Cocaine's Lethal Twist: Fentanyl Contamination Skyrockets Overdose Deaths
Dr Eric Bornstein
Medical and Science Content Creator, Best Selling Author, Scientific Writer and Speaker: INR Seminars:
Cocaine, on its own, has profound adverse effects on human metabolism, primarily through its impact on the cardiovascular and central nervous systems. (1) The drug stimulates the release of adrenaline, leading to increased heart rate and blood pressure, which can result in significant metabolic strain. Chronic cocaine use can lead to the development of cardiovascular diseases, including heart attacks and strokes, due to the persistent elevation of these metabolic parameters. (2)
Moreover, cocaine's neurotoxic effects further exacerbate its negative impact on metabolism. The drug alters the function of neurotransmitters, particularly dopamine, which plays a crucial role in regulating mood, reward, and energy balance. (3) This disruption can lead to a range of metabolic disorders, including hyperthermia, characterized by an abnormally high body temperature. Hyperthermia can cause severe damage to kidneys (via rhabdomyolysis) and other vital organs and is a common cause of death in cocaine users. (4)
Cocaine's addictive properties are primarily rooted in its profound impact on the mesolimbic dopamine system, a critical neural pathway involved in reward and pleasure. When cocaine is consumed, it rapidly increases the levels of dopamine in the synaptic cleft by blocking the dopamine transporter, which usually reabsorbs dopamine into the presynaptic neuron. (5) This blockade results in an accumulation of dopamine in the synapse, leading to prolonged stimulation of dopamine receptors and addiction.
The heightened activation of the mesolimbic pathway, particularly in the nucleus accumbens, produces intense feelings of euphoria and reinforces drug-taking behavior. This powerful reinforcement mechanism is a critical factor in the development of cocaine addiction, as users seek to replicate the pleasurable effects. (6)
New Dangers: Cocaine purchased on the street is laced with fentanyl
The dangers of cocaine purchased on the street being laced with fentanyl are profound and multifaceted. Fentanyl, a potent synthetic opioid, is significantly more powerful than heroin and morphine, and its presence in cocaine dramatically increases the risk of overdose and death. (7)
Users often unknowingly consume fentanyl-laced cocaine, leading to unintentional opioid overdoses. (8) The combination of a CNS stimulant (cocaine) and a CNS depressant (fentanyl) creates a dangerous physiological response, as the opposing effects on the central nervous system can lead to respiratory depression, cardiac arrest, and death. The prevalence of fentanyl-laced cocaine has contributed to a significant rise in overdose deaths, highlighting the urgent need for public health interventions and harm reduction strategies.
Click the two recent articles below describing Cocaine/Fentanyl deaths.
Moreover, the presence of fentanyl in street-purchased cocaine exacerbates the public health crisis by complicating treatment and prevention efforts. Traditional approaches to cocaine addiction may not address the risks associated with opioid contamination, necessitating a more comprehensive strategy that includes opioid overdose education and the distribution of naloxone. This opioid antagonist can reverse the effects of an opioid overdose, but does not reverse cocaine.
领英推荐
The unpredictable nature of street drugs underscores the importance of increased awareness, testing, and regulation to protect individuals from the deadly consequences of fentanyl-laced substances. America is now in a Poly-substance crisis.
As the opioid crisis continues to evolve, addressing the intersection of stimulant and opioid use is critical for reducing harm and saving lives.
?
1.????? Turillazzi, Emanuela, et al. "Cardiovascular effects of cocaine: cellular, ionic and molecular mechanisms." Current Medicinal Chemistry 19.33 (2012): 5664-5676.
2.????? Pergolizzi Jr, Joseph V., et al. "Cocaine and cardiotoxicity: a literature review." Cureus 13.4 (2021).
3.????? Omidvari, Samareh, et al. "Molecular mechanisms and treatment strategies for methamphetamine?induced neurodegeneration, inflammation and neurotoxicity." Acta neurobiologiae experimentalis 83.4 (2023): 414-431.
4.????? Marco, Catherine A., et al. "Hyperthermia associated with methamphetamine and cocaine use." The American Journal of Emergency Medicine 42 (2021): 20-22.
5.????? Thomas, M. J., P. W. Kalivas, and Y. Shaham. "Neuroplasticity in the mesolimbic dopamine system and cocaine addiction." British journal of pharmacology 154.2 (2008): 327-342.
6.????? Loganathan, Kavinash, and Eric Tatt Wei Ho. "Value, drug addiction and the brain." Addictive behaviors 116 (2021): 106816.
7.????? Nolan, Michelle L., et al. "Increased presence of fentanyl in cocaine-involved fatal overdoses: implications for prevention." Journal of Urban Health 96 (2019): 49-54.
8.????? Reed, Megan K., et al. ""You can't go wrong being safe": Motivations, patterns, and context surrounding use of fentanyl test strips for heroin and other drugs." International Journal of Drug Policy 103 (2022): 103643.
Dr. Eric Bornstein is a biochemist, dentist, photobiologist, and renowned medical lecturer. He lives in Suffern, NY, and has delivered lectures on the subjects of opioid safety, addiction, adolescent sleep problems, Circadian Medicine and Nutrition, Opioid Addiction, and the dangers of vaping and marijuana to over 170,000 healthcare professionals. Dr. Bornstein currently lectures 12-14 times per month to healthcare professionals. His bestselling books are available on Amazon. https://www.amazon.com/stores/Eric-Bornstein/author/B0CS28WQZP?ref=ap_rdr&isDramIntegrated=true&shoppingPortalEnabled=true
Dr. Bornstein's Full CE Lecture Schedule:https://www.inrseminars.com/seminarsb.aspx