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Cocaine

What Are the Medical Complications of Cocaine Abuse?

In the body cocaine causes the release of large amounts of the stress hormone noradrenaline, which causes the blood vessels in the body to narrow and your blood pressure to go up. As a result, some of the most frequent complications are effects on the heart. Cocaine can increase the heart rate, breathing and blood pressure. It can disrupt the electrical messages to the heart and bring on serious irregularities of the heart beat, called ventricular fibrillation. It can cause heart attacks and stroke.

The main blood vessel in the body, known as the aorta, can be damaged by cocaine use. This can lead to a tearing of the lining of the aorta, known as an aortic dissection. This tends to cause a crushing pain in the upper back or chest.

Cocaine can affect the lungs, causing chest pains, and sometimes the lungs may stop working. It can affect the brain, resulting in fever and headaches as well as strokes and seizures, and it can affect the stomach, causing abdominal pain and nausea. Chronic cocaine users can lose their appetites and become run-down, with accompanying weight loss. Eating cocaine can damage the blood supply to the bowel, resulting in gangrene.

Mental health effects are many and varied. Cocaine commonly causes anxiety, restlessness, panic attacks, depression and feelings of paranoia. This can lead to a paranoid psychosis where the person loses touch with reality and experiences auditory hallucinations (a sensation of hearing voices).

Regular users of cocaine can become impulsive and aggressive in their behaviour and lose their sense of perspective. This can lead to more violence and risk-taking, for example when driving.

Mixing Cocaine and Alcohol

There is a potentially dangerous interaction between cocaine and alcohol. Taken in combination, the two drugs are converted by the body to cocaethylene. Alcohol makes cocaine last longer because of the way the drugs interact in the liver. Mixing cocaine and alcohol significantly increases the risk of heart attack.

Cannabis

What Is Cannabis?

The cannabis plant contains many different chemicals and can come in many different strengths, with variable effects. The plant is used as either the resin (a brownish/black lump) or as herbal cannabis, which is made from the dried leaves and flowering tops. Other names for cannabis include ‘marijuana’, ‘weed’, ‘puff, ‘hash’ and ‘wacky backy’. Cannabis is usually taken by mixing it with tobacco. It is then inhaled deeply into the lungs for a number of seconds. Cannabis can also be smoked in a pipe and can be brewed as tea or even cooked as ‘hash cakes’.

Whereas there is much literature on disclosure of HIV status to children and adolescents, little has been written about the emerging sexuality of the HIV-positive child. What young people who are HIV-positive feel and experience as they approach stages in life in which they must make decisions about themselves that have an impact on others has had limited exploration. It is not well documented that many clinicians are in discussion with HIV-positive children about their relationships and their choices:

How should teenagers express to another teen that they are HIV-positive? Should they always disclose? When should they disclose? At the beginning of a friendship? After trust has developed? If this is someone with whom the adolescent thinks they will have a more physical relationship, should they tell the other person they are HIV-positive before they progress to a closer relationship? Should this be discussed before any physical contact? Before sexual contact? What are the implications for the youth who is HIV-positive and what are the implications for the potential partner? What happens when the teen invariably ‘breaks up’ with the person to whom they have disclosed? Are the rules different for adults or for teens? What information sharing is in the best interest of whom?

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Mental health professionals at the forefront of medical care are in a position to assess and address these questions as part of the routine care of children and young people who are HIV-positive. Studies suggest that teens do not plan to become sexually active, it just ‘happens’. This indicates a need for providers to preemptively initiate a dialogue about sex.

At an age when youth often find themselves in a series of relationships there are complicated issues that emerge. Once an individual discloses their HIV status to a peer, they cannot go back and ‘undisclose’ the information for Canadian Viagra Online. The choice to disclose in a relationship that may be temporary is emotionally laden. The first disclosure to a friend, peer, boyfriend or girlfriend could be the last disclosure. Young teenagers may not always be mature in their ability to discern the strengths, weaknesses and trustworthiness of their peers. As a result, such decisions are complex and cumbersome:

In one situation, a father decided it was time to tell his 14-year-old daughter that she was HIV-positive. She had been having sex with a 14-year-old friend at school (unbeknownst to her father). In response to the information that she was HIV-positive, and in an attempt to be responsible, she told her boyfriend that she had just learned she was HIV-positive. He panicked and told the principal, who panicked and called the police. Both children were suspended from school and suddenly everyone in the school knew that this child was HIV-positive.