00:00 / 00:00
Generalized anxiety disorder
Social anxiety disorder
Major depressive disorder
Major depressive disorder with seasonal pattern
Premenstrual dysphoric disorder
Neuroleptic malignant syndrome
Lewy body dementia
Attention deficit hyperactivity disorder
Autism spectrum disorder
Disruptive, impulse control, and conduct disorders
Fetal alcohol syndrome
Body dysmorphic disorder
Body focused repetitive disorders
Cluster A personality disorders
Cluster B personality disorders
Cluster C personality disorders
Female sexual interest and arousal disorder
Genito-pelvic pain and penetration disorder
Male hypoactive sexual desire disorder
Somatic symptom disorder
Alcohol use disorder
Physical and sexual abuse
Post-traumatic stress disorder
Amnesia, dissociative disorders and delirium: Pathology review
Anxiety disorders, phobias and stress-related disorders: Pathology Review
Childhood and early-onset psychological disorders: Pathology review
Dementia: Pathology review
Developmental and learning disorders: Pathology review
Drug misuse, intoxication and withdrawal: Alcohol: Pathology review
Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review
Drug misuse, intoxication and withdrawal: Other depressants: Pathology review
Drug misuse, intoxication and withdrawal: Stimulants: Pathology review
Eating disorders: Pathology review
Malingering, factitious disorders and somatoform disorders: Pathology review
Mood disorders: Pathology review
Personality disorders: Pathology review
Psychiatric emergencies: Pathology review
Psychological sleep disorders: Pathology review
Schizophrenia spectrum disorders: Pathology review
Trauma- and stress-related disorders: Pathology review
0 / 10 complete
0 / 2 complete
Stevie Nicks: "I Used to Carry a Gram of Cocaine in My Boot" | Master Class | Oprah Winfrey Network
Cocaine, sometimes called coke, is a powerful psychoactive stimulant that alters how the brain functions—specifically, how we perceive our surroundings.
Cocaine comes from the leaves of the South American coca plant, and has been used for over a thousand years.
In modern times, it’s become a popular “party drug” because cocaine reduces inhibitions and creates a feeling of euphoria or pleasure; this feeling lasts between fifteen and ninety minutes, depending on how the drug’s it’s administered.
Around 18 million people worldwide use cocaine, and because of its strong potential for addiction and overdose, the drug is heavily regulated in many countries.
To understand how cocaine works, let’s zoom into one of the synapses of the brain.
Normally, electrical signals, or action potentials, travel down the axon to the axon terminal, where they trigger the release of chemical messengers called neurotransmitters from synaptic vesicles into the synapse.
The neurotransmitters travel across the synapse and bind to receptors on the postsynaptic neuron, where they give the cell a message.
After the neurotransmitters have done their job, they unbind from the receptors, and can just diffuse away, get degraded by enzymes, or get picked up by proteins and returned to their release site in a process called reuptake.
Cocaine increases the release of certain neurotransmitters, but it’s biggest effect is blocking reuptake receptors on presynaptic axon terminals.
Both of these actions keep neurotransmitters like dopamine, norepinephrine, and serotonin in the synapse longer, increasing their effects.
For example, increased concentrations of dopamine in the brain’s reward pathway (which includes the nucleus accumbens, ventral tegmentum, and prefrontal cortex) produce intense feelings of euphoria, pleasure, and the emotional “high” associated with cocaine.
This physical “high” or feeling of hyper-stimulation is caused by increased norepinephrine concentrations throughout the brain, which produces a variety of effects throughout the body like increased energy, constricted blood vessels, dilated pupils, increased body temperature, increased heart rate, and increased blood pressure. Finally, these higher levels of serotonin are associated with greater confidence.
Cocaine can get into the blood and to the brain via a few different methods.
One way is by simply ingesting it, but the drug is often inactivated by stomach acid unless it’s mixed with something alkaline.
Cocaine is also metabolized by the liver, and it causes capillaries in the mouth and esophagus to constrict, which makes it harder for the body to absorb.
A more direct route is insufflation—snorting it—because the drug is easily and rapidly absorbed through the mucous membranes of the nasal passages, or smoking it so the drug can be absorbed through the lungs.
The fastest route, though, is direct injection into the blood.
Typically, the faster cocaine reaches the brain, the stronger the relationship between the behavior and the reward, which ultimately leads to addiction.
Latest on COVID-19
Nurse Practitioner (NP)
Physician Assistant (PA)
Create custom content
Raise the Line Podcast
Copyright © 2024 Elsevier, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
Cookies are used by this site.
Terms and Conditions
USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.