POWDER KEG

Cocaine And The Body

Danniella Westbrook bears the stigmata of coke addiction on her face. Not
every cocaine addict suffers quite the damage that she has, with the very
membrane between the nostrils (the septum) eaten away by the alkaline white
powder, but there are many celebrities and has-beens on each side of the
Atlantic with irreversibly eroded cartilage in their noses.

Cocaine constricts the blood vessels. The membranes within the nose are
delicate, and snorting coke can cause intense irritation but numbness at the
same time (cocaine is used medically as an anaesthetic). As the drug wears
off and the blood begins to flow normally again, users often experience the
symptoms of a bad cold with a runny nose or stuffiness and irritation.

Some users head for over-the-counter inhalers to unblock their nose which
only constrict the tiny blood vessels further. The thin tissue is starved of
blood - and therefore oxygen - and gradually dies. Holes develop in the
membrane separating the nostrils. They get bigger with frequent snorting
until there is no membrane left - and in worst cases, no septum either.
Danniella has a classic case of what doctors call saddle nose deformity.

Set against the damage are the legendary highs. Like amphetamines, cocaine
makes you feel exhilaration and indifference to pain and tiredness. It makes
you feel you are braver, stronger, brighter and more beautiful than all the
rest of the world put together. Coke users are often very talkative - it's
popular with those in showbiz and business who have to perform in public
under stress. But all it really gives you is confidence. Lab tests on humans
have shown that things do not go better with coke. You are not performing
better - you just think you are.

Cocaine has a reputation for improving sexual performance and
responsiveness. To a degree, it's true - in low doses it can delay orgasm
and heighten pleasure. But at high doses or if it is used all the time, it
dampens your sexual desire.

The most common unpleasant physical effects according to the charity
DrugScope are dry mouth, sweating, loss of appetite and increased heart and
pulse rate. More regular users may hear a buzzing in the ears, feel
tightness in the chest and suffer diarrhoea, insomnia, exhaustion and an
inability to relax.

If you are sniffing cocaine, the effects hit the brain and peak somewhere
between 15 to 40 minutes and then diminish. So you need another snort every
20 minutes or so to keep up the exhilaration and sense of power. Large doses
or a run of quickly repeated doses over a period of some hours can cause
anxiety and panic, which may develop into paranoia and hallucination.

Most people will suffer nothing more than a moderate increase in blood
pressure and mild heart pounding. But with a very large dose, or a lot of
smaller doses, blood pressure and pulse may suddenly rocket and the heart
starts skipping beats, which can lead to a collapse or heart attack.

The consequences of long-term use, says DrugScope, become unpleasant. That
euphoria turns into an uncomfortable restlessness, over-excitability,
nausea, insomnia and weight loss. Some people become anorexic. Others
develop a sort of persecution mania. Confusion and exhaustion due to lack of
sleep are not uncommon.

All this sorts itself out over a few months if cocaine use is stopped.
Damage to the nose is "much rarer than is generally believed", says
DrugScope - but it is irreversible.