Cocaine and the critical care challenge

Abstract

Cocaine use is an expanding health hazard, despite intense governmental efforts to contain its distribution and use. Recognition of the signs and symptoms of cocaine toxicity help anticipate the subsequent organ dysfunction and implement earlier organ system support.

Treading the Fine White Line: Cocaine Trafficking

“…A coca bush can grow as tall as 8 feet and has a lifespan of approximately 40 years. Its leaves yield approximately 0.65-1.2% of their weight in cocaine [19]. Since only a small amount of cocaine alkaloid is present in the leaves, a vast quantity is required to produce a concentrated product.…”

“…At this stage, the cocaine paste will contain approximately 40-50% cocaine alkaloid. It is sold to laboratories which add hydrochloric acid to the cocaine paste to produce cocaine hydrochloride [3,10,19].…”

“…Cocaine hydrochloride is water soluble which means it can be absorbed through the mucous membranes in the nasal cavity by snorting or through intravenous injection [3,10,19]. The high that is achieved through snorting cocaine lasts for 15-30 minutes [20] (Figure 4 & 5).…”

“…In 2011, Ashley Wiltshire was arrested for embossing F1, playboy and superman logos on 1kg cocaine blocks [21]. Cocaine hydrochloride can readily be converted into crack cocaine by dissolving it in water and baking soda or sodium bicarbonate and heating the resultant mixture [3,10,19]. Crack cocaine can also be prepared for injection with the addition of a weak acid such as lemon juice, vinegar, citric acid or ascorbic acid [22].…”

Chromatographic Methodologies for Analysis of Cocaine and Its Metabolites in Biological Matrices

“…According to the World Drug Report 2011 (UNODC, 2011), drug of abuse-related deaths are estimated between 104,000-263,000 per year, and they include fatal overdoses (over 50% of all deaths), accidents, suicides, deaths from infectious diseases transmitted through the use of contaminated needles, including hepatitis C and HIV, or complications due to chronic use, namely organ failure and myocardial infarction (Kloner et al, 1992;Shanti & Lucas, 2003;UNODC, 2011).…”