Side Effects of Cocaine Abuse: Multiorgan Toxicity and Pathological Consequences

Abstract

Cocaine is a powerful stimulant of the sympathetic nervous system by inhibiting catecholamine reuptake, stimulating central sympathetic outflow, and increasing the sensitivity of adrenergic nerve endings to norepinephrine (NE). It is known, from numerous studies, that cocaine causes irreversible structural changes on the brain, heart, lung and other organs such as liver and kidney and there are many mechanisms involved in the genesis of these damages. Some effects are determined by the overstimulation of the adrenergic system. Most of the direct toxic effects are mediated by oxidative stress and by mitochondrial dysfunction produced during the metabolism of noradrenaline or during the metabolism of norcocaina, as in cocaine-induced hepathotoxicity. Cocaine is responsible for the coronary arteries vasoconstriction, atherosclerotic phenomena and thrombus formation. In this way, cocaine favors the myocardial infarction. While the arrhythmogenic effect of cocaine is mediated by the action on potassium channel (blocking), calcium channels (enhances the function) and inhibiting the flow of sodium during depolarization. Moreover chronic cocaine use is associated with myocarditis, ventricular hypertrophy, dilated cardiomyopathy and heart failure. A variety of respiratory problems temporally associated with crack inhalation have been reported. Cocaine may cause changes in the respiratory tract as a result of its pharmacologic effects exerted either locally or systemically, its method of administration (smoking, sniffing, injecting), or its alteration of central nervous system neuroregulation of pulmonary function. Renal failure resulting from cocaine abuse has been also well documented. A lot of studies demonstrated a high incidence of congenital cardiovascular and brain malformations in offspring born to mothers with a history of cocaine abuse.

Assessment of inhibitory control in crack and/or cocaine users: a systematic review

“…This causes users to be highly vulnerable to clinical diseases, impulsive behavior, violence, and promiscuity, in order to obtain the drug. [4][5][6] The profile of crack users is generally young adults who are users of multiple PS, but adopt crack as their drug of choice. [7][8][9] The most common pattern of crack consumption described in the literature is characterized by loss of control, seeking behavior (despite obvious harm to various aspects of life), intense craving, and frequent relapses.…”

Gambling Problems Among Community Cocaine Users

“…Cocaine misuse contributes to the development of several psychosocial and health consequences (Lévesque et al 2014;Riezzo et al 2012;Smith et al 2014) including social dysfunction, unemployment, mental health problems, HIV and hepatitis C viral infections Hser et al 2004;Karila et al 2009). It is therefore important to better characterize cocaine users in order to develop effective interventions to reduce the health burden related to problematic cocaine use (McRae et al 2007).…”

The potential utility of some legal highs in CNS disorders

“…However, neurotoxic effects are likely due to high dose bingeing (Schwendt et al, 2009); 4) psychoses from cannabinoids, hallucinogens and high dose stimulants which might evoke psychotic events, leading the user to undertake dangerous activities; 5) bladder fibrosis from ketamine-like drugs; 6) other organ damage e.g. kidney, liver or lungs (from smoking drugs) (Pateria et al, 2013;Riezzo et al, 2012).…”