Institute of Forensic Pathology, Department of Experiemental and Clinical Sciences, University of Foggia, Viale degli Aviatori, n. 1 71100, Foggia, Italy.
Curr Med Chem. 2012;19(33):5647-57. doi: 10.2174/092986712803988811.
Drug use is seen more as an individualistic behaviour and is therefore not readily conceived of from a population perspective. There is general recognition of several phases and degrees of drug abuse, from initiation and early-use patterns to long-term chronic use. Cocaine and its derivative "crack" cocaine provide an example of both the globalization of substance use and the cyclical nature of drug epidemics. Cocaine is a powerful CNS (Central Nervous System) stimulant but exerts its action in a several types of adverse health effects, including acute toxic effects (i.e. overdose, accidental injury and violence), dependence, cardiovascular disease, cirrhosis, bloodborne bacterial and viral infections, and mental disorders. Of interest, many people who use Cocaine will use also other drugs; therefore, ascribing adverse health effect to a certain drug might be difficult. Any mucous membrane can act as a port of entry for cocaine and the systemic effect is greatly influenced by the route and speed of administration. The effects of Cocaine mainly depend on the user's addiction, the dose received and the mode of assumption. Laws restricting the availability of cocaine saw a decrease in consumption in these countries until the 1960s. The number of cocaine users worldwide ranged from 14 million to 21 million (0.3-0.5% of the population aged 15-64 years). The largest market was North America, then western and central Europe and South America.
药物滥用被视为一种个体化行为，因此不易从人群角度来考虑。人们普遍认识到，药物滥用有几个阶段和程度，从开始使用和早期使用模式到长期慢性使用。可卡因及其衍生物“快克”可卡因既提供了物质使用全球化的一个例子，也提供了毒品流行周期性的一个例子。可卡因是一种强大的中枢神经系统（CNS）兴奋剂，但会产生多种类型的不良健康影响，包括急性毒性效应（即过量、意外损伤和暴力）、依赖、心血管疾病、肝硬化、血液传播的细菌和病毒感染以及精神障碍。值得注意的是，许多使用可卡因的人还会使用其他药物；因此，将不良健康影响归因于某种药物可能很困难。任何粘膜都可以作为可卡因的进入点，其全身效应受给药途径和速度的影响很大。可卡因的影响主要取决于使用者的成瘾程度、所接受的剂量和使用方式。限制可卡因供应的法律在这些国家减少了可卡因的消费，直到 20 世纪 60 年代。全世界可卡因使用者的数量为 1400 万至 2100 万（占 15 至 64 岁人口的 0.3-0.5%）。最大的市场是北美，其次是西欧和中欧以及南美。
