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Health timebomb as rising cocaine use threatens heart problems in young.

Up to 10% of patients with chest pains took drug
Greater acceptability and lower prices fuel growth


Ian Sample, science correspondent
Monday October 24, 2005
The Guardian (UK)

A surge in cocaine use is pushing Britain towards a "healthcare disaster" that will see a dramatic rise in heart attacks, strokes and neurological
problems among young people, says a leading specialist. The warning
follows a three-year investigation into cocaine use carried out at a

London hospital emergency unit which indicates that the medical
complications of the drug will become a significant burden on hospital
resources.
The study looked at levels of cocaine in people who arrived at the
accident and emergency unit of St Mary's hospital, Paddington, London, who
were complaining of chest pains, a common side-effect of the drug. It
found that on Friday or Saturday nights up to half the young people tested
had cocaine in their system.

While fewer tested positive for the drug during the week, the numbers were
still surprisingly high, said John Henry, a leading toxicologist and
professor of accident and emergency medicine, who led the study. "Cocaine
usage has peaked in the US but here it is still on the rise, which means
the worst is yet to come. We're going to see more severe addiction, more
strokes and heart attacks in young people, and more of the other
complications linked to its usage," said Professor Henry, who is regarded
as the UK's leading expert on illicit drug use. "It's a healthcare
disaster and it's coming here."

Records taken during the study, to be published in an academic journal,
show that between 7% and 10% of all those complaining of chest pains were
found to have traces of cocaine in their urine. With the under-40s cocaine
usage was markedly higher; a third of this group tested positive for the
drug on weekdays, rising to 50% over the weekend. Tests on a control group
admitted to A&E without chest pains showed only 3% had taken cocaine.

The study confirms the fears of other healthcare professionals that
cocaine use in Britain has reached an unprecedented level. In an audit of
drug tests carried out by the City Hospital NHS teaching trust in
Birmingham cocaine use was found to be increasing by about 50% every three
years, a trend showing no sign of slowing. "The arrival of the cocaine
epidemic has now started to become a reality in the UK," said Stephen
George, the doctor who did the survey.

The rise of cocaine has been boosted by greater acceptability of the drug
and better supply, bringing more drugs to UK streets and lower prices. A
gram wrap of cocaine now costs as little as 45. Experts fear cocaine use
will continue to soar until it reaches a peak, as it did in the 1990s in
the US where there are now 25 million users and two million addicts.

The increased availability of the drug has been picked up by coroners'
offices which have found that most heroin addicts dying of an overdose now
have cocaine in their systems. "Even 10 years ago we didn't see cocaine in
those cases," said Susan Paterson, a toxicologist at Imperial College,
London, who works with coroners on more than half of the capital's heroin
deaths.

Cocaine tightens up blood vessels, making the heart work harder and
raising blood pressure. While long-term heart problems can build up in
cocaine users, as little as two 100mg lines (a fraction of an ounce) is
enough to cause chest pains. US studies found that 5% of cocaine users
attending A&E departments with chest pains had heart attacks because of
their drug usage. Hospitals are already reporting patients in their early
30s suffering strokes and severe coronary heart disease brought on by
cocaine use. Many do not smoke, are not overweight and do not have
naturally high blood pressure.

In the US a condition called aortic dissection has become common among
cocaine users. Caused by blood being forced into the lining of big
vessels, it essentially creates a new channel for blood to flow down. The
rupture itself causes crushing chest pains but also reduces blood flow to
vital organs, leading to brain and kidney damage in many cases. A third of
the cases of aortic dissection in the US are attributed to cocaine use.

The drug has also lead to a rise in foetal deaths in the US. It is
believed that one in 10 babies dying in the womb do so because their
mother took cocaine - a factor that leads to a rupture of the placenta,
making it shear away from the womb.

Groups that deal with cocaine addicts say users are often oblivious to the
harm cocaine can cause. And low prices, a poor understanding of the drug's
medical effects and wide acceptability of cocaine, mean there is little to
put the brakes on its soaring popularity. "There's no measure of an
increase in heart problems yet, but I foresee it happening. We're
attacking the other risk factors for heart disease, such as smoking ...
but the rise in cocaine usage is the introduction of another serious risk
factor. It's already impacting on emergency services," said Prof Henry.


Special report
Drugs in Britain

Net notes
10.07.2002: Cannabis