthesis, turnover and dynamic regulation in multiple brain regions of mice lacking the serotonin transporter. Neuropharmacology. 2005 Nov; 49(6):798-810. Fields of Study Major Field: Neuroscience Graduate Studies Program viii Table of Contents Abstract ............................................................................................................................... ii Dedication .......................................................................................................................... iv Acknowledgments .............................................................................................................. v Vita .................................................................................................................................... vii Publications ....................................................................................................................... vii Table of Contents ............................................................................................................... ix List of Figures .................................................................................................................... xi Chapter 1: Introduction to animal models of cocaine addiction ......................................... 1 Chapter 2: Dopamine Transporter Inhibition is Necessary for Cocaine-Induced Increases in Dendritic Spine Density in the Nucleus Accumbens .................................................... 22 2.1 Background and Introduction .................................................................................. 22 2.2 Materials and Methods ............................................................................................ 25 2.3 Results ..................................................................................................................... 28 2.4 Discussion ............................................................................................................... 30 Chapter 3: Characterizing cocaine reward and stimulation in mice expressing cocaine- insensitive norepinephrine transporter. ............................................................................. 40 3.1 Background and Introduction .................................................................................. 40 ix 3.2 Materials and Methods ............................................................................................ 42 3.3 Results ..................................................................................................................... 47 3.4 Discussion ............................................................................................................... 49 Chapter 4: General discussion and future direction .......................................................... 63 References ......................................................................................................................... 71 Abbreviations .................................................................................................................... 91 x List of Figures Figure
Recommended publications
  • Interview with Pierre Pichot
    PSYCHOPHARMACOLOGY AND THE HISTORY OF PSYCHIATRY PIERRE PICHOT Could we begin with your recollections of the 1955 Paris meeting, which was effectively the first world wide meeting on chlorpromazine. The meeting was organised in Paris by Jean Delay. It was supported by Specia, the pharmaceutical firm which had produced chlorpromazine, which was a branch of the Rhone Poulenc Group. For the first time people engaged in what was called psychopharmacology came together. They came from many countries, including the United States. The efficacy of the drug and the mechanism of action were discussed. However, at that time the biochemistry of the brain, as it exists now, was unknown. It was only at the beginning of the 60s, that we began to speak of the role of the neurotransmitters in the action of both neuroleptic drugs and antidepressants and of their potential abnormalities in the disease process. So in practice 1955 was only a meeting on therapy with chlorpromazine. I have always been very much impressed by the fact that chlorpromazine, which had been introduced only 3 years before, was already used all over the world. Theoretical ideas take usually a very long time to travel from one country to another, and sometimes they never make it. I quote always, the case of Karl Jaspers’ General Psychopathology, which is considered in the German speaking world as one of the basic books of psychiatry. This was published in 1913 but appeared in English translation only in 1963, 50 years later and, even then, a paper published in the American Journal of Psychiatry wrote ingenuously that, until this publication, many psychiatrists in the United States had not realised that Jaspers was not only a philosopher, but also a psychiatrist.
    [Show full text]
  • Assessing Neurotoxicity of Drugs of Abuse
    National Institute on Drug Abuse RESEARCH MONOGRAPH SERIES Assessing Neurotoxicity of Drugs of Abuse 136 U.S. Department of Health and Human Services • Public Health Service • National Institutes of Health Assessing Neurotoxicity of Drugs of Abuse Editor: Lynda Erinoff, Ph.D. NIDA Research Monograph 136 1993 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutes of Health National Institute on Drug Abuse 5600 Fishers Lane Rockville, MD 20857 ACKNOWLEDGMENT This monograph is based on the papers and discussions from a technical review on “Assessing Neurotoxicity of Drugs of Abuse” held on May 20-21, 1991, in Bethesda, MD. The technical review was sponsored by the National Institute on Drug Abuse (NIDA). COPYRIGHT STATUS NIDA has obtained permission from the copyright holders to reproduce certain previously published material as noted in the text. Further reproduction of this copyrighted material is permitted only as part of a reprinting of the entire publication or chapter. For any other use, the copyright holder’s permission is required. All other material in this volume except quoted passages from copyrighted sources is in the public domain and may be used or reproduced without permission from the Institute or the authors. Citation of the source is appreciated. Opinions expressed in this volume are those of the authors and do not necessarily reflect the opinions or official policy of the National Institute on Drug Abuse or any other part of the U.S. Department of Health and Human Services. The U.S. Government does not endorse or favor any specific commercial product or company.
    [Show full text]
  • Methylphenidate Amplifies the Potency and Reinforcing Effects Of
    ARTICLE Received 1 Aug 2013 | Accepted 7 Oct 2013 | Published 5 Nov 2013 DOI: 10.1038/ncomms3720 Methylphenidate amplifies the potency and reinforcing effects of amphetamines by increasing dopamine transporter expression Erin S. Calipari1, Mark J. Ferris1, Ali Salahpour2, Marc G. Caron3 & Sara R. Jones1 Methylphenidate (MPH) is commonly diverted for recreational use, but the neurobiological consequences of exposure to MPH at high, abused doses are not well defined. Here we show that MPH self-administration in rats increases dopamine transporter (DAT) levels and enhances the potency of MPH and amphetamine on dopamine responses and drug-seeking behaviours, without altering cocaine effects. Genetic overexpression of the DAT in mice mimics these effects, confirming that MPH self-administration-induced increases in DAT levels are sufficient to induce the changes. Further, this work outlines a basic mechanism by which increases in DAT levels, regardless of how they occur, are capable of increasing the rewarding and reinforcing effects of select psychostimulant drugs, and suggests that indivi- duals with elevated DAT levels, such as ADHD sufferers, may be more susceptible to the addictive effects of amphetamine-like drugs. 1 Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada M5S1A8. 3 Department of Cell Biology, Medicine and Neurobiology, Duke University Medical Center, Durham, North Carolina 27710, USA. Correspondence and requests for materials should be addressed to S.R.J. (email: [email protected]). NATURE COMMUNICATIONS | 4:2720 | DOI: 10.1038/ncomms3720 | www.nature.com/naturecommunications 1 & 2013 Macmillan Publishers Limited.
    [Show full text]
  • Characterization of Multiple Sites of Action of Ibogaine
    ——Chapter 6—— CHARACTERIZATION OF MULTIPLE SITES OF ACTION OF IBOGAINE Henry Sershen, Audrey Hashim, And Abel Lajtha Nathan Kline Institute Orangeburg, New York 10962 I. Introduction.................................................................................................................. II. Issues Related to Ibogaine in the Treatment of Drug Dependence............................. A. Dopamine as a Primary Site of Drug-Mediated Responses .................................. B. Ibogaine or Its Metabolite and Acute versus Long-Term Effect........................... C. Single or Multiple Sites of Action of Ibogaine ..................................................... III. Effect of Ibogaine on Drug-Induced Behavior............................................................ IV. Binding Site Activity ................................................................................................... A. Relevant Site of Action.......................................................................................... V. Functional Activity ...................................................................................................... VI. Stimulant Drug Actions/Behaviors.............................................................................. VII. Current Non-Ibogaine Drug Treatment Protocols ....................................................... VIII. Conclusions.................................................................................................................. References...................................................................................................................
    [Show full text]
  • The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines
    The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines World Health Organization F10 - F19 Mental and behavioural disorders due to psychoactive substance use Overview of this block F10. – Mental and behavioural disorders due to use of alcohol F11. – Mental and behavioural disorders due to use of opioids F12. – Mental and behavioural disorders due to use of cannabinoids F13. – Mental and behavioural disorders due to use of sedative hypnotics F14. – Mental and behavioural disorders due to use of cocaine F15. – Mental and behavioural disorders due to use of other stimulants, including caffeine F16. – Mental and behavioural disorders due to use of hallucinogens F17. – Mental and behavioural disorders due to use of tobacco F18. – Mental and behavioural disorders due to use of volatile solvents F19. – Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances Four- and five-character codes may be used to specify the clinical conditions, as follows: F1x.0 Acute intoxication .00 Uncomplicated .01 With trauma or other bodily injury .02 With other medical complications .03 With delirium .04 With perceptual distortions .05 With coma .06 With convulsions .07 Pathological intoxication F1x.1 Harmful use F1x.2 Dependence syndrome .20 Currently abstinent .21 Currently abstinent, but in a protected environment .22 Currently on a clinically supervised maintenance or replacement regime [controlled dependence] .23 Currently abstinent, but receiving treatment with
    [Show full text]
  • Do You Know... Cocaine
    Do You Know... Street names: blow, C, coke, crack, flake, freebase, rock, snow Cocaine What is cocaine? Cocaine is a stimulant drug. Stimulants make people feel more alert and energetic. Cocaine can also make people feel euphoric, or “high.” Pure cocaine was first isolated from the leaves of the coca bush in 1860. Researchers soon discovered that cocaine numbs whatever tissues it touches, leading to its use as a local anesthetic. Today, we mostly use synthetic anesthetics, rather than cocaine. In the 1880s, psychiatrist Sigmund Freud wrote scientific papers that praised cocaine as a treatment for many ailments, including depression and alcohol and opioid addiction. After this, cocaine became widely and legally available in patent medicines and soft drinks. As cocaine use increased, people began to discover its dangers. In 1911, Canada passed laws restricting the importation, manufacture, sale and possession of cocaine. The use of 1/4 © 2003, 2010 CAMH | www.camh.ca cocaine declined until the 1970s, when it became known How does cocaine make you feel? for its high cost, and for the rich and glamorous people How cocaine makes you feel depends on: who used it. Cheaper “crack” cocaine became available · how much you use in the 1980s. · how often and how long you use it · how you use it (by injection, orally, etc.) Where does cocaine come from? · your mood, expectation and environment Cocaine is extracted from the leaves of the Erythroxylum · your age (coca) bush, which grows on the slopes of the Andes · whether you have certain medical or psychiatric Mountains in South America.
    [Show full text]
  • Anew Drug Design Strategy in the Liht of Molecular Hybridization Concept
    www.ijcrt.org © 2020 IJCRT | Volume 8, Issue 12 December 2020 | ISSN: 2320-2882 “Drug Design strategy and chemical process maximization in the light of Molecular Hybridization Concept.” Subhasis Basu, Ph D Registration No: VB 1198 of 2018-2019. Department Of Chemistry, Visva-Bharati University A Draft Thesis is submitted for the partial fulfilment of PhD in Chemistry Thesis/Degree proceeding. DECLARATION I Certify that a. The Work contained in this thesis is original and has been done by me under the guidance of my supervisor. b. The work has not been submitted to any other Institute for any degree or diploma. c. I have followed the guidelines provided by the Institute in preparing the thesis. d. I have conformed to the norms and guidelines given in the Ethical Code of Conduct of the Institute. e. Whenever I have used materials (data, theoretical analysis, figures and text) from other sources, I have given due credit to them by citing them in the text of the thesis and giving their details in the references. Further, I have taken permission from the copyright owners of the sources, whenever necessary. IJCRT2012039 International Journal of Creative Research Thoughts (IJCRT) www.ijcrt.org 284 www.ijcrt.org © 2020 IJCRT | Volume 8, Issue 12 December 2020 | ISSN: 2320-2882 f. Whenever I have quoted written materials from other sources I have put them under quotation marks and given due credit to the sources by citing them and giving required details in the references. (Subhasis Basu) ACKNOWLEDGEMENT This preface is to extend an appreciation to all those individuals who with their generous co- operation guided us in every aspect to make this design and drawing successful.
    [Show full text]
  • Urine Drug Toxicology and Pain Management Testing
    Urine Drug Toxicology and Pain Management Testing Kara Lynch, PhD, DABCC University of California San Francisco San Francisco, CA Learning Objectives • Describe what chronic pain is, who is affected and how they are commonly treated • Explain the common methodologies used in pain management testing • Interpret urine drug testing results • Create protocols to minimize the occurrence of false positive or false negative results Pain – definition and types • Pain - an unpleasant sensory and emotional experience associated with actual or potential tissue damage • Chronic pain - pain that extends beyond the expected period of healing • Nociceptive Pain – Pain caused by tissue injury – Stimulus-evoked, high intensity – Opioid sensitive • Neuropathic Pain – Caused by nerve injury – Spontaneous activity – Develops in days or month – Opioid insensitive Chronic Pain Patients • Arthritis • Fibromyalgia – Osteoarthritis • Headaches – Rheumatoid arthritis – Migraine – Gout – Tension • Cancer – Cluster • Chronic non-cancer pain • Myofascial pain • Central pain syndrome • Neuropathic pain – CNS damage – Diabetic Peripheral – Multiple Sclerosis Neuropathy – Parkinson’s disease – Postherpetic neuralgia • Chronic abnominal pain • Neck and Back Pain – Intestinal obstructions Chronic Pain Medications • Opiates • Synthetic opioids – Codeine – Fentanyl – Morphine – Methadone • Semi-synthetic opioids – Meperidine – Oxymorphone – Tramadol – Oxycodone – Propoxyphene – Hydromorphone – Levorphanol – Hydrocodone – Tapentadol – Buprenorphine • Anticonvulsant • Muscle
    [Show full text]
  • Influence of Antipsychotic and Anticholinergic Loads on Cognitive Functions in Patients with Schizophrenia
    Hindawi Publishing Corporation Schizophrenia Research and Treatment Volume 2016, Article ID 8213165, 10 pages http://dx.doi.org/10.1155/2016/8213165 Research Article Influence of Antipsychotic and Anticholinergic Loads on Cognitive Functions in Patients with Schizophrenia Michael Rehse,1,2 Marina Bartolovic,1 Katlehn Baum,3 Dagmar Richter,1 Matthias Weisbrod,1,3 and Daniela Roesch-Ely1 1 Department of Psychiatry, University of Heidelberg, 69115 Heidelberg, Germany 2Psychiatrisches Zentrum Nordbaden, 69168 Wiesloch, Germany 3Department of Psychiatry and Psychotherapy, SRH Hospital Karlsbad-Langensteinbach, 76307 Karlsbad, Germany Correspondence should be addressed to Daniela Roesch-Ely; daniela [email protected] Received 14 October 2015; Revised 19 February 2016; Accepted 7 March 2016 AcademicEditor:L.Citrome Copyright © 2016 Michael Rehse et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Many patients with schizophrenia show cognitive impairment. There is evidence that, beyond a certain dose of antipsychotic medication, the antipsychotic daily dose (ADD) may impair cognitive performance. Parallel to their D2 receptor antagonism, many antipsychotics show a significant binding affinity to cholinergic muscarinic receptors. Pharmacological treatment with a high anticholinergic daily dose (CDD) significantly impairs attention and memory performance. To examine the relationships between individual cognitive performance and ADD and/or CDD, we conducted a retrospective record-based analysis of a sample of = 104 in patients with a diagnosis of schizophrenia, all of whom had completed a comprehensive neuropsychological test battery. To calculate the individual ADD and CDD, the medication at the time of testing was converted according to equivalence models.
    [Show full text]
  • Cocaine Use a Problem? A
    ? Q&A Q. IS COCAINE USE A PROBLEM? A. YES. There were 1.9 million current (past-month) cocaine users ages 12 or older in 2015.11 About 900,000 users ages 12 or older met the criteria for a diagnosable disorder with significant negative effects because of COCAINE 12 their cocaine use in the past year. In 2014, overdoses and deaths caused by cocaine use increased by 42 THE TRUTH ABOUT COCAINE percent.13 Q. WHAT IS THE DIFFERENCE BETWEEN COCAINE SLANG: COKE/FLAKE/C/COCA/BUMP/ AND CRACK? COCAINE IS A WHITE POWDER that can be snorted or TOOT/SNOW/BLOW/ROCK (CRACK) A. dissolved in water and injected. Crack, an altered form of cocaine, is a rock crystal that is usually smoked.14 GET THE FACTS Q. WHAT IS THE MOST DANGEROUS WAY TO USE COCAINE AFFECTS YOUR BRAIN. Cocaine causes a brief high COCAINE? that makes the user feel more energetic, talkative, and alert; this ANY METHOD OF COCAINE USE CARRIES A RISK can be followed by feelings of restlessness, irritability, and panic.1 A. of addiction and/or overdose.15 Snorting cocaine can Cocaine is highly addictive and can increase the risk of negative result in frequent nosebleeds or loss of sense of smell. psychological states, including paranoia, anxiety, and psychosis.2,3 Injecting cocaine can cause infected sores at the COCAINE AFFECTS YOUR BODY. People who use cocaine often injection sites or exposure to serious diseases such as don’t eat or sleep regularly. They can experience increased heart HIV and hepatitis C by sharing needles.
    [Show full text]
  • COCAINE (Street Names: Coke, Snow, Crack, Rock) December 2019 Introduction: Exposures) and 30 Deaths Related to Cocaine in 2017
    Drug Enforcement Administration Diversion Control Division Drug & Chemical Evaluation Section COCAINE (Street Names: Coke, Snow, Crack, Rock) December 2019 Introduction: exposures) and 30 deaths related to cocaine in 2017. And, for 2018, Cocaine abuse has a long, deeply rooted history in U. S. drug there were 5,778 exposures, 1,358 single substance exposures, and culture, both urban and rural. It is an intense and euphorigenic drug 28 deaths. with strong addictive potential. With the advent of the free-base form of cocaine (“crack”), and its easy availability on the street, cocaine User Population: continues to burden both law enforcement and health care systems in Recent findings indicate that cocaine use may be re-emerging as the U.S. a public health concern in the United States. According to the National Survey on Drug Use and Health (NSDUH), survey estimates indicate Licit Uses: that in 2015, 968,000 people aged 12 or older initiated cocaine use in Cocaine hydrochloride (4% and 10%) solution is used primarily the past year (0.4 percent of the population), which was higher than as a topical local anesthetic for the upper respiratory tract. The vaso- in each of the years from 2008 to 2014. The 2015 estimate represents constrictor and local anesthetic properties of cocaine cause a 26 percent increase compared with 2014, with 766,000 new cocaine anesthesia and mucosal shrinkage. It constricts blood vessels and users in the past year (0.3 percent of the population), and a 61 percent reduces blood flow, and is used to reduce bleeding of the mucous increase compared with 2013, with 601,000 new cocaine users in the membranes in the mouth, throat, and nasal cavities.
    [Show full text]
  • Cocaine Drugfacts
    DrugFacts Revised Abril 2021 Cocaine DrugFacts What is cocaine? Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. Although health care providers can use it for valid medical purposes, such as local anesthesia for some surgeries, recreational cocaine use is illegal. As a street drug, cocaine looks like a fine, white, crystal powder. Street dealers often mix Photo ©Shutterstock/Africa Studio it with things like cornstarch, talcum powder, or flour to increase profits. They may also mix it with other drugs such as the stimulant amphetamine, or synthetic opioids, including fentanyl. Adding synthetic opioids to cocaine is especially risky when people using cocaine don’t realize it contains this dangerous additive. Increasing numbers of overdose deaths among cocaine users might be related to this tampered cocaine. How do people use cocaine? People snort cocaine powder through the nose, or they rub it into their gums. Others dissolve the Page 1 powder and inject it into the bloodstream. Some people inject a combination of cocaine and heroin, called a Speedball. Another popular method of use is to smoke cocaine that has been processed to make a rock crystal (also called "freebase cocaine"). The crystal is heated to produce vapors that are inhaled into the lungs. This form of cocaine is called Crack, which refers to the crackling sound of the rock as it's heated. Some people also smoke Crack by sprinkling it on marijuana or tobacco, and smoke it like a cigarette. People who use cocaine often take it in binges—taking the drug repeatedly within a short time, at increasingly higher doses—to maintain their high.
    [Show full text]