Cocaine

What is cocaine?

Cocaine is a very addictive drug that is made from leaves of the coca plant found in South America. It is mostly available as an illegal drug that some people use to get high. In rare cases, it is also used as a prescription drug for for anesthesia during certain surgeries.

As a street (illegal) drug, cocaine is usually a fine, white, crystal powder. Street dealers sometimes mix it with cornstarch, talcum powder, or flour to make it look like they have more cocaine. That way they can make more money. They may also mix it with other illegal drugs. Another form of the drug is crack cocaine. Crack cocaine has been heated to make it into a rock crystal.

How do people use cocaine?

People snort cocaine powder through the nose or rub it into their gums. Others dissolve the powder and inject it into the bloodstream. Some people inject a combination of cocaine and heroin, called a "speedball." Crack cocaine is smoked.

What are the short-term effects of cocaine?

Cocaine is a stimulant that can make people feel like they have more energy and are extra alert. But it can also make people feel restless, irritable, anxious, and paranoid. Large amounts of cocaine can lead to bizarre, unpredictable, and violent behavior.

Cocaine's effects appear almost immediately and disappear within a few minutes to an hour. How long the effects last and how intense they are will depend on how the person used it.

In some cases, cocaine can cause very serious health problems such as a heart attack, stroke, or coma.

What are the long-term effects of cocaine?

People who use cocaine over the long term may develop health problems. Which problems they have will depend on how they used the cocaine:

• Snorting it can lead to a loss of sense of smell, nosebleeds, nasal damage, and trouble swallowing.
• Smoking it can cause a cough, asthma, trouble breathing, and a higher risk of infections like pneumonia.
• Injecting it with a needle can lead to skin or soft tissue infections, as well as scarring. It can cause collapsed veins. When a vein collapses, the blood cannot flow through it. Injecting cocaine also puts a person at higher risk of getting diseases such as HIV and hepatitis C.

Other long-term effects of cocaine use may include malnutrition and movement disorders, including Parkinson's disease.

Repeated use of cocaine can lead to tolerance. This means users need more and more of the drug to have the same effect. At higher doses over time, the body becomes dependent on cocaine. If someone who is dependent on cocaine stops using it, they will have withdrawal symptoms. These symptoms can include:

• Depression
• Restlessness
• Fatigue
• Increased appetite
• Bad dreams and insomnia
• Slowed thinking

Repeated use of cocaine can also lead to cocaine use disorder, also called addiction. This is more than physical dependence. It's a chronic (long-lasting) brain disorder. When someone has it, they continue to use cocaine even though it causes problems in their life. Some examples include health problems and not being able to meet responsibilities at work, school, or home. Getting and using cocaine becomes their main purpose in life.

Can a person overdose on cocaine?

It's possible to overdose on cocaine. This happens when a person uses so much cocaine that it causes a life-threatening reaction or death. Some people use cocaine along with other drugs or alcohol. This can increase the risk of an overdose.

A cocaine overdose can cause health problems such as:

• Stroke
• Seizures
• irregular heartbeat (arrhythmia)
• Heart attack

There is no specific medicine to treat an overdose. Health care providers will focus on treating the specific health problems caused by the overdose.

What are the treatments for cocaine use disorder?

The treatments for cocaine use disorder are different types of behavioral therapies. There are no medicines which can treat it.

NIH: National Institute on Drug Abuse

Coma

A coma is a deep state of unconsciousness. An individual in a coma is alive but unable to move or respond to his or her environment. Coma may occur as a complication of an underlying illness, or as a result of injuries, such as brain injury.

A coma rarely lasts more than 2 to 4 weeks. The outcome for coma depends on the cause, severity, and site of the damage. People may come out of a coma with physical, intellectual, and psychological problems. Some people may remain in a coma for years or even decades. For those people, the most common cause of death is infection, such as pneumonia.

NIH: National Institute of Neurological Disorders and Stroke

Creutzfeldt-Jakob Disease

Creutzfeldt-Jakob disease (CJD) is a rare, degenerative brain disorder. Symptoms usually start around age 60. Memory problems, behavior changes, vision problems, and poor muscle coordination progress quickly to dementia, coma, and death. Most patients die within a year.

The three main categories of CJD are :

• Sporadic CJD, which occurs for no known reason
• Hereditary CJD, which runs in families
• Acquired CJD, which occurs from contact with infected tissue, usually during a medical procedure

Cattle can get a disease related to CJD called bovine spongiform encephalopathy (BSE) or "mad cow disease." There is concern that people can get a variant of CJD from eating beef from an infected animal, but there is no direct proof to support this.

NIH: National Institute of Neurological Disorders and Stroke

Degenerative Nerve Diseases

Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical condition such as alcoholism, a tumor, or a stroke. Other causes may include toxins, chemicals, and viruses. Sometimes the cause is unknown.

Degenerative nerve diseases include:

• Alzheimer's disease
• Amyotrophic lateral sclerosis
• Friedreich ataxia
• Huntington's disease
• Lewy body disease
• Parkinson's disease
• Spinal muscular atrophy

Degenerative nerve diseases can be serious or life-threatening. It depends on the type. Most of them have no cure. Treatments may help improve symptoms, relieve pain, and increase mobility.

Dementia

What is dementia?

Dementia is a loss of mental functions that is severe enough to affect your daily life and activities. These functions include:

• Memory
• Language skills
• Visual perception (your ability to make sense of what you see)
• Problem solving
• Trouble with everyday tasks
• The ability to focus and pay attention

It is normal to become a bit more forgetful as you age. But dementia is not a normal part of aging. It is a serious disorder that interferes with your daily life.

What are the types of dementia?

The most common types of dementia are known as neurodegenerative disorders. These are diseases in which the cells of the brain stop working or die. They include:

• Alzheimer's disease, which is the most common form of dementia among older people. People with Alzheimer's have plaques and tangles in their brain. These are abnormal buildups of different proteins. Beta-amyloid protein clumps up and forms plaques in between your brain cells. Tau protein builds up and forms tangles inside the nerve cells of your brain. There is also a loss of connection between nerve cells in the brain.
• Lewy body dementia, which causes movement symptoms along with dementia. Lewy bodies are abnormal deposits of a protein in the brain.
• Frontotemporal disorders, which cause changes to certain parts of the brain:
  • Changes in the frontal lobe lead to behavioral symptoms
  • Changes in the temporal lobe lead to language and emotional disorders
• Vascular dementia, which involves changes to the brain's blood supply. It is often caused by a stroke or atherosclerosis (hardening of the arteries) in the brain.
• Mixed dementia, which is a combination of two or more types of dementia. For example, some people have both Alzheimer's disease and vascular dementia.

Other conditions can cause dementia or dementia-like symptoms, including:

• Creutzfeldt-Jakob disease, a rare brain disorder
• Huntington's disease, an inherited, progressive brain disease
• Chronic traumatic encephalopathy (CTE), caused by repeated traumatic brain injury
• HIV-associated dementia (HAD)

Who is at risk for dementia?

Certain factors can raise your risk for developing dementia, including:

• Aging. This is the biggest risk factor for dementia.
• Smoking
• Uncontrolled diabetes
• High blood pressure
• Drinking too much alcohol
• Having close family members who have dementia

What are the symptoms of dementia?

The symptoms of dementia can vary, depending on which parts of the brain are affected. Often, forgetfulness is the first symptom. Dementia also causes problems with the ability to think, problem solve, and reason. For example, people with dementia may:

• Get lost in a familiar neighborhood
• Use unusual words to refer to familiar objects
• Forget the name of a close family member or friend
• Forget old memories
• Need help doing tasks that they used to do by themselves

Some people with dementia cannot control their emotions and their personalities may change. They may become apathetic, meaning that they are no longer interested in normal daily activities or events. They may lose their inhibitions and stop caring about other peoples' feelings.

Certain types of dementia can also cause problems with balance and movement.

The stages of dementia range from mild to severe. In the mildest stage, it is just beginning to affect a person's functioning. In the most severe stage, the person is completely dependent on others for care.

How is dementia diagnosed?

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A physical exam
• Tests of your thinking, memory, and language abilities
• Other tests, such as blood tests, genetic tests, and brain scans
• A mental health evaluation to see whether a mental disorder is contributing to your symptoms

What are the treatments for dementia?

There is no cure for most types of dementia, including Alzheimer's disease and Lewy body dementia. Treatments may help to maintain mental function longer, manage behavioral symptoms, and slow down the symptoms of disease. They may include:

• Medicines, which may temporarily improve memory and thinking or slow down their decline. They only work in some people. Other medicines can treat symptoms such as anxiety, depression, sleep problems, and muscle stiffness. Some of these medicines can cause strong side effects in people with dementia. It is important to talk to your health care provider about which medicines will be safe for you.
• Occupational therapy to help find ways to more easily do everyday activities
• Speech therapy to help with swallowing difficulties and trouble speaking loudly and clearly
• Mental health counseling to help people with dementia and their families learn how to manage difficult emotions and behaviors. It can also help them plan for the future.
• Music or art therapy to reduce anxiety and improve well-being

Can dementia be prevented?

Researchers have not found a proven way to prevent dementia. Living a healthy lifestyle might influence some of your risk factors for dementia.