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Cocaine Abuse

Elizabeth A. Warner, MD
[+] Article, Author, and Disclosure Information

From the University of South Florida, Tampa, Florida. Requests for Reprints: Elizabeth A. Warner, MD, Box 19, University of South Florida, Department of Internal Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612. Acknowledgments: The author thanks Susan W. Smith and Paul Wallach, MD, for reviewing the manuscript.

Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;119(3):226-235. doi:10.7326/0003-4819-119-3-199308010-00009
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Purpose: To discuss the forms of cocaine that are available and their methods of administration and to review the medical complications of cocaine abuse.

Data Sources: Pertinent articles were identified through a MEDLINE search of the English-language literature from 1986 to 1992 and through a manual search of bibliographies of all identified articles.

Study Selection: All articles describing complications of cocaine use were either case reports, review articles, or small series. No controlled studies on the subject were available.

Data Synthesis: A qualitative description of reported complications without the use of quantitative methods.

Results: Multiple complications of cocaine use have been described and are often related to the method of administration of cocaine. Since the introduction of freebase and crack cocaine, new complications have been noted, and nearly all organ systems have been affected. Indirect complications, related to violent behavior and infectious diseases, are also important consequences of cocaine use.

Conclusions: Adverse reactions to cocaine use should be considered in the differential diagnosis of various disorders, particularly ischemic events in young adults. The actual frequency of each complication is unknown.


Grahic Jump Location
Figure 1.
A comparison of the time, in minutes, to achieve peak physiologic and subjective changes in human volunteers given cocaine by various routes of administration.

Adapted from reference 13, with permission.

Grahic Jump Location




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