Körperliche und psychische Folgen des Kokain- und Crackkonsums

Zusammenfassung

Die Zunahme des Kokain- und Crackkonsums erfordert eine differenzierte Auseinandersetzung mit den daraus resultierenden Begleiterscheinungen. In der Wirkung unterscheiden sich Kokain und Crack primär in der Geschwindigkeit des zentralnervösen Wirkungseintritts. Körperliche Komplikationen ergeben sich aus der vasokonstriktorischen Wirkung als auch durch das Abbauprodukt Kokaethylen bei gemeinsamem Konsum mit Alkohol. Da Kokain meistens nicht als Monosubstanz eingenommen wird, sind somatische Folgen selten monokausal auf das Kokain zurückzuführen. Das Missbrauchs- und Abhängigkeitspotenzial ist zum Teil auf die Wirkung auf spezifische Neurotransmittersysteme zurückzuführen. Das Craving und die Toleranzentwicklung sind bei Crackkonsum deutlicher ausgeprägt. Es besteht eine hohe Komorbidität vor allem mit Persönlichkeits- und affektiven Störungen. Bisher hat die medikamentöse Behandlung der Kokainabhängigkeit keine ausreichende Effektivität gezeigt, während verschiedene psychosoziale Interventionen eine positive Wirkung erzielten.

Abstract

The increase in cocaine and crack use calls for a differentiated assessment of its health consequences. The primary difference in the effect of cocaine and crack lies in the speed of central nervous action. Somatic complications result due to vasoconstriction as well as related to the metabolite cocaethylene when consumed together with alcohol. Since cocaine is frequently not used alone, somatic complications seldom have a monocausal relationship to cocaine. The abuse and addictive potential is related to the action in specific neurotransmitter systems. Craving and development of tolerance are more frequent with crack use. There is a high rate of comorbidity especially with personality and affective disorders. Pharmacological treatment of cocaine addiction has not been shown to be sufficiently effective, while several psychosocial interventions have led to positive results.

Schlüsselwörter

Kokain - Crack - Psychische Folgen - Somatische Komplikationen

Key words

Cocaine - Crack - Mental Health - Somatic Complications

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