Cocaine & Crack

"Cocaine is a strong central nervous system stimulant that increases levels of dopamine, a brain chemical associated with pleasure and movement, in the brain’s reward circuit. Certain brain cells, or neurons, use dopamine to communicate. Normally, dopamine is released by a neuron in response to a pleasurable signal (e.g., the smell of good food), and then recycled back into the cell that released it, shutting off the signal between neurons. Cocaine acts by preventing the dopamine from being recycled, causing excessive amounts of dopamine to build up, amplifying the message, and ultimately disrupting normal communication. It is this excess of dopamine that is responsible for cocaine’s euphoric effects. With repeated use, cocaine can cause long-term changes in the brain’s reward system and in other brain systems as well, which may eventually lead to addiction. With repeated use, tolerance to the cocaine high also often develops. Many cocaine abusers report that they seek but fail to achieve as much pleasure as they did from their first exposure. Some users will increase their dose in an attempt to intensify and prolong the euphoria, but this can also increase the risk of adverse psychological or physiological effects."

"Cocaine is a sympathomimetic drug with CNS stimulant and euphoriant properties. High doses can cause panic, schizophrenic-like symptoms, seizures, hyperthermia, hypertension, arrhythmias, stroke, aortic dissection, intestinal ischemia, and MI."

"Most cocaine users are episodic recreational users. However, about 25% (or more) of users meet criteria for abuse or dependence. Use among adolescents has declined recently. Availability of highly biologically active forms, such as crack cocaine, has worsened the problem of cocaine dependence. Most cocaine in the US is about 50 to 60% pure; it may contain a wide array of fillers, adulterants, and contaminants."

"Most cocaine in the US is volatilized and inhaled, but it may be snorted, or injected IV. For inhalation, the powdered hydrochloride salt is converted to a more volatile form, usually by adding NaHCO3, water, and heat. The resultant precipitate (crack cocaine) is volatilized by heating (it is not burned) and inhaled. Onset of effect is quick, and intensity of the high rivals IV injection. Tolerance to cocaine occurs, and withdrawal from heavy use is characterized by somnolence, difficulty concentrating, increased appetite, and depression. The tendency to continue taking the drug is strong after a period of withdrawal."

"Toxicity or overdose: An overdose [of cocaine] may cause severe anxiety, panic, agitation, aggression, sleeplessness, hallucinations, paranoid delusions, impaired judgment, tremors, seizures, and delirium. Mydriasis and diaphoresis are apparent, and heart rate and BP are increased. Death may result from MI or arrhythmias.

Severe overdose causes a syndrome of acute psychosis (eg, schizophrenic-like symptoms), hypertension, hyperthermia, rhabdomyolysis, coagulopathy, renal failure, and seizures. Patients with extreme clinical toxicity may, on a genetic basis, have decreased (atypical) serum cholinesterase, an enzyme needed for clearance of cocaine.

The concurrent use of cocaine and alcohol produces a condensation product, cocaethylene, which has stimulant properties and may contribute to toxicity."

"Treatment of mild cocaine intoxication is generally unnecessary because the drug is extremely short-acting. Benzodiazepines are the preferred initial treatment for most toxic effects, including CNS excitation and seizures, tachycardia, and hypertension .... Hyperthermia can be life threatening and should be managed aggressively with sedation plus evaporative cooling, ice packs, and maintenance of intravascular volume and urine flow with IV normal saline solution. .... Occasionally, severely agitated patients must be pharmacologically paralyzed and mechanically ventilated to ameliorate acidosis, rhabdomyolysis, or multisystem dysfunction."

(2008) An estimated 1.1 million Americans aged 12 or older used crack cocaine in 2008. Of those, 726 thousand were White, 256 thousand were Black, and 84 thousand were Hispanic.

(2008) "According to the 2008 Monitoring the Future survey—a national survey of 8th-, 10th-, and 12th-graders—cocaine use among students did not change significantly, though it remained at unacceptably high levels: 3.0 percent of 8th-graders, 4.5 percent of 10th-graders, and 7.2 percent of 12th-graders have tried cocaine; 0.8 percent of 8th-graders, 1.2 percent of 10th-graders, and 1.9 percent of 12th-graders were current (past-month) cocaine users. Crack cocaine use, which has been steadily declining since 1990, showed a significant decrease among 12th-graders in the past year.

(2007) "According to the 2007 National Survey on Drug Use and Health, 35.9 million Americans aged 12 and older reported having used cocaine, and 8.6 million reported having used crack. An estimated 2.1 million Americans were current (past-month) users of cocaine; 610,000 were current users of crack. There were an estimated 906,000 new users of cocaine in 2007—most were 18 or older when they first used cocaine. Among young adults aged 18 to 25, the past-year use rate was 6.4 percent, showing no significant difference from the previous year."

A case argued before the US Supreme Court (Ferguson, Crystal v. City of Charleston, et al.) involved the rights of mothers to seek medical care during pregnancy without fear of prosecution for a positive urine drug test. The Medill School of Journalism at Northwestern University reported that "because a live fetus was a "person" under South Carolina law, a woman who used cocaine after the 24th week of pregnancy could be found guilty of the crime of distributing an illegal substance to a person under the age of 18."

"Black cocaine is created by a chemical process used by drug traffickers to evade detection by drug sniffing dogs and chemical tests. The traffickers add charcoal and other chemicals to cocaine, which transforms it into a black substance that has no smell and does not react when subjected to the usual chemical tests."

"Damage to soils resulting from cultivation and elimination of the natural vegetation is widely reported in reference to the environmental impacts of illicit drug cultivation, as are the likely effects of the discharge of the chemical wastes from coca processing to soils and waterways. However, very little field assessment on the quantity of discharges and their effects on the environment (soils, fauna, flora or water) has been carried out by government agencies or universities. The only analysis found by this study was conducted in Chapare (Bolivia) in 1992 (Southwest Research Associates, 1993, quoted by Henkel, 1995). Here, a study of three cocaineprocessing laboratories found that pollution was concentrated in a small area at the processing site. Most chemicals were disposed of in holding ponds constructed for the purpose and were not dumped into nearby streams. Chemical spills at the site were quickly diluted by the high rainfall received in the region. Because coca processing sites are widely scattered in the Chapare, pollution is widely dispersed rather than concentrated at a few large sites. Some loss of soil microorganisms was noted, but no damage to wildlife, vegetation, fish species or bird life was detected near the processing laboratories. However, the study did not assess the long-term effects of pollution.
"For Colombia, DNE (2002) states that the agrochemicals used in coca processing are capable of polluting freshwater sources for human consumption, but no specific cases of this are given."

"The data on total reduction of forest cover over Colombia and that on losses resulting from coca cultivation span different periods of time, so only rough comparisons of the two can be made. It is likely that several hundred thousand hectares of forest were cleared due to the direct and indirect effects of coca cultivation prior to 2000, before UNODC estimates from remote sensed data were available. Forest cover change in Colombia for the period 1990 2000 is estimated at 190,470 hectares per year. If this rate was assumed to have continued from 2000 to 2004, the total area deforested in those four years would have been 761,880 hectares, of which the 97,622 hectares of primary forest identified as converted to coca cultivations in this period would form 13%. As already noted, the actual of primary forest cleared due to coca cultivation is greater than the area being directly cultivated for this purpose, because of the other crops and activities of the farmers including the opening of roads and airstrips for transport of coca products."

(2004) In 2004, a kilogram of cocaine base in Colombia typically sold for $810 and a kilogram of cocaine typically sold for $1,713. In Peru in 2004, a kilogram of cocaine base typically sold for $700 and a kilogram of cocaine typically sold for $1,000. In Mexico in 2004, a kilogram of cocaine typically sold for $7,880. In the United States in 2001, a kilogram of cocaine typically sold for $23,500.

The U.S. Penal Code violations for cocaine/crack cocaine and possible sentences:

Violation: "(ii) 5 kilograms or more of a mixture or substance containing a detectable amount of - (I) coca leaves, except coca leaves and extracts of coca leaves from which cocaine, ecgonine, and derivatives of ecgonine or their salts have been removed; (II) cocaine, its salts, optical and geometric isomers, and salts of isomers; (III) ecgonine, its derivatives, their salts, isomers, and salts of isomers; or (IV) any compound, mixture, or preparation which contains any quantity of any of the substances referred to in subclauses (I) through (III); (iii) 50 grams or more of a mixture or substance described in clause (ii) which contains cocaine base"
Sentence: Not "less than 10 years or more than life" "No person sentenced under this subparagraph shall be eligible for parole during the term of imprisonment imposed therein."

Violation: "(ii) 500 grams or more of a mixture or substance containing a detectable amount of - [same as above];" "(iii) 5 grams or more of a mixture or substance described in clause (ii) which contains cocaine base"
Sentence: Not "less than 5 years and not more than 40 years" "No person sentenced under this subparagraph shall be eligible for parole during the term of imprisonment imposed therein."

Sec. 844. Penalties for simple possession [of Controlled Substances - also called the Crack/Powder Cocaine Disparity]

STATUTE
(a) Unlawful acts; penalties
".... Notwithstanding the preceding sentence, a person convicted under this subsection for the possession of a mixture or substance which contains cocaine base shall be imprisoned not less than 5 years and not more than 20 years, and fined a minimum of $1,000, if the conviction is a first conviction under this subsection and the amount of the mixture or substance exceeds 5 grams, if the conviction is after a prior conviction for the possession of such a mixture or substance under this subsection becomes final and the amount of the mixture or substance exceeds 3 grams, or if the conviction is after 2 or more prior convictions for the possession of such a mixture or substance under this subsection become final and the amount of the mixture or substance exceeds 1 gram."

"In establishing the mandatory minimum penalties for cocaine, Congress differentiated between the two principal forms of cocaine – cocaine hydrochloride [hereinafter referred to as powder cocaine] and cocaine base [hereinafter referred to as crack cocaine] – and provided significantly higher punishment for crack cocaine offenses.9 As a result of the 1986 Act, federal law10 requires a five-year mandatory minimum penalty for a first-time trafficking offense involving five grams or more of crack cocaine, or 500 grams or more of powder cocaine, and a ten-year mandatory minimum penalty for a first-time trafficking offense involving 50 grams or more of crack cocaine, or 5,000 grams or more of powder cocaine. Because it takes 100 times more powder cocaine than crack cocaine to trigger the same mandatory minimum penalty, this penalty structure is commonly referred to as the '100-to-1 drug quantity ratio.'"

"From December 2000 to February 2001, US-backed antidrug drives resulted in the destruction of more than 29,000 hectares of coca fields (enough to produce 200-250 tons of cocaine annually)."

"Critics note that the spraying has not prevented the tripling of the area under coca cultivation since Pastrana's inauguration, and that the spraying simply destroys the means of livelihood of subsistence farmers and displaces the crops deeper into the jungle. The coca producers have also adapted by developing new varieties of the coca plant, such as the Tingo Maria, which produces three times as much coca as the traditional varieties."

"Current projections call for 80,000 hectares to be sprayed (largely in Putumayo), which, if achieved, will bring the annual total to roughly 65 percent of the area currently thought to be under cultivation. Fifteen specially designed fumigation aircraft are due to be transferred to Colombia in 2001, augmenting the eight planes already in action."

The lack of quality prenatal care is associated with undesirable effects often attributed to cocaine exposure: prematurity, low birth weight, and fetal or infant death.

Research funded by the National Institute on Drug Abuse (NIDA) and the Albert Einstein Medical Center in Philadelphia states: "Although numerous animal experiments and some human data show potent effects of cocaine on the central nervous system, we were unable to detect any difference in Performance, Verbal or Full Scale IQ scores between cocaine-exposed and control children at age 4 years."

Among the general population there has been no detectable increase in birth defects which may be associated with cocaine use during pregnancy.

Well-controlled studies find minimal or no increased risk of Sudden Infant Death Syndrome (SIDS) among cocaine-exposed infants.

"Smoking of crack cocaine was found to be an independent risk factor for HIV seroconversion among people who were injection drug users. This finding points to the urgent need for evidence-based public health initiatives targeted at people who smoke crack cocaine. Innovative interventions that have the potential to reduce HIV transmission in this population, including the distribution of safer crack kits and medically supervised inhalation rooms, need to be evaluated."