Smoked Cocaine: Patterns of Use and Pulmonary Consequences

Abstract

This article offers a perspective on the use of volatilized alkaloidal cocaine in its freebase and crack forms and on the pulmonary consequences of such use. The inhalational route of administration of freebase and crack cocaine exposes the lung to their combustion products, raising concern about possible adverse pulmonary effects. A brief historical review of cocaine and its methods of use precedes the presentation of data concerning current modes and patterns of use and some pulmonary complications of crack and freebase use. Results from a systematic study of a large sample of cocaine users document a high frequency of occurrence of acute respiratory symptoms in temporal association with cocaine smoking. No relationship was detected between the prevalence of acute pulmonary symptoms and identifiable aspects of techniques of cocaine administration. These results suggest that the respiratory consequences of alkaloidal cocaine are most likely attributable to the inhaled cocaine itself, rather than to variable characteristics of usage.

Smokers versus snorters: Do treatment outcomes differ according to route of cocaine administration?

“…While the effectiveness of treatment retention toward improvement in drug use remains questionable (Pearson et al, 2012), treatment retention is often cited as a key outcome measure and several lines of research have reported positive relationships between treatment duration and drug use outcomes (C.-Y. Chen & Lin, 2009; De Giorgi et al, 2012; Khalsa, Tashkin, & Perrochet, 1992; Ruiz, Cleary, Nassiri, & Steele, 1994; Welch, Todd, & Krause, 1991). Second, intranasal users achieved longer periods of sustained abstinence than smokers (non-significant trend), yet the percentage of days abstinent did not differ between the groups.…”

Pulmonary alterations in cocaine users

“…Among these are adverse effects on the lungs. 37 Respiratory system alterations depend not only on the administration route, but also on the dose and time of use, presence of microbiological contaminants or substances used to adulterate the sample, sharing of paraphernalia used for the drug consumption and host responses of the individual user. 38 Small doses of cocaine cause acute respiratory stimulation and large doses lead to respiratory depression.…”

Aumento da procura de tratamento por usuários de crack em dois ambulatórios na cidade de São Paulo: nos anos de 1990 a 1993

“…No trato respiratório, têm sido observados vários problemas como: tosse, expectoração enegrecida, dor peitoral, redução da função pulmonar, com capacidade de expiração comprometida e, em casos mais graves, pneumotórax espontâneo e enfisema no mediastino 6 . No aparelho cardiovascular, o aumento da freqüência cardíaca e da PA e o notável efeito vasoconstritor podem levar a uma parada cardíaca.…”