My friend recently smoked some pot laced with cocaine. First of all, is this possible? Whatever the case may be, he seems to be infatuated with the idea of trying straight coke. I've heard that trying coke for the first time is quite dangerous, true? Also, what are the effects of the high? And how detrimental is coke in general?

Sincerely, Concerned Friend

Dear Concerned Friend,

Kudos to you for trying to dig up accurate information for your friend. Cocaine is a stimulant drug and a naturally occurring anesthetic. Most of the effects of coke, however, occur when the drug interrupts the neurotransmitter balance in the central nervous system. The initial effects of this interruption are pleasant — increased confidence, a willingness to work, greater motivation, increased libido, and a euphoric rush or high. At the same time, coke raises blood pressure, increases heart rate, causes rapid breathing, tenses muscles, and causes the jitters (although many don't notice because they're feeling so alert and euphoric). Over time, and with regular use, people may get paranoid, anxious and confused, and sometimes experience hallucinations. Insomnia, agitation, and depression can also result from frequent cocaine use.

Regarding the question of mixing or combining drug, yes it is both possible and known to happen. Some users will mix drugs in an effort to enhance effects, while others will try mixing opposite effect drugs to prevent going too far. Either way, mixing or combining illegal drugs has potential dangers. You might note that mixing legal drugs (like prescription and over the counter items) also can result in negative outcomes and thus labels mention consulting with a health care provider before taking a new medication when already using other items. There have also been some adverse outcomes associated with using drugs like cocaine while on prescriptive drugs.

The physical effects of coke are the same as any other stimulant drug — except that the rush from the very first use is possibly much more intense. The problems with cocaine come from doing too much, its mixture with other drugs, and the crash after binge use. The latter arrives when the initial feelings of well-being and confidence, the sense of omnipotence, and the satisfied feelings disappear as suddenly as the rush appeared, leaving the user with the desire to have more.

Cocaine use can easily slide into abuse — and yes, abuse can begin shortly after one's first cocaine experience. The brain's pleasure centers that cocaine short-circuits makes its use a mighty hard habit to kick — despite the side effects of chronic nasal irritation, nosebleeds, paranoia, and bank account depletion.

If you and/or your friend want more information on cocaine, Columbia students on the Morningside campus can speak with a substance abuse specialist at Counseling and Psychological Services (CPS) who can talk with either you and/or your friend about the short- and long-term effects of cocaine use. Call 212-854-2878 to make an appointment. If you are on the CUMC campus, you may call the Mental Health Service at 212-305-3400 to make an appointment.

Again, good for you for looking out for your friend… we should all be so lucky to have someone like you in our lives!


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