Getting high falling low

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Carly * dreamed of being a musician. Hanging out at clubs to see bands play was part of her plan. One night when Carly was 14, someone offered her cocaine. Curious to try out what her older friends were doing, she snorted a line.

“After the first time … it was all I could think about,” Carly, now 25, says. “I’d always try to find people who had it and hang out with them and mooch off of them, and then I started paying for it a little bit and then paying for it a lot.” Within a couple of years, Carly couldn’t snort cocaine anymore because the powder had put a hole in her septum, the wall of cartilage that separates the nostrils. Rather than stopping, she switched to injecting herself daily to satisfy the craving for a high.

The Straight Dope

Carly lives in Canada, but her experience mirrors that of many U.S. teens. In this country, 6.4 percent of high school students have tried cocaine. Students in 11th and 12th grades are more likely to have tried it than those in ninth and 10th grades, according to the 2009 National Youth Risk Behavior Survey.

Cocaine comes in many forms, and each has different effects and risks. (See “One Drug, Many Variations,” page 22.) But all the forms carry the risk of addiction. The reason is that cocaine affects the reward system in a person’s brain. Normally, pleasing activities, such as playing sports, being with friends, or smelling good food, cause the brain to release a substance called dopamine, which produces a rewarding sensation. But cocaine causes the brain to release dopamine at almost four times its normal level.

“The problem is, the brain does not allow that type of release to continue forever,” explains Dr. Anthony Dekker, the medical director at Brighton Hospital, a rehab center in Brighton, Mich. The overstimulation of dopamine causes the brain to become numb to its effects over time. “Pretty soon you start having a reactive effect where the things that normally made you happy don’t do that anymore because your brain is used to such strong stimulation. The only way to get that feeling back is to score some more cocaine.”

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Your Brain on Coke

Getting hooked is even easier at a young age. Recent studies have shown that teens are more sensitive than adults to the addictive properties of cocaine because their brains are still developing. Researchers have found that people who start using the drug in their early teens are more likely to develop an addiction than those who start later.

“During teenage development, the brain is more sensitive to those rewarding feelings that are associated with cocaine,” says Sue Andersen, director of McLean Hospital’s Developmental Psychopharmacology Laboratory in Boston. The front part of the brain “undergoes these periods during adolescence where it’s learning how to interact with its environment.” A teen’s brain is learning so much, in fact, that it can “overlearn” habits, such as addiction, more than an adult would. As a result, the changes caused by cocaine are about four times greater in a teenage brain than in an adult’s.

Shaun, * who lives in California and started snorting cocaine at 14, felt the urges immediately. The day after his first high, which he describes as a spinning feeling that gave him a massive rush of energy, he bought more. Pretty soon, he was stealing money, phones, and iPods from classmates so that he could buy more coke. When he started showing up high for class and baseball practice, his teammates stopped talking to him.

“It kind of made me want to stop because I thought, I’m losing my friends over this,” Shaun says. “But then again I’d be using, like, right after. And I’d think, They’re my friends but who cares. I don’t need them; I need this.”

Long-Lasting Consequences

Although a cocaine high can span anywhere from 10 minutes to 45 minutes, its consequences are much longer lasting. Users have reported headaches, nausea, respiratory problems, paranoia, and hallucinations while they’re high. Because the drug increases body temperature, heart rate, and blood pressure, it raises the risk of stroke, respiratory failure, seizures, heart attacks, and death. “Cocaine speeds your heart up and makes your heart pump harder and faster, and your heart may not be able to take it,” says Dekker. Because every person’s body reacts differently, there’s no way to know what amount will lead to an overdose. Aside from cocaine’s physical effects, it can also take a toll on a person’s mental health.

In Carly’s case, friends and family stopped talking to her because she was always irritable and angry. She joined a punk rock band and signed with a record label, only to get kicked out of the group because she was missing practice to get high. It wasn’t until Carly started feeling suicidal that she realized she needed help.

Rehab can take almost twice as long for teens as for adults, according to Andersen. That’s because teens develop stronger attachments not only to cocaine, but also to the places and situations they link it with. “It’s like the cologne of a boyfriend. If you smell it again, it kind of takes you back, and you have all these great feelings,” Andersen says. “It takes longer for teens to decrease these associations [with cocaine] even when they’re not using.”

For Carly, detoxification took four months. When she got out of rehab, Carly found living in the same surroundings as she’d been in during her cocaine-using days was difficult. So she moved across the country to start fresh and go to college. Carly says she still has problems with her family because they don’t fully trust her.

As for Shaun, when Current Health spoke with him, he was two weeks away from finishing rehab and had been clean for 60 days. He now sees cocaine very differently. “The only time it did anything for me was when I was high,” Shaun says, “but then when it was over, it wasn’t ever worth it.”

Think About It

Why, do you think, do people use cocaine despite the risks of addiction, serious health problems, and death? What might convince them not to use it?

One Drug, MANY Variations

Cocaine is extracted and chemically processed from the leaf of the coca plant, which is native to the South American Andes. As a drug, it takes many forms:

POWDER A white powder can be snorted through the nose. It can cause nosebleeds, loss of smell, and problems with swallowing. Reports have also shown that substances in contaminated cocaine can cause a person’s outer skin layer to rot.

LIQUID Powder diluted in water can be injected directly into the bloodstream. That can cause allergic reactions and transmit blood-borne pathogens, such as human immunodeficiency virus (HIV), through exposure to contaminated needles.

FREEBASE OR CRACK A crystal form can be heated to release vapors that are inhaled. Smoking produces the fastest high because the cocaine goes straight into the bloodstream (by way of the lungs) and reaches the brain quickly. The rush is short-lived and can be extremely addictive because users will often seek it out again.

Research has shown that people who use cocaine, in any form, have a higher chance of contracting HIV because of contaminated needles, mouth wounds caused by crack pipes, and an increase in risky behaviors, such as unprotected sex.

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* Names have been changed.

Key Points

* Cocaine is a mind-altering drug that carries a risk of addiction in all its forms.

* Teens, whose brains are still forming, are at an even higher risk of cocaine addiction than are adults.

* Health consequences of cocaine use include serious physical and psychiatric problems, as well as death.

* For teens, rehabilitation from cocaine use may be a long struggle because of the deep dependence on the drug they may form and because of the associations they develop to situations in which they use it.

Think and Discuss

Why, do you think, do people use cocaine despite the risks of addiction, serious health problems, and death? What might convince them not to?

Extension Activity

Use the article as a jumping-off place to help students learn and practice strategies for resisting peer pressure. Write a few short scripts depicting teens in scenarios where they must choose whether to use cocaine (or other drugs). Then select students to act out the scenarios. As a class, list and discuss realistic ways that teens can resist using drugs.

Resources

* NIDA for Teens: Mind Over Matter–Cocaine

www.teens.drugabuse.gov/mom/mom_stim1.php

* No Problem, by Dayle Campbell Gaetz (Orca Book Publishers, 2006)

* Neuroscience for Kids–Cocaine

faculty.washington.edu/chudler/coca.html

Sylvester, Natalia M.

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