Leaves: Green, smooth, glossy,
opaque, oval, tapering at extremities,
2-3 cm wide and 3-11 cm long.
Leaves when chewed have pleasant,
Poisonous parts: Leaves
Toxins: Methylbenzoylecgonine i.e.
Cocaine an active principal obtained
from leaves (0.5-1% Al.Cocaine)
Grows throughout the tropical
1.Whole of Latin American Countries
such as Columbia, mexico, ecuador,
and other countries such as Chile,
Peru, India, Indonesia, Sri Lanka, etc.
Bolivia-leading producer-80% world
total cocaine producer.
High risk geographical areas:
3. Brazil – Amazon region
3000 B.C.:Leaves chewed throughot
South America. Coca believed to be a
gift from Go.
1708 A.D. Coca first time mentioned
in materia medica.
1850: Coca tinctures used in throat
1855: Cocaine 1st time extracted
from coca leaves.
1884: Used as local anaesthetic in
1886: Cocaine introduced in newly
launched soft drink - Coca Cola.
1901: Cocaine removed from Coca
1905: Snorting cocaine in the form
of powder became popular.
1910:1st case of nasal damage seen.
1912: U.S. Govt. reports 5000
cocaine related fatalities in one year
1914: Banned of cocaine in U.S.
Cost of making 1 kg cocaine: $200-
Cost of 1 kg cocaine- at present
$15000 – 35000.
Hydrochloride Salt: It is the
powdered form of cocaine, dissolves
in water and when abused, can be
taken i.v. or snorted.
Freebase: Compound that has not
been neutralized by an acid to make
hydrochloride salt. It can be smoked.
Crack: When freebase is heated with
sodium bicarbonate it yields crack.
Why the word crack?
It is smoked.
Principle Routes of Abuse
Ingestion: both cocaine and leaves
of coca plants
What is snorting?
Metabolites can be detected for
varying lengths of time in urine
depending upon the dose consumed
and sensitivity of the assay.
Metabolites in urine is generally
detected in urine for 24-72 Hrs. even
after brief consumption.
With chronic use it is deposited in
body in fats/cns. and is slowly
released. Hence, can be detected in
urine for even couple of weeks.
Metabolites also detectable in
blood, saliva, hair and sweat.
Blood and saliva: Provide accurate
conc. of the drug consumed.
Urine: Provides longer window of
opportunity for detection.
Speedball: Mixture of cocaine and
heroin. Taken i.v.
Local: Anaesthetic when comes in
contact with mucous membrane.
Increase heart rate/B.P./temp.
It is powerful addictive drug.
Once having tried, an individual may
have difficulty in predicting the extent
to which he will continue to use the
Abusers are of upper class society
peoples to enhance self image or
improve professional performance.
Reason for addiction?
Its stimulant and addictive effects are
thought to be primarily a result of its
ability to inhibit the reabsorption of
dopamine by nerve cells.
Note: Dopamine is directly or
indirectly involved in addictive
properties of every major drug of
Cocaine in brain: In normal
communication process, dopamine is
released by neuron into the synapse,
where it can bind with dopamine
receptors on neighbouring neurons.
Normally dopamine is then recycled
back into the transmitting neuron by a
If cocaine is present, it attatches to
the dopamine transporter and blocks
the normal recycling process, resulting
in a building up of dopamine in the
synapse which contributes to the
pleasurable effects of cocaine.
GIT – abdominal pain
Tongue and teeth are black
Regular snorting can lead to loss of
sensation of smell, nose bleeding,
problem of swallowing, hoarseness
and irritation of nasal septum leading
to chronically inflammed running nose
Ingested cocaine can cause bowel
gangrene due to reduced blood flow.
Many chronic cocaine habitual
suffers loss of appetites and can
experience significant weight loss and
Cocaine bugs phenomenon: Grains of
sand are lying under skin or some small
insects are creeping on the skin giving
rise to itching sensation – a form of
Loss of libido
Irregular menstrual cycle, infertility,
Crack Babies: Increased risk of foetal
malformation fo cardiovascular and
cerebrovascular system due to chronic
abuse of cocaine by the mother.
Specific antidote-Amyl Nitrate by
Only symptomatic treatment
Consultation with psychiatric –
psychotherapy, and other related
Symptomatic Treatment Includes
Diazepam for seizure.
Propanolol for ventricular
Haloperidol for pshchosis.
Fatal dose:1 – 1.5 gram orally.
Fatal Period: Few minutes to few
Chronic abuser can tolerate up to
10 gms per day.
No specific findings
Atrophy, inflammation of nasal
Endocarditis due to aseptic i.v.
infusion of drug.
Pulmonary granulomatosis due to
infusion of adulterated particles viz.
starch, talc, etc.
CSF rhinorrhoea due to thinning of
Cocaine can be recovered by
sampling from recent injection sites or
by swabs from the nasal mucosa.
Brain is the excellent source.
Circumstances of Poisoning
Generally accidental overdose.
Rarely used for homicide/sucide.
Aphrodisiac - to increase the
duration of sexual act by desensitizing
the sensory nerves of glans penis
when applied locally.
Prostitutes injects cocaine solution
into the vagina to produce local
anaesthetic effect during coitus.