What happens in the body when a person uses cocaine or heroin for the first time

Cocaine is a vasoconstrictor; it constricts the blood vessels. It also interrupts the normal release of dopamine in the brain. (Representational image clicked with baking powder by Colin Davis via Unsplash)

Earlier this week, the Directorate of Revenue Intelligence (DRI) seized 50.23 kilograms of "high-quality" cocaine from the Nhava Sheva Port near Navi Mumbai. Worth Rs 502 crore, the cocaine was found in a shipping container carrying fruits.

Cocaine is typically 'cut' with fillers - cocaine constricts the blood vessels (vasoconstrictor). High quality cocaine indicates lower concentration of fillers and therefore higher commercial value.

Different drugs, of course, have different effects on the body and different rates of forming dependency. Here's a look at the health effects two of the worst habit-forming drugs, cocaine and heroin:

The numbers story

Around 100 million people consume illicit drugs such as cocaine or heroin in India – this revelation was made by the Narcotics Control Bureau DDG (Operations) Sanjay Kumar Singh in an interview to Moneycontrol in June 2022. These are just the reported numbers; the actual estimates are significantly higher.

Moreover, the country is seeing a rise in drug seizures ever since the pandemic struck – 343 kg of heroin was confiscated in 2020, 1052 kg in 2021, and 331 kg had been seized until May 2022.

So why do people get hooked to cocaine or heroin? Let’s dive into the biomechanism of how these drugs are processed by the body when consumed for the first time.

Also read: Drone from Pakistan drops over 3 kg heroin along border in Rajasthan

Heroin and cocaine: The basics

The main constituent of heroin is morphine, a natural ingredient derived from opium poppy plants. It can be produced in black or white powdered form or a sticky black tar form, which is also known as black tar heroin.

People consume heroin by sniffing, snorting, and smoking. Sometimes, it is mixed with crack cocaine – a practice commonly called speedballing.

Cocaine is derived from coca leaves and is produced in powdered form. Drug users consume it by injecting it after mixing the powder with water, sniffing, smoking, and orally (by rubbing it on the gums).

What gives the 'high'

Our brain has a specific “reward” centre, which controls emotions, feelings of pleasure and pain, breathing, heart rate, movement and sleep cycle. It contains opioid receptors that stimulate the release of dopamine, a naturally-occurring neurotransmitter (neurotransmitters transmit signals across two nerve cells). Dopamine is released whenever a person performs rewarding activities, such as eating, sleeping, sexual intercourse, etc. The activation of the reward centre gives a feeling of pleasure and well-being to a person. After that, dopamine is reabsorbed by the nerve cells and the brain stores this feeling as a memory for reinforcing the rewarding behaviour or activity.

When a person consumes heroin or cocaine for the first time, it enters the brain rapidly and binds with these very receptors. These drugs activate the reward centre and stimulate the release of dopamine. However, the normal functioning of dopamine gets interrupted. These drugs prevent the reabsorption of dopamine and therefore, multifold levels of dopamine get accumulated in the brain. As a result, the ideal subtle feeling of pleasure gets amplified, making the user feel “high” or euphoric. The intensity of the rush depends upon the quantity, quality, receptor-binding capacity, and route of administration of cocaine or heroin.

What else can happen after consuming drugs?

Other than euphoria, there are many common experiences, which are not really pleasurable. These are:

·         Dry mouth and flushed or itchy skin

·         A feeling of heaviness in the arms and legs

·         Nausea and vomiting

·         Mental confusion, clouded judgement, and hypersensitivity to light and sound

·         Depressed breathing, impaired heart and brain function, permanent brain damage or coma on taking heroin

·         High blood pressure, increased heart rate, tremors, elevated stress hormones, headache, restlessness, paranoia, muscle twitches, seizure, anxiety, panic attacks, violent behaviour, stroke, and coma on consuming cocaine.

·         Life-threatening effects of cocaine and heroin include cardiac arrest and seizures that can also result in sudden death.

·         Overdose of heroin and cocaine is also fatal.

Some users think that the drug effects are controllable, but that's obviously a slippery slope. These illicit drugs produce intensified pleasure sensation, thus signalling the brain to produce less dopamine after the drug wears off, which can make other normal activities of life seem less pleasurable. Once that happens, the person slips into withdrawal mode and depression, and starts seeking more drugs to feel normal.

These drugs also degrade users' decision-making ability, cognitive function, judgement, behaviour control and creativity, which often result in poor academic or workplace performance. Brain scans of drug users have shown detrimental changes in the areas of the brain that are critically associated with these life-sustaining activities. Therefore, to gain more control, the user falls into the trap of addiction, even in the very initial stages of drug use.

Drugs like cocaine and heroin tap into the users' brain and nervous system and interfere with the process of sending, receiving and processing information. They overstimulate the system and give a sudden high or euphoria. A person can experience withdrawal even within a few hours after the last consumed dose.

Common symptoms of withdrawal include restlessness, insomnia, diarrhoea, vomiting, cold skin, etc.  These symptoms can persist for several months.

In the long run, cocaine and heroin use cause lung complications, heart, liver and kidney diseases, HIV and hepatitis due to unsafe injection use, mental disorders, sexual dysfunction, and rob the person of every pleasure of life.

Drug addiction can be successfully treated if the problem is recognized in time. Counselling, behaviour change, and support is available for everyone who wishes to come out of this trap.

The key to rehabilitation is reaching out for help, and sticking with the programme. Where there is a will, there is a way!

Also read: 40,000 kg drugs destroyed in Northeast in virtual presence of Amit Shah

References:

1.      https://nida.nih.gov/sites/default/files/soa_2014.pdf

2.      https://nida.nih.gov/publications/drugfacts/heroin

3.      https://nida.nih.gov/publications/research-reports/heroin/what-are-medical-complications-chronic-heroin-use

4.      https://nida.nih.gov/publications/research-reports/cocaine/how-cocaine-used