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Cocaine is one of the most
widely used drugs in the entire world.
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While the indigenous peoples of South
America have been using the coca leaf
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00:00:06,539 --> 00:00:10,143
for medicinal and stimulative purposes
for thousands of years,
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it was the refinement
and purification of the cocaine
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alkaloid inside the leaf
that led to the drug we know of today.
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In today's video,
with the help of the cadavers
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here in the lab, we're going to discuss
what cocaine does to the body,
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as well as the mass destruction
it leaves in its wake.
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It's going to be an important one.
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Let's do this.
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Cocaine can be consumed in various forms.
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It can be swallowed,
smoked, injected intravenously
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or snorted through the nose
in what's known as nasal insufflation.
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But once it gets into the bloodstream,
the effects on the nervous
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and endocrine system
are essentially going to be the same,
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although the timing in terms of the onset
and duration of the effects
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are going to be different.
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However,
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there are unique consequences to the body
depending on how it was consumed.
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Intravenous administration
can come with a risk of infection
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as well as permanent damage to blood
vessels.
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Smoking can come with tooth decay,
abscesses and lung damage.
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Our focus today is primarily
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going to be on nasal
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insufflation, considering that's
the most common form of consumption,
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and that can come with severe consequences
for the nasal passageways.
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You are looking at a midsagittal view
of the head, which allows us
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to see the internal
anatomy of the nasal cavity.
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And you're going to notice,
if you look closely,
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that there are three projections
in this nasal cavity.
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These are the superior, middle
and inferior, conchae.
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Or sometimes you'll also hear them
be referred to as turbinates.
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And between them
are going to be passageways
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The air will actually travel through
as it's going into the body.
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But covering these cocci
is going to be mucosal membranes,
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and these mucosal membranes
are highly vascular
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and they act to warm up the air
as well as humidify it.
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As the air travels through
goes down the nasal pharynx
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and into the lower respiratory tract.
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This is going to be the nasal septum
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and it divides the left
and right aspects of the nasal cavity.
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And it's actually a combination
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of cartilage, which is this portion here
and bony tissue,
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but it would also be covered
in mucosal membranes.
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And this would actually be more vascular
than the conchae would be.
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And it's this vascularization
that's going to be most important
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and interesting to us for our conversation
today, because the effect that cocaine
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has on the blood vessels
inside of the nasal cavity
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can really only be described
as utterly destructive.
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Real quick, I want to thanks
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And given how easy it is to consume,
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And you can almost think of it
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You're then going to take a sip
and carry on with your day.
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Look, I'm the type of guy
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So knowing that a significant amount of my
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first thing in the morning, well,
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Cocaine is a vasoconstrictor,
and that means it causes blood vessels
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to get smaller.
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And this is actually why
it's still used medicinally in certain
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and very specific circumstances
to this day.
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But when cocaine is snorted,
it is going to coat the mucosal membranes
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and get absorbed by the blood
vessels inside.
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Now, undoubtedly,
some of the cocaine will make its way
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into the nasopharynx
and down into the lower respiratory tract.
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But this is still going to be
the primary route of absorption.
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And this actually takes time to occur.
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And this is why snorting cocaine is one of
the slowest acting forms of consumption.
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Whenever anything abnormal enters
the nasal passageway,
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the mucosal membrane responds
by producing mucous.
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Just think of allergens.
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But the mucus is meant to stop whatever
it is from getting deeper into your body.
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And cocaine is no different.
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So if someone is using cocaine
multiple times over the course of,
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say, a day or an evening,
there's going to be a progressive buildup
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of mucus inside of the nasal cavity
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until it gets to the point
where there is a complete blockage.
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And this will actually prevent them
from continuing
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to use the cocaine,
which is why you often hear users
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snorting.
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And as it's been described to me,
this serves two primary purposes.
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The first is
they're desperately trying to unblock
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the nasal passageways
so they can consume more cocaine.
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But they also are kind of hoping
that there's cocaine in the mucus, that
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by snorting, it's somehow going to get
freed up and get into their system.
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When the blood vessels are constricted,
that means nutrients and namely oxygen
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isn't able to get to the nasal mucosa,
the nasal septum,
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and even the bony tissue underneath
both of them.
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And considering the nasal septum,
which is partly cartilaginous, already
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has a limited blood supply, it's possible
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to develop a septal perforation —
a hole inside of that nasal septum
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— in a matter of weeks
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with consistent cocaine usage,
although that also can take longer.
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And it's important to note
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this is a permanent hole
that can only be repaired surgically.
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For chronic users,
the situation only gets worse.
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The bones of the skull
can begin to degenerate.
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Midfacial Osteomyelitis is a potential
consequence of long term usage.
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So this right here is the Vomer,
and just above it is the Ethmoid.
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And behind it,
this right here is called the Sphenoidal
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Sinus and it belongs to a bone
called the Sphenoid.
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All of these, including other bones
such as the Maxilla, which we can't see
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here, can degenerate and house
bacterial infections.
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So essentially a giant hole starts
to form in the center of the skull.
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Once cocaine gets to the bloodstream,
it will make its way to the heart,
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which will then pump it
and distribute it all throughout the body.
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Once it gets to the brain,
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it has to pass through
what's known as the blood-brain barrier.
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The blood-brain barrier essentially exists
to prevent harmful substances
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from interacting with the brain tissue.
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It does this through tight
cellular junctions and mechanisms.
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Cocaine is highly lipophilic, which means
that it dissolves into fats and oils.
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And unfortunately,
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this type of lipophilicity also means
that it relatively easily gets through
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the blood-brain barrier through passive
diffusion, which you can just think of it
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naturally making its way through
without any energy requirements.
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Although mouse studies have also shown
that cocaine can be actively transported.
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This is where energy is actually
being used
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to also push it
through the blood-brain barrier,
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making it even easier
to get into the brain tissue.
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Once cocaine gets into the brain,
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and the overall nervous system
for that matter, it has profound effects
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on three neurotransmitters: dopamine,
serotonin and norepinephrine.
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Now, neurotransmitters are molecules
that act at the synapse,
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which is just the connection
of two neurons.
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The neurotransmitter
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will leave the first neuron and enter
into what's known as the synaptic cleft.
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This is the gap between two neurons.
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From there,
it'll then bind to that second neuron
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and it'll either excite, inhibit or alter
a signal.
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The neurotransmitter will
then be brought back into a neuron,
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and that will essentially just stop
whatever the effect it was causing.
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We call this
reuptake, and cocaine interferes with it.
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Cocaine blocks
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what are known as dopamine, serotonin
and norepinephrine transporters.
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And by blocking them,
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the neurotransmitters stay in the synaptic
cleft, continuing to act.
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Dopamine is involved with things
such as joy
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and pleasure and just overall
feeling rewarded for different things.
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So that means cocaine
is going to make you,
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or at least in the presence of cocaine,
feel very rewarded.
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Serotonin does a ton of different things,
but it's involved with
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mood, sleep, digestion, breathing.
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So that means cocaine is going
to have an effect on all of those.
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Norepinephrine is the primary driver
of the sympathetic
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nervous system, which is an aspect
of the autonomic nervous system.
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Now, I discussed
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the autonomic nervous system
in quite some detail in a previous video,
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so I'll go ahead and link
that up above for you to check out.
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But you could think of the autonomic
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nervous system
as the automatic nervous system.
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It's things you don’t have to think about.
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So this is going to be like your “fight
or flight” or your “rest and digest”.
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Norepinephrine is the driver
for the “fight or flight”,
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so this can be things like pupil dilation,
sweating, the muscles
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being engorged with blood, blood
going away from the internal organs.
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So that means cocaine is going
to have an effect on all of that as well.
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So based on this, you'll likely understand
all the signs and symptoms associated
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with cocaine usage, such as lockjaw,
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excitability, dilated pupils,
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extreme thirst, runny nose,
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weight loss, mood swings,
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social isolation, risky
behaviors, nosebleeds,
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a boost in confidence, yes,
but talkative habits and changes
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in sleeping and eating patterns,
and plenty more.
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Cocaine is also extremely addictive,
and the proposed mechanism
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of that addiction is what's known
as the dopamine hypothesis of addiction.
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And the idea is pretty simple.
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With abnormally high levels of dopamine,
you’re creating new baseline for dopamine.
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And then as the drug wears off
and that dopamine goes below the baseline,
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that creates a cascade of downstream
effects.
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This hypothesis of addiction
isn't unique to cocaine,
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but is also proposed
for many other substances.
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But there's still some real science
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that needs to be done
in proving this hypothesis to be true.
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And it's likely that
dopamine is just going to be one factor
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among many other factors
when it comes to addiction and dependency.
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But it's important to note
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that smoking cocaine,
as well as intravenous injections,
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that's going to actually be more addictive
than intranasal consumption,
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but insufflation is still highly
addictive.
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00:10:35,101 --> 00:10:37,236
It's also important to note
that cocaine doesn't
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only bind to dopamine, serotonin
and norepinephrine transporters —
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00:10:41,007 --> 00:10:45,845
it also binds to neurotransmitter
receptors, plasma proteins, voltage
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00:10:45,845 --> 00:10:50,216
gated ion channels and metabolic enzymes
all throughout the body.
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00:10:50,216 --> 00:10:54,253
This means it has a direct effect
on the cardiovascular system,
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00:10:54,253 --> 00:10:58,591
respiratory system, urinary system,
even the immune system.
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Cocaine also doesn't
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00:10:59,492 --> 00:11:02,862
last a long time in the body,
or at least your perception of it.
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00:11:03,062 --> 00:11:07,133
That is because you can still feel the
effects of cocaine for days afterwards.
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But let's say you consume it intranasally.
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You can feel the effects of cocaine
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from anywhere from 15 minutes
up to an hour in some cases,
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which is how
and why many users will consume
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it multiple times over the course
of an evening or throughout a party.
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00:11:23,015 --> 00:11:26,852
And unfortunately, this also then
increases the likelihood of an overdose.
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Now, whether or not you overdose depends
on a variety of factors such as sex,
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weight, tolerance,
the route of administration.
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So did you smoke it?
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00:11:36,162 --> 00:11:38,764
Did you inject it,
or did you insufflate it?
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00:11:38,764 --> 00:11:40,366
All of these are going to matter
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and can even affect the concentration
of cocaine in your system.
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00:11:44,370 --> 00:11:47,473
Regardless, it's
surprisingly easy to overdose on cocaine,
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especially if you have
a preexisting condition
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such as cardiovascular disease,
for instance.
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00:11:51,711 --> 00:11:56,882
But overdosing can result in cardiac
arrhythmias, heart attacks, seizures,
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00:11:57,149 --> 00:12:02,088
strokes, high blood pressure, difficulty
breathing and even extreme anxiety.
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00:12:02,121 --> 00:12:05,157
Cocaine is also commonly paired
with alcohol and heroin, which
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00:12:05,157 --> 00:12:09,328
just dramatically increases the chances
of an overdose or harm to the body.
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00:12:09,662 --> 00:12:14,166
When alcohol and cocaine are consumed
together, the byproducts of their
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consumption are converted by the liver
into something called cocaethylene,
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00:12:18,504 --> 00:12:22,541
which actually has a stronger effect on
dopamine, but less of effect on serotonin
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00:12:22,541 --> 00:12:23,275
norepinephrine.
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But it lasts longer in the system
than normal cocaine
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does and can result
in liver failure and seizures.
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I've known many people over the years
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that use cocaine,
and it's just a terrible drug.
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00:12:33,986 --> 00:12:38,023
Besides all the physical effects that we
just discussed, it's extremely expensive
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00:12:38,257 --> 00:12:41,260
and it just destroys the relationships
with friends and family.
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If you or a loved one
are in need of assistance
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00:12:44,330 --> 00:12:46,665
when it comes to cocaine dependency
or addiction,
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00:12:46,665 --> 00:12:50,169
We've provided some resources down in the
description below for your convenience.
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Thanks for watching, everyone.
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00:12:51,137 --> 00:12:52,705
While this topic isn't necessarily
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00:12:52,705 --> 00:12:56,041
fun or light hearted, we're hopeful
you were able to learn something valuable.
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00:12:56,442 --> 00:12:57,710
Be sure to click the link
in the description
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00:12:57,710 --> 00:12:59,845
below and begin your AG1 journey today.
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00:12:59,845 --> 00:13:04,483
And as always, be sure to like, comment,
subscribe if you feel so inclined,
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and I'll see you in the next video.
22107
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