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Cocaine History, Function, and Treatment Overview

Cocaine is a psychoactive stimulant drug derived from the leaves of the coca bush native to South America. Coca leaves have been chewed or infused in teas for centuries by indigenous peoples for a variety of uses including pleasure, anesthetic, and prevention of altitude sickness. In 1855, German chemist Friedrich Gaedcke first isolated the coca alkaloid, which he called erythroxaline. The extraction and purification process was refined and published in 1860 by Albert Niemann, who gave the drug the name that stuck: cocaine. 

Throughout the rest of the 19th and early 20th century, many studies revealed cocaine’s effectiveness as a local anesthetic and enhancer of both mood and vitality. It became an extremely popular product available for purchase at stores in powdered form, tablets, creams, beverages (including its namesake Coca Cola), cigarettes, and injectable solutions. The United States’ Harrison Narcotics Tax Act of 1914 heavily restricted the manufacturing and sale of coca products, making many of them illegal, which eventually led to a powerful black market for the drug. Today, cocaine is the second most used illicit drug in the world, after cannabis.

Cocaine functions by blocking reuptake of the neurotransmitters dopamine, serotonin, and norepinephrine, particularly in the brain’s reward pathway known as the mesolimbic dopamine system. This can lead to a feeling of pleasure, increased alertness and sociability, increased energy and stamina, elevated or irregular heart rate, uncontrolled muscle activity, and hyperventilation. Cocaine’s effect on the reward pathway is what makes it particularly addictive. The brain adapts very quickly to a situation in which pleasure and expectation of pleasure derive solely from the consumption of cocaine and repeated use both reinforces and exacerbates this effect. Cocaine dependence diminishes users’ ability to experience pleasure from non-drug-related stimuli, such as eating, sexual activity, and social interaction. Withdrawal from cocaine may result in depression, anti-social behavior, irritability, anger, and a sense of hopelessness. 

Cocaine-induced changes to the structure and neuronal activity of the limbic system of the brain may account for cravings and susceptibility to relapse in the cocaine user, even after long periods of abstinence. In addition to effects on the reward pathway, repeated cocaine use also changes parts of the brain associated with stress. Research indicates a direct relationship between amount of cocaine used over time and strength of stress-induced cravings. Furthermore, prolonged cocaine use weakens the brain’s orbitofrontal cortex, diminishing the quality of decision-making, self-insight, and adapting behavior to negative consequences. 

Because cocaine’s mechanisms of action are numerous, its addictive properties are so strong, and evidence of its presence is easy to hide, treatment for the cocaine addict is complicated and difficult to maintain. Studies continue with mixed results on compounds that block or counteract cocaine’s functionality or reduce withdrawal symptoms. However, many behavioral therapies have proven to be effective, including motivational incentives to abstain and cognitive-behavioral therapies. Combined behavioral, pharmacological, and auxiliary services that address a user’s specific needs, such as vocational training or relationship counseling may be the most effective treatment for the abstinence and recovery from cocaine addiction. Most importantly, a drug-free support community can be a vital force in aiding a recovering user. 

The earlier a habit is detected, the greater the chance for recovery. Regular testing of blood or urine for benzoylecgonine (the cocaine metabolite) is a valuable tool for monitoring the progress of a user’s recovery, especially since relapse risk remains high long after regular use ends. Pyxis Laboratories supplies cocaine-BSA conjugates and cocaine monoclonal antibodies for detection of benzoylecgonine in biological fluids, as well as a wide range of antigen conjugates and antibodies for the manufacture of drug tests. These include Amphetamines, Benzodiazepines, Cannabinoids both natural and synthetic, Ketamine, PCP, Opioids and others. 

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