Addiction (continuation)
Persons who lack the enzyme cholinesterase have an extreme sensitivity to cocaine and can be poisoned by very small amounts. Cocaine deaths are usually caused by severe disturbances of the heart rhythm (ventricular fibrillation), heart attack (myocardial infarction), repeated convulsions, or depression of the respiratory center in the brain.
Crack
A form of cocaine, known by its street name of “crack” or “rock,” has emerged as an even greater menace than cocaine in its more familiar powdered form. Crack is freebase cocaine, a smokable form of the drug, that has been extracted (“freed”) from the hydrochloride salt of cocaine and formed into pellets using baking soda and water. The name comes from the cracking sound the drug makes when heated and smoked.
Cocaine taken in this way is rapidly and efficiently absorbed into the bloodstream. It reaches the brain in 8 to 10 seconds and, in this concentrated form, produces a very rapid and intense high. The high lasts only a few minutes, however, so the user requires another dose very soon to sustain the high. Repeated doses of the highly concentrated form of the drug cause the user to become addicted very quickly.
With crack, all the medical and psychological problems produced by powdered cocaine are magnified. The extremely high levels of cocaine in the blood greatly increase the possibility of serious toxic reactions, such as high blood pressure, irregular heartbeat, fever, and potentially fatal brain seizures. Among serious respiratory problems suffered by crack smokers are wheezing, chest congestion, chronic cough, and impairment of lung function. Psychological consequences often include radical changes in personality and behavior, which can range all the way from irritability and withdrawal to paranoid reactions and suicidal behavior.
