Amphetamine-cocaine Abuse

ALSO KNOWN AS
* Some of the common street names for cocaine include "big C", "blow", "nose candy", "coke", "flake", "snow", "lady", "rock", "ice", and "crack".
* "Cat", "crystal", "speed", "bennies", "ups", "jollies", "uppers", and "dexies" are some of the street names for amphetamine.

DESCRIPTION
* When cocaine (in the hydrochloride form) is treated with Ammonia or baking soda it is called "crack". Medically, cocaine is used at low doses as a topical anesthetic in some procedures, while forms of amphetamine (e.g., Ritalin, now being abused as well) are use to treat Attention Deficit Disorder (ADD). These drugs can be inhaled, snorted, injected, smoked, or swallowed.
* Cocaine and amphetamines are stimulant type drugs. In general, they cause euphoric emotions. Medically, they affect the part of the nervous system that "revs up" the body similar to adrenaline. They are psychologically addictive (intensely craved), but are not physically addictive like narcotics, such as heroin (physical addiction means, an individual becomes ill when he attempts to discontinue a drug).

SYMPTOMS
* Sweating
* Heart racing
* Dilated eyes
* High Blood Pressure
* Hyperactivity
* Confusion
* Paranoid delusions
* Depression after quitting or prolonged use.
* Malnutrition due to suppression of appetite (especially with amphetamines)

HOW THE DIAGNOSIS IS MADE
* Urine test is best.
* Blood test not usually sensitive enough to find these drugs

TREATMENT
* Addiction:

1. Bromocriptine may help craving
2. Addiction treatment programs
3. If addicted to these drugs, never stop them suddenly without medical or psychiatric help.
4. Do not take these drugs (at all) if you have a medical condition or you are taking other drugs or medications.

* Overdose:

1. Maintain airway
2. Mechanical ventilation if necessary
3. Treat Coma, heart attacks, or Seizures as they occur
4. Diazepam or Midazolam for agitation or psychosis
5. If overdose by mouth, gastric lavage (pump stomach) and charcoal -- do not induce vomiting.
6. Phentolamine, Nifedipine, or Labetalol for elevated blood pressure (do not use pure beta-blockers by themselves for elevated blood pressure due to amphetamine abuse)
7. Esmolol for rapid heart race/rapid heart arrythmias (this is a pure beta-blocker so another agent must be used to treat elevated blood pressure if this is occurring)

COMPLICATIONS
* Heart attacks
* Strokes
* Seizures
* Aortic Dissection
* Psychosis
* Lung damage
* Hyperthermia (elevated body temperature)
* Fetal abnormalities
* Placental abruption
* Premature births