Kokainomaniya – chronic abuse of the substances containing cocaine. Cocaine is on sale in the form of powder, is a part of a crack and spidbol. Ways of reception: inhalation through a nose, oral introduction, intravenous, subcutaneous and intramuscular injections, smoking, introduction under language, rektalno or vaginalno. After reception there is euphoria, the person feels active, vigorous and hardy. The need for food and for a dream decreases. Heartbeat becomes frequent, there is short wind, HELL and body temperature raises. It is long the existing kokainomaniya it is fraught with emergence of psychoemotional violations, somatic frustration are possible.
Kokainomaniya is one of the most ancient dependences. It is widespread around the world, especially – in South America. Statistically, in the USA and Great Britain about 2% of the population suffer from a kokainomaniya. In Russia because of range of delivery and the high price of a kokainomaniye caused by this circumstance occurs mainly at people with a high financial and social status. In other countries cocaine also often is considered as "elite" drug.
The most widespread direction of use at a kokainomaniye – inhalation of powder through a nose (classical option, "a cocaine path"). Also intravenous administration is possible. Residents of the countries in whom grows the cook can use cheaper version – cocaine paste which can be rubbed, swallowed or used in the form of candles. One more cheap option of cocaine is the crack – specially processed cocaine intended for smoking. There is also a mix of heroin and a crack – which is smoked or enter intravenously. Medicine constitutes big danger because of development of heavy cross dependence and pronounced negative impact on cardiovascular system.
Cocaine and development of a kokainomaniya
Cocaine – the natural alkaloid which is contained in leaves cooks. Leaves collect and subject to difficult multistage processing. Powder is as a result formed. At inclusion in an organism 20-40% of cocaine get, at inhalation – too 20-40%, at intravenous administration – 100% and when smoking – 6-32%. Cocaine is quickly soaked up in blood and distributed on an organism. Time of the beginning of action depends on a way of introduction and fluctuates of several seconds when smoking up to 15-20 minutes at inhalation. Effect of medicine quickly takes place (at most – within several hours at intravenous administration). For prolongation of effect use cocaine in a combination with etanolsoderzhashchy drinks.
At receipt in blood cocaine begins to affect receptors of the central and peripheral nervous system. It improves mood, reduces the need for a dream and food, increases physical endurance, causes euphoria, inflow of cheerfulness and working capacity. These qualities of cocaine since the most ancient times were used by the soldiers, travelers, people occupied with hard physical work and then – and psychologists, including Freud. It became known later that at the long use cocaine causes heavy dependence, provokes mental violations and somatic frustration.
At the initial stages people accept cocaine because of euphoria and effects which look "useful" at violation of a day regimen, excessive physical or psychological activities. As a stimulator cocaine is quite often used by singers, actors, representatives of other creative professions, businessmen and "gilded youth". The important factor promoting distribution of a kokainomaniya are "prestigiousness" and "fashionableness" of this drug.
Now among researchers in the field of narcology there is no consensus concerning the dependence nature at a kokainomaniye: one scientists consider it as mental, others – as physical. Most of researchers inclines that physical dependence at a kokainomaniye is absent. The effect of cocaine very short-term, after cancellation of drug of the patient tests the expressed dysphoria, feels angry and oppressed. Pronounced mental dependence induces the person suffering from a kokainomaniya, any way to look for a new dose.
Allocate two groups of effects of cocaine reception: central (caused by impact on TsNS receptors) and peripheral (caused by change of exchange processes in peripheral nervous system). Euphoria and a condition of a peculiar intoxication are among the central effects. The patient suffering from a kokainomaniya feels strong, vigorous, physically hardy and self-assured. He feels activization of mental abilities, becomes talkative, sleeps a little and eats a little. Expansion of pupils, heartbeat increase, short wind, increase HELL and the general temperature, and also sweating strengthening is among peripheral effects. The sexual inclination at a kokainomaniye increases, the sexual behavior because of the changed mental state becomes less operated.
The listed effects are not followed by an incoordination, delay of thinking and speed of reaction and other symptoms characteristic of alcohol and the majority of narcotic medicines. It creates a false sense of security of drug. Upon termination of effect of medicine of people, suffering from a kokainomaniya, feels sharp decrease in mood and feels the need to accept a new dose. Further it is possible as long reception of drug in the same doses, and significant increase in a dose.
At it is long the existing kokainomaniya a number of the frustration caused by violations of exchange of neurotransmitters develops. The patients suffering from a kokainomaniya have problems with a dream, suffer from nausea and a headache. Bystry fatigue develops, memory worsens, there are difficulties in attempt to concentrate attention. Trembling of extremities is possible. Typical manifestations of a kokainomaniya are damages of a mucous nasal cavity which are shown in the form of cold and nasal bleedings. At a kokainomaniye destruction of a nasal partition can be observed.
Kokainomaniya is followed by the progressing changes of the personality. Emotions are flattened, become monotonous, the focus of interest is narrowed. The strong-willed sphere is surprised, patients cease to aspire to something and live in one afternoon, without working and parasitizing on close people. Aggression and the increased irritability is quite often observed. Appearance worsens, patients with a kokainomaniya become slovenly and look is more senior than the years. Development of the crazy ideas, emergence of tactile, acoustical and visual hallucinations is possible. A typical sign of a kokainomaniya are tactile hallucinations at which it seems to patients that at them under skin insects creep. There can be suicide thoughts and intentions.
Decrease in body weight up to a kakheksiya is characteristic of late stages of a kokainomaniya, puffiness of the person and unhealthy grayish skin color. On skin hems are often visible from having combed in attempt to take insects. Traces of the abscesses caused by decrease in immunity can come to light. From internals short wind, stenocardia and violations of a rhythm is possible. At the patients suffering from a kokainomaniya the probability of development of a stroke and myocardial infarction increases.
Men with a kokainomaniya have violations of a potentiality, at women strengthening of sexual desire is noted. Problems in the sexual sphere in combination with a rastormozhennost and emotional flattening provoke tendency to sexual perversions, is frequent – with sadism elements. Personal changes and violations of the psychoemotional sphere can become the reason of asocial behavior. Patients with a kokainomaniya behave is noisy and inconsiderately, often break an order and easily use physical force at emergence of the conflicts.
Overdose symptoms at a kokainomaniye arise within several minutes at intravenous administration or smoking and within 30-60 minutes at other directions of use. In hard cases the condition of excitement is replaced by oppression of nervous system. Cocaine affects all departments of a brain including on a medulla in which the sosudodvigatelny and respiratory centers therefore at oppression of TsNS violations of breath and warm activity are possible are located. Death can come from respiratory standstill, and at cardiovascular pathology – from a heart attack or heavy violations of a rhythm.
In mild cases consciousness is kept, patients with a kokainomaniya complain of pains of stenokardichesky character behind a breast. Excitement, increase of pulse, increase HELL, expansion of pupils and comes to light. At heavier overdose there is sharp psychosis which is followed by the expressed violations from the blood circulatory system. Spasms, hypostasis of lungs, heavy arrhythmia, a heart attack and a stroke are possible. At a serious poisoning the coma develops. At early stages of poisoning the patients suffering from a kokainomaniya most often perish from the heavy arrhythmia, a malignant hyperthermia, strokes and epileptic seizures passing into the epileptic status. In the subsequent violations of coagulability of blood, renal or polyorgan failure can become the reason of a lethal outcome.
Diagnostics, treatment and the forecast at a kokainomaniye
The diagnosis of a kokainomaniya is exposed by the narcologist on the basis of the anamnesis, data of an objective research and analyses on existence in an organism of cocaine and its metabolites. Preliminary techniques are used: chromatography, polarizing , immunofermental and immunokhromatografichesky analysis. At positive result of the preliminary analysis the confirming research is conducted: a thin layer chromatography, chromaTO - mass spectrometry, a liquid chromatography and a gas-liquid chromatography. Results of the confirming researches are legally significant and can be presented in court.
At treatment of overdose of the patient suffering from a kokainomaniya place in intensive care unit. Hold events for elimination of pathological symptoms and normalization of work of internals. If necessary use IVL. Planned treatment of a kokainomaniya because of the expressed mental dependence is recommended to be performed in the conditions of a hospital. Cocaine is cancelled in one stage. Sick with a kokainomaniya place in a quiet situation, appoint soothing medicines. Carry out individual and group psychotherapy. The peak of a dysphoria falls on 1-3 days, the state is normalized within 2 weeks, is more rare – within a month.
After hospitalization rehabilitation, actions for change of a circle of contacts and restoration of a normal social environment is necessary. Preferable option is long stay in the rehabilitation center or the therapeutic commune where the patient can get the qualified psychological assistance and support of more skilled "colleagues by misfortune" who could already cope with a kokainomaniya. In some cases useful are programs offered by society "Anonymous Addicts". Effective drug treatment of a kokainomaniya does not exist yet, medicines can be used only as supportive applications for stabilization of mentality and an emotional condition of patients.
The forecast at a kokainomaniye is defined by weight and duration of dependence and depth of personal changes. A lot of things depend on desire of the patient to get rid of dependence, and also of quality and duration of actions for social and psychological rehabilitation. People who in the past suffered from a kokainomaniya after the termination of reception can have permanent depressive frustration which quite often become the reason of a recurrence. Therefore treatment of a kokainomaniya surely has to include observation of the psychiatrist or psychotherapist.