• Psychedelic Medicine
  • Psychedelic Medicine Moderator: mr peabody
  • Bluelight HOT THREADS
  • Let's Welcome Our NEW MEMBERS!

Addiction Cocaine

mr peabody

Moderator: PM
Staff member
Joined
Aug 31, 2016
Messages
2,144
Location
Frostbite Falls, MN

Where are you going?


Cocaine and alcohol together are a ‘deadly combination,’ doctors warn

by Conrad Duncan | the Independent | 1 Oct 2019

Taking cocaine and alcohol together produces a “deadly combination” that can lead to increased violent and impulsive behaviour, doctors have warned.

At least 13 “self-inflicted” deaths have occurred between April 2018 and March 2019 in England among people who took the two substances together, according to an investigation by the BBC.

That figure included two contestants from the reality TV show Love Island, Mike Thalassitis and Sophie Gradon, whose deaths received national media attention.

The term “self-inflicted” is used to describe deaths in which a person has injured or harmed themselves, according to the charity Inquest.

In May, an analysis of waste water found that cocaine use in Britain has more than doubled in five years, while a global drug survey suggested people in Britain get drunk more often than in any other country.

Julia Sinclair, a professor of addiction psychiatry at the University of Southampton, has called alcohol and cocaine a “toxic combination”.

“Alcohol is a depressant, it increases the levels of Gaba (gamma-aminobutyric acid) in the brain, which is like the brain’s handbrake and makes us feel less anxious,” Ms Sinclair told the BBC’s Victoria Derbyshire.

“You add cocaine into the mix and you almost have a rocket-fuelled increased impulsivity which gives people the driver to complete an act that they may not otherwise do.”

She added: "People are looking for the ingredient that makes alcohol and cocaine such a toxic combo. It might be cocaethylene - but we don't know and everyone has a different response."

Research in the US has found that the use of alcohol and cocaine together makes the user 16 times more likely to take their own life.

The study in New York City concluded that the risk was “substantially higher than the rate observed with either substance alone.”

In the case of Gradon’s death, the coroner Eric Armstrong warned specifically of the dangers of taking cocaine and alcohol together.

“There's a good deal of concern at the moment because of the consequences of taking alcohol and using cocaine,” Mr Armstrong said.

“The combination, I'm given to understand, is used by those who believe it brings on a so-called high much quicker."

“What they don't appreciate is that it also appears to give rise to violent thoughts. If Sophie's death is to serve any purpose at all, that message should go far and wide.”


In response to the investigation, a spokesperson for the Department of Health and Social Care told the BBC that it is investing £25m in suicide prevention and is “committed to reducing drug- and alcohol-related harms”.


Dr. Bruno Chaves has performed over 1200 treatments with ibogaine in hospital without a single adverse event. 62% of those treated remain abstinent long term. Dr. Chaves is currently accepting new patients for treatment in hospital in São Paulo, Brazil. For more information, contact Dr. Chaves directly : [email protected] -pb
 
Last edited:

mr peabody

Moderator: PM
Staff member
Joined
Aug 31, 2016
Messages
2,144
Location
Frostbite Falls, MN



What to expect on an ibogaine trip*

The Third Wave | Aug 15 2019

Ibogaine is among our planet’s most powerful psychoactive substances. It can be found in high concentrations in the root bark of Tabernanthe iboga, Voacanga Africana, and Tabernaemontana undulata, which are endemic to only three countries in Central Africa: Gabon, Cameroon, and Republic of Congo.

This sacred plant is used in the Bwiti spiritual discipline which is observed by the Babongo, Mitsogo, and Fang – indigenous peoples of today’s Gabon and Cameroon. Their ritualistic ingestion of the root bark serves for spiritual initiation and healing. It has a centuries-long tradition of use in rite of passage ceremonies and magic.

Ibogaine has extremely powerful addiction-curing, dissociative, and visionary properties. Typically, an ibogaine trip will last far longer than that of any other substance, and go far deeper into the user’s mind, unearthing repressed and sealed-off memories, and dismantling habitualized patterns of thought and behavior.

Many refer to the iboga experience as an encounter with “The Truth.” It is touted as the most intense inward psychedelic journey one can take.

How to try iboga

Due to its long duration and extreme mind/body/soul effects, recreational use of iboga is virtually non-existent. It is used in traditional ceremonial contexts in Africa, and largely in rehabilitative purposes in other parts of the world where its clinical use is legal. Retreat centers and (mostly illegal) independently organized guided sessions that serve spiritual growth are also present, though not in great numbers.

Unless you suffer from a serious substance abuse disorder in a country where addiction clinics use iboga, in order to have this experience, you will have to travel to Central Africa, or to the countries where legal iboga retreat centers can be found.

Warning: Do not procure iboga and consume it on your own. You absolutely must be screened in advance for cardiac issues, and have medical supervision throughout your trip.

- Mis-dosing can be extremely psychologically unforgiving and without professional help severe traumas and permanent mental scarring is possible

- There is real risk of physical danger; a number of fatalities have been reported (estimated death rate is one in 400), the main causes being cardiac toxicity, but also the combination of nausea and loss of coordination, which can potentially lead to choking on your own vomit.

Taking iboga

The consumption of iboga is relatively straightforward. Unlike ayahuasca, it doesn’t require an elaborate preparation process, nor a multi-day adherence to a mind-and-body cleansing diet. The bitter root bark can simply be chewed for a few minutes, and then the mush can be swallowed, allowing the alkaloid content to be fully digested.

However, some retreat centers and guides make the ingestion process a bit more complex. They supply iboga root bark in a powdered form and/or pure ibogaine extract and/or Total Alkaloid (TA) – an extract that contains all the alkaloids (about 30 have been detected so far) from the plant minus the cellulose content. Guests are given the choice, and, ultimately, it’s up to the guide’s discretion what form or mixture they should receive.

The powder can be chewed in the same way as the solid bark. Pure ibogaine is usually given to those who want a more intense visionary experience. TA can be taken instead of the powder/solid bark or additionally with it, in order to increase the potency. It’s also more likely to cause vomiting, and normally causes less dizziness and difficulties moving around during the journey. Pure ibogaine extract can be taken instead of the bark or TA, or mixed together.

Small amounts of iboga may be taken throughout the day before the ceremony in order to initiate the resonance with the spirit of the plant and check for any unwanted reactions. The full – flood – dose is usually taken at night.

In the morning, plan to eat lightly. Fasting is recommended for around eight hours prior to the experience. It’s recommended that you stay hydrated throughout the day, but stop drinking water two hours before the flood.

Depending on the potency of the plant and your weight, 5-25g of root bark should suffice for a flood journey. This is another reason why having a guide is vital – you need someone who knows the particular plant and the adequate dosages to administer. Pure ibogaine content makes up about 1-5% of the bark volume.

The ibogaine trip

Once you take the iboga, it should take up to an hour, sometimes even longer, for the effects to come on. The first changes you’re likely to feel will be dizziness, a decline in muscle coordination, and increasing difficulty in moving. Nausea may come next, and purging often follows. Expect your heart rate to rise, your mind to race, and your brain to begin comprehending that something strange is taking over. Soon, it will become apparent that there will be no turning back for a long time.

The quality and intensity of your hallucinations (with eyes open and closed) will depend on how much iboga/ibogaine you consumed. Unlike entheogens such as ayahuasca and psilocybin mushrooms, which are known to show completely different realities, iboga/ibogaine visuals are mostly an expression of your subconscious, and resemble a lucid dream more than hyperdimensional alternate universes.

Open-eyed hallucinations usually come on early and last throughout the journey. They can distort the space around you, ingrain shape-shifting patterns and faces on the walls, morph objects and breathe motion into them, create floating shapes that fill the space, manifest apparitions of seemingly real or imaginary beings, or come in any of the myriad variations that your mind can invent.

Closed-eyed visuals can be either life-like, abstract, in the form of cartoons or animations, or a confusing mix of all styles. They can be fast-paced, absurd, bizarre, demonic, entertaining, pleasing, or present you with a slow, stable, and cohesive instructional narrative for your learning needs.

Visuals are accompanied by consistent nausea, a buzzing sound, and, often, the stern and resounding presence of “The Truth.” Fast-paced and sometimes repetitive Bwiti harp music can be played throughout the journey, or at peak points, and, surprisingly, it can feel quite soothing and defragmenting for a mind in an overclocked state.

Encountering ‘The Truth’

Prior to the experience itself, you are advised to write down a list of questions you want answered. These should be read to you by your guide during the ceremony. You may be blindfolded at this time, in which case the answers should spell themselves out for you in the darkness, download themselves directly into your consciousness, or be conveyed by the voice of The Truth.

Many people experience the latter as a conversation with an infinitely wiser form of themselves, which can be relentless in its intention to invoke positive change. It accomplishes this by means of pinpointing and mercilessly criticizing all aspects of thought and deed that are holding the person back from growth.

This conversation can take on demonstrative forms, as the soul is guided through the psycho-base of past experiences. The Truth’s criticisms are then vividly displayed through situations when erring thought and action took place.

Going further, the soul can often witness the entire succession of events in which these destructive mechanisms were manifested. Seeing how they were formed, took root, developed, fortified, and adapted often provides enough insight for the individual to understand how to dismantle them. This is why iboga is so effective at curing addictions.

Our thought patterns and habits can be destructive both toward ourselves and others. If we are hurting others, iboga will show us this as mercilessly as it demonstrates our self-destruction. It’s common to experience visions of one’s friends, partners, relatives, ancestors, and other relevant people, and vividly feel the pain we inflict on them. Iboga deconditions these kinds of behaviors by associating the empathized suffering of others with our thoughts and actions directed at them.

It also works the other way. People who have hurt us can appear in our visions, and their behavior can be explained just like ours. This way, iboga can teach us to understand and forgive others, as they are also imperfect humans acting with incomplete insight into how their actions affect others. Emotional releases are common for these shifts in perception.

Unlike with other psychedelics, iboga’s teachings usually come in a very straightforward form. It bluntly explains what you’ve been doing wrong, makes you accept it, insists you not make a big deal out of it, and gives you ways to do better. This direct confrontation with one’s mistakes can be highly effective, but quite grueling for those who have been running away from, and suppressing their flaws their whole lives.

With iboga, you don’t get a choice. You must surrender and accept its lessons.

After the fact

Iboga floods can last up to 36 hours, and the afterglow can persist up to one week. As it’s a lipophilic compound, ibogaine stays in your tissues for a long time after the main effects wear off. It gradually releases grasp over the course of days, and is converted to noribogaine as it passes through the liver. If you’ve taken pure ibogaine, the afterglow should wear off a bit more quickly than if you ingested the root bark or TA extract, which contain a host of other alkaloids.

Unlike after most psychedelics, after an ibogaine trip, it’s virtually impossible to sleep – some people stay awake for dozens of hours. Not having restful sleep after the ordeal also prevents the mind from blending the journey with dreams, and keeps it firmly anchored in your real-life experience.

After the body of the trip comes a long period of consolidation. The after-effects are quite noticeable and can be uncomfortable: any movement in your visual field will leave behind dark traces; you will be exhausted, but unable to sleep; you may feel intensely sad and agitated. This state should be treated with restful and mindful activities such as meditation and reading.

Aside from these symptoms, dizziness and nausea should also persist until you are able to sleep. The combination of all these factors makes the iboga aftermath the most strenuous and memorable out of all the psychedelic comedowns.

When you are finally able to fall asleep, though, all of this should disperse. You should have a long rest full of vivid dreams, and wake up refreshed, content, and grateful for what you experienced. A healthy diet, exercise, and spending time self-reflecting in sunlight and nature in the coming days will make for successful integration of this most challenging psychedelic experience.

*From the article here:

 
Last edited:

mr peabody

Moderator: PM
Staff member
Joined
Aug 31, 2016
Messages
2,144
Location
Frostbite Falls, MN



"The public needs to know that today's cocaine contains fentanyl"*

by Justin Herdman | Oct 22 2019

Socrates Kokkalis came to Cleveland last year for several business meetings. When the meetings were over, Kokkalis ate dinner with colleagues then visited the casino downtown. He also made a series of quick phone calls seeking cocaine, which he ultimately purchased from a dealer.

Kokkalis then went to his room on the hotel’s 24th floor, but he never came out. He died on his hotel room floor, apparently unaware the cocaine he bought actually included fentanyl, a lethal opioid that is up to 40 times more potent than heroin.

The story of Socrates Kokkalis has a sad ending that is becoming all too common in Northeast Ohio. Kokkalis, the son of a Greek billionaire, is not the typical drug overdose victim in Cleveland. But the method of his death – ingestion of cocaine laced with fentanyl – is now the signature killer for an overdose crisis that has entered a new phase.

Ohio has been on the front lines of the nation’s opioid epidemic for more than a decade, going back to pill mills flooding our streets with prescription painkillers. Pills gave way to heroin, which was cheaper and became more easily available, and heroin was eventually cut with fentanyl, a more powerful, and still cheaper, synthetic opioid made not from poppies but from chemicals in labs in China and Mexico.

At each stage of this crisis, deaths have risen precipitously as the substances became more potent and easily available. Now this epidemic has changed again. Heroin is now hard to find. Instead, we are in the midst of a surge in deaths from cocaine, either alone or mixed with fentanyl. Among cocaine’s effects on the body is to speed the heart. When mixed with fentanyl, which depresses breathing, the result is life threatening. Even a very small dose of fentanyl can kill a human being.

Last year was the first time since the start of this crisis that Cuyahoga County saw more people die from cocaine than heroin. So far in 2019, more than 60 percent of overdose deaths in Cuyahoga County are associated with cocaine, either as a stand-alone narcotic or mixed with fentanyl.

This trend is changing the demographics of who is dying. Victims from cocaine-associated overdoses span several generations, from ages 19 to 71. Many of those dying, however, are in their 50s and 60s. And we are on pace to have 134 African-American people die from a drug overdose in Cuyahoga County this year. In 2015, that number was 25.

So why is this happening? And what can we do about it?

There are a number of reasons why fentanyl may be mixed with cocaine. Some believe dealers are intentionally mixing fentanyl with cocaine to create a new market of opioid addicts. Another possibility is the narcotic effect of combining cocaine and fentanyl drives user demand. We also cannot discount instances where neighborhood drug dealers simply sell whatever is available that will turn a profit, or may be working in an unsanitary environment with multiple drugs.

We do know the cocaine being intercepted at our borders typically arrives unmixed with fentanyl, so this cross-contamination is likely happening closer to the street level.

This month, the community group Greater Than Heroin, advertising agency Marcus Thomas, our office and others are launching a public awareness campaign to warn everyone that they should operate under the assumption that the drugs they buy on the street contain fentanyl. Separate efforts continue to make free fentanyl test strips and the opioid antidote Narcan more readily available.

Let’s be clear: nobody should be using drugs like cocaine or heroin. There is no safe amount to try recreationally. In fact, our office filed a record number of indictments last year against the people who bring drugs into Ohio and seek to profit from this wave of death and broken lives, including bringing federal charges against the man who sold Socrates Kokkalis the fentanyl-laced cocaine.

Yet we also have to acknowledge the opioid crisis has set its sights on a new group of victims, those who use cocaine and crack-cocaine, with absolutely no idea that the mistake they are making may be the last mistake they ever make. The scourge of addiction in our communities presents many problems for families, law enforcement and the criminal justice system. In the age of fentanyl, it may also be an automatic death sentence.

*From the article here:

 
Last edited:

mr peabody

Moderator: PM
Staff member
Joined
Aug 31, 2016
Messages
2,144
Location
Frostbite Falls, MN



“A vast, uncontrolled experiment” — Ibogaine, 10 years on

by Loren DeVito, PhD | February 19, 2019

Nearly 10 years ago, I stepped out on a Saturday night to meet a friend for a movie in Davis Square. The movie, I’m Dangerous with Love, was playing as part of a special event. As I settled into the Somerville theater, I wasn’t quite sure what I was in for, or how this documentary would end up informing me of a revolution in medicine to come nearly a decade later.

Living dangerously: clandestine healing

The film followed Dimitri Mugianis, a former musician and recovering addict, as he bounced back and forth between his NYC base to treat people across the nation and in Canada. While the opioid epidemic is all around us in 2019, back then, the vernacular of addiction was still relegated to those taking illicit drugs like heroin. With zero medical training, Dimitri set out to heal those addicted to drugs with an alkaloid from a traditional plant native to West Africa: ibogaine.

His clandestine healing sessions intrigued me immediately. This former rocker who treated his addiction using this very method was traveling to people’s homes to administer a plant that, in the majority of cases, almost immediately “cured” people. As a neuroscientist-in-training, every cell in my brain lit up.

How could this plant be so effective? How could no one in the West have heard of this “miracle”?

I watched captivated as Dimitri administered the plant, cared for people as they went through agonizing, albeit, brief detox. Then, as they awoke, he talked them through their new life. Of course, not everyone was able to maintain their abstinence long-term, but most people in the film did get a chance to live without drug dependency for a significant amount of time.

Nevertheless, this treatment was not without harm. In fact, ibogaine can cause severe cardiac side effects, which is extremely dangerous when treating people without a medical license at their homes with a drug that is not exactly mentioned in medical textbooks. After one such case, Dimitri realized he was treating patients without proper knowledge of the plant in its entirety. Therefore, he set out to Gabon to learn more about how the plant is traditionally used to better inform his practice.

After a brief discussion following the movie, I left the theater buzzed. As a good little scientist, I immediately pulled up PubMed (the science version of Google) when I got home to search for studies on ibogaine. While there were many studies using preclinical models, I could find very little information for its use in humans.

I filed ibogaine away as one of the cool things I would study when I had my own lab and could start pursuing (funding permitting) my own research passions, and that’s where ibogaine sat for many years—a paper in the accordion file of my brain—that is, until a few years ago.

Pharmacology of an ancient root

One night, I happened upon a study while numbly scrolling through social media. Researchers found that ibogaine enhances neuroplasticity in the brain. “I knew it!” I exclaimed to no one.

My heart started to race, and images appeared of the movie I had seen years before. Could this be how ibogaine helps people rapidly recover from addiction?

The part of the film that really struck a chord involved a scene with a woman who had taken ibogaine. The day after her treatment, she reported feeling as though her senses were “renewed”: Food tasted different, colors were brighter, and everything had changed overnight.

Neurogenesis occurs in the hippocampus, a part of the brain essential to memory and the region I happened to be studying in graduate school, as well as the olfactory regions in adults. The woman’s report following ibogaine made me think of neurogenesis and neuroplasticity immediately because a supply of new neurons and connections flooding the brain would likely cause these perceptions. Of course, I still didn’t know the first thing about the chemical properties of ibogaine, so I got to work.

Getting to know ibogaine

Ibogaine comes from the roots of Tabernanthe Iboga, a shrub native to West Africa. Lower doses are used to help alleviate fatigue, while higher doses are used in religious ceremonies. Noribogaine is the drug's active metabolite.

Ibogaine works by inhibiting the reuptake of neurotransmitters (brain chemicals), including serotonin, which may induce hallucinogenic experiences similar to other psychedelic substances. As I accidentally discovered one night, ibogaine also contributes to neuroplasticity, which is the brain’s ability to reorganize itself when presented with new information.

A preclinical study showed that ibogaine increases glial cell line-derived neurotrophic factor, a substance that promotes the survival and differentiation of cells in the brain. Additionally, noribogaine changes the structure of brain cells, affecting how they interact with other cells.

Clinical studies have found that a single oral dose of ibogaine can significantly reduce cravings for cocaine and heroin, as well as symptoms of depression, for up to 30 days following treatment. While long-term effectiveness of the treatment varies, a survey of patients who received ibogaine treatment in Mexico showed that 30 percent abstained from opioid use for up to two years, with 41 percent reporting abstinence for more than six months, across a three-year follow-up period. There is also some evidence that ibogaine may help those with alcohol addiction.

A blocked path to progress

While the Food and Drug Administration (FDA) entertained the idea of approving a clinical trial for ibogaine in 1993, they decided against it due to safety concerns, despite the fact that people were getting treated in droves at clinics outside the U.S.

In 2005, a few years before the movie came out, the director of anti-addiction drug development at the National Institute on Drug Abuse (NIDA) referred to ibogaine as a "vast, uncontrolled experiment"—a pretty accurate description at that time—but times have changed.

Traditional medicines like cannabis and psilocybin finally started to hit the mainstream (i.e., in the West) a few years ago and are making significant strides toward legalization through rigorous clinical trial studies. Essentially, we are finally realizing their potential after thousands of years of anecdotally documented benefits.

Flash-forward to today, and we now have quite a surplus of data on ibogaine. In fact, a current search on ibogaine produces more than 450 hits, a far higher number than when I originally started on my expedition. Yet, it still begs the question of the true effectiveness of ibogaine and, most importantly, its safety.

Unsafe unknowns

While ibogaine remains illegal in the U.S., people continue to travel to clinics throughout the world in an attempt to break the cycle of addiction. Despite a decade of additional research, safety concerns remain significant.

Ibogaine treatment can be deadly. Administration of the drug can cause serious cardiac effects since ibogaine decreases the heart rate. Unfortunately, these effects can come on quite quickly. While a small clinical trial identified the time it takes to clear a small dose of ibogaine from the body, additional study is needed to better understand how to safely dose ibogaine.

While there is evidence that low-dose administration of ibogaine can effectively reduce withdrawal symptoms and cravings, it’s not possible to guarantee the safety of ibogaine treatment. People who take ibogaine do so at their own risk. Ibogaine remains an illegal substance in the U.S., so, is there any hope for ibogaine? Yes, with more research, of course.

A Phase 2 clinical trial is currently underway evaluating ibogaine for alcohol addiction. The Multidisciplinary Association for Psychedelic Studies (MAPS) has conducted two observational studies in Mexico and New Zealand. U.S. state legislators are also proposing new bills to fund research for ibogaine, and one Republican lawmaker in Iowa just filed a state bill to legalize its medical use.

Ten years later and there is still a lot of work to be done, but I’m Dangerous with Love opened my eyes to the immense potential of using an ancient plant to solve a modern health crisis, and for that, I thank you, Dimitri.

https://prohbtd.com/a-vast-uncontrol...10-years-later
 
Last edited:

mr peabody

Moderator: PM
Staff member
Joined
Aug 31, 2016
Messages
2,144
Location
Frostbite Falls, MN
Ibogaine is an indole alkaloid isolated from the root bark of the African tree Tabernanthe Iboga, known to cause Long QT Syndrome (LQTS) — a dangerous condition that can lead to cardiac arrhythmia and death. But the risk is manageable. Dr. Bruno Chaves of Brazil has performed over 1200 treatments with ibogaine in hospital without a single adverse event. 62% of those treated by Bruno remain abstinent long term. Dr. Chaves is currently accepting new patients for treatment in hospital in São Paulo. For more information, contact Dr. Chaves directly : [email protected]

 
Last edited:

mr peabody

Moderator: PM
Staff member
Joined
Aug 31, 2016
Messages
2,144
Location
Frostbite Falls, MN
Not yesterday's cocaine: Death toll rising from tainted drug

by Laura Ungar | Kaiser Health News | Dec 2 2019

A pain pill prescription for nerve damage revived Gwendolyn Barton's long-dormant addiction last year, awakening fears she would slip back into smoking crack cocaine.

She'd done that drug and others for about 20 years before getting sober in 2008. But things were different back then. This time, the 62-year-old knew she needed to seek treatment before it was too late.

"If I used today," she said, "I'd be dead."

The powerful opioid fentanyl is often mixed into cocaine, turning the stimulant into a much bigger killer than the drug of the past. Cocaine-related overdoses took the lives of nearly 14,000 Americans in 2017, up 34% in just a year, the latest federal figures show. And they're expected to soar even higher as cocaine's popularity resurges.

Barton, who is African American, is wise to be wary. Deaths are rising most precipitously among African Americans, who are more likely to use cocaine than whites and fatally overdosed at an 80% higher rate.

But the scourge is festering quietly, overshadowed by the larger opioid epidemic that kills tens of thousands each year, the vast majority of them white.

More than 30 states have seen cocaine death rates rise since 2010, with Ohio leading the way. Overdoses from crack and powder cocaine killed 14 of every 100,000 Ohioans of all races in 2017—seven times more than in 2010, according to the University of Minnesota's State Health Access Data Assistance Center.

Colin Planalp, senior research fellow with the center, said deaths have risen steeply in rural and urban areas across America since 2000, and the increase is directly related to the national opioid crisis.

Most of the time, fentanyl is the stealth culprit, posing a particular danger to longtime cocaine users who may be older, sicker and unaccustomed to the effects of opioids.

"Your whole system is kind of thrown a curveball," said Katherine Engel, director of nursing at the Center for Addiction Treatment in Cincinnati. "You're an opiate virgin, so to speak."

Tom Synan, police chief in Newtown, just outside Cincinnati, said the risk extends to cocaine users who also have used older opioids such as heroin because fentanyl is 50 times more potent.

"In the '70s, a 'speedball' was a mix of cocaine and heroin. I call this 'speedball 2.0." Fentanyl has made it much worse," he said. "It's made every drug people are addicted to into a crisis."

In May, in Cincinnati's county of Hamilton, cocaine overdoses killed six people over 10 days.

The crisis is growing as more people use cocaine.

A federal survey showed about 2 million Americans used the stimulant regularly in 2018, up from 1.4 million in 2011. One in 100 African Americans used the drug regularly last year, a rate 40% higher than among whites.

Supply helps drive use. A 2018 report by the U.S. Drug Enforcement Administration says record cocaine production in Colombia, the primary source for cocaine seized in the United States, has widened the cocaine market and pushed down prices. The agency expects the trend to continue.

Synan said the supply has ebbed and flowed over the years and cocaine never went away. What's different now, he said, is the intentional and unintentional addition of fentanyl.

Sometimes, law enforcement experts said, dealers spike cocaine with the inexpensive synthetic opioid to hook people. Other times, it gets mixed in through sloppy handling or packaging somewhere along the way.

"The reason they're putting it in is it's cheap," said Thomas Fallon, commander of the Hamilton County Heroin Coalition Task Force. "Also, they're not chemists. They don't always know what they're doing."

Still, longtime cocaine users often trust their dealers. "They're less likely than heroin or pill users to carry the opioid overdose reversal drug naloxone," treatment professionals and police say, "because they don't think of themselves as opioid users and don't believe they'll need it."




While some users overdose and die from cocaine mixed with fentanyl, others come to crave the potent combination for its high.

"Instead of being a deterrent, it's an incentive for some," said Evonne Stephenson, a nurse practitioner at the Urban Minority Alcoholism and Drug Abuse Outreach Program of Cincinnati. "Everyone thinks they're invincible."

Actually, drug use makes them more vulnerable to serious health problems or death, especially as they age. Indeed, the steepest rise in cocaine-related overdose deaths nationwide was among people 45 to 54 years old.

William Stoops, a University of Kentucky professor who studies drug and alcohol addiction, said longtime cocaine use causes cardiovascular problems, which raises the risk of dying from an overdose even before fentanyl is added to the mix.

Barton likens doing cocaine these days to a game of Russian roulette.

"One person might get super high," she said. "The next one may take it and die."

Efforts to reduce these deaths face several obstacles.

Long-simmering resentment among African Americans around the criminalization of cocaine addiction in the 1980s and '90s fuels an ongoing mistrust of law enforcement and public health efforts.

Back then, possessing 5 grams of crack, which many associated with low-income African Americans, brought the same prison sentence as possessing 500 grams of powder cocaine, which many associated with middle-class or affluent whites.

"The way people think about and tackle drug use has been influenced by who we think uses them," said Jeffrey Coots, who directs John Jay College of Criminal Justice's "From Punishment to Public Health" initiative in New York.

And though African Americans use opioids, too, today the drugs are typically associated with white users.

"There's a thought that no one cared until a bunch of white people started dying," said Stephenson, the Cincinnati nurse practitioner. "That's so tragic."

Synan said he's heard this sentiment. People ask: "'Why do you care now if you didn't care back then?'" he said. "So you have to overcome that. Whether it's real or perceived, it doesn't matter, because it's still an issue."

Synan said he understands the concerns and acknowledged that society sees opioids more through a medical lens. But he said "that's partly because of an evolving understanding of addiction and the sheer numbers of overdose deaths in recent years, which require urgent action."

To be sure, overdoses involving opioids kill more Americans: 47,600 in 2017, including 5,513 African Americans. Overdoses involving cocaine killed 3,554 African Americans—although categories overlap because deaths may involve more than one drug.

Another challenge: There's less in the treatment arsenal for cocaine addiction. While medications such as Suboxone and methadone treat people hooked on opioids, there are no federally approved medications to treat cocaine problems, even though researchers were testing promising medications nearly 15 years ago.




Public health officials say they're focusing more on cocaine addiction in light of today's deadly overdose threat, and trying to address the larger issue of addiction in general.

"What we'd certainly like to see more of is community-level interventions that go at the drivers of drug use in the first place—seeing it as the symptom of a problem," Coots said.

In Ohio, the Hamilton County Heroin Coalition—which plans to change its name to reflect a focus on all addictions—has reached out to African Americans through black churches, public forums and community leaders. It tries to spread messages about prevention, the dangers of today's cocaine, where to get help and the need for every drug user to carry naloxone.

The group also has a "quick response team" including police, emergency workers and addiction specialists who follow up with overdose victims, often going to their homes to try to get them into treatment.

That treatment needs to be "culturally competent," Stephenson said, meaning providers respect diversity and the cultural factors that can affect health. These are key goals of the Urban Minority Alcoholism and Drug Abuse Outreach Program, where she works.

Barton said treatment she gets through this program is helping keep her sober and productive. She works as a cook in nearby Covington, Ky., and also tries to help friends still struggling on the streets.

Lately, she's been especially worried about one friend, a longtime cocaine user who has overdosed repeatedly and landed in the hospital.

She pleads with him to be careful, delivering a dire warning:

"One day, you're just not gonna come back."

 
Last edited:

mr peabody

Moderator: PM
Staff member
Joined
Aug 31, 2016
Messages
2,144
Location
Frostbite Falls, MN

NCA Officers seizing £60 million worth of cocaine on a yacht off the Welsh coast


Europe becomes cocaine exporter as countries overflow with the drug*

by John Walsh and William Cohn | The Telegraph | 30 Nov 2019

European countries have become so saturated with cocaine that the region has now become a hub for exporting the drug to markets such as Australia, Turkey and Russia, according to new data.

Record levels of production of the drug in South America and new smuggling routes opening up into the continent means that Europe is now a transit area for the export of cocaine.

The phenomenon is outlined in a new Europol analysis of the drug market, and comes after Spain seized a submarine carrying cocaine from Colombia in a European first this week. New trafficking routes are also being developed through war-torn west African states.

Les Fiander, one of the authors of the 2019 Drugs Market Report, said there were a number of reasons why South American production has soared in recent years.

“Organised crime groups have been able to expand their production, because authorities in source countries are not able to use anymore pesticides to fight it."


Spanish officials seized the submarine earlier this week.

He added that the ongoing peace process in Colombia is another factor, as the vacuum left by the Farc has been rapidly filled by coca farmers looking to make quick money.

According to the report, Belgium, the Netherlands and Spain remain main entry points and distribution hubs for cocaine in the EU. Smuggling operations are becoming more sophisticated and harder to detect.

The European Union’s law enforcement agency’s 2019 Drugs Market Report, shows that the value of the drugs trade in Europe is roughly €30 billion. Cannabis, accounting for 39% of the total market, is the most consumed illicit drug followed by cocaine at 31%. It is estimated that four million European citizens use cocaine.

Last week's submarine was carrying three tonnes of cocaine valued at €100 million when it was detained off the north-west coast of Spain. The submarine had travelled from South America and it is believed the cocaine was destined for the British market.

West and North Africa appears to be emerging as a more significant transit point for both air and maritime shipments of cocaine destined for the European and possibly other markets.

The report found that heroin production, mainly in Afghanistan, is also on the rise and consequently there is likely to be a much greater availability of the drug in Europe over the coming years.

The use of heroin and other opioids still accounts for the largest share of drug-related harms. The retail value of the heroin market in 2017 was estimated to be at least €7.4 billion.

*From the article here:

 
Last edited:
Top