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Cocaine: a powerful and a destructive drug glamorized by models, rock stars and celebrities. We zoom inside the human body from the moment the substance enters our systems. With the guidance of doctors, we learn about the intense highs and painful lows of one of the most widely used stimulants in the U.S.
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00:00Es una de las más adictivas en el mundo.
00:07Some of the names crack rocks, butas, powder, they call it girl ear.
00:14Whatever you call it, nearly 37 million Americans have used it at least once.
00:20Shirley, Scoop, we used to call it cheese when we were on the phone, that way nobody would know what we were talking about.
00:26Cocaine, so desirable it sells on the street for $175,000 a kilo.
00:35This is the story of what cocaine does to you, and how it makes you feel.
00:40King of the world, I feel like a god.
00:42We follow coke users as they take the drug, and discover how it hijacks the mind and body.
00:51How addictive it can become, and its potential to kill.
00:57You're just sort of wondering, are you about to die?
01:11For many people, a line of this white powder is a little bit of heaven.
01:16Somebody made a suggestion here, try this, and it was like I was off to the races.
01:21Over the last 30 years, cocaine has grown into a $70 billion illegal industry.
01:29Its revenues rival the world's largest corporations.
01:32In the U.S., around 100,000 kilos of smuggled cocaine is seized every year.
01:38This is only a fraction of the amount that actually reaches dealers and users on the street.
01:42Its success is down to a simple chemical reaction, the biochemical high it induces in the brains of humans.
01:51Once you get that cocaine, it's like a chase. The chase begins.
01:54It went right into my bloodstream, rushed straight to my heart, and it almost made me feel like it was about to explode.
02:00But that was the best time. When I got that kind of rush is when I wanted to do it again, and again, and again.
02:11Cocaine was once the party drug of the rich and famous, but its popularity has soared as its price has dropped.
02:17In some parts of the world, it costs as little as a bottle of beer.
02:25And for young people, it can be a normal part of a good night out.
02:32Damien and Josie are typical of those who use cocaine regularly in their social life.
02:37Right, we need to sort this party out, don't we?
02:40We're going to follow them as they throw a party in which cocaine will just be part of the fun.
02:44The first time I took coke, literally just took it, smoked a cigarette, puked everywhere.
02:51And then straight after I puked, it just felt bloody amazing.
02:54Just like absolutely amazing.
02:56It just felt like all my worries had been lifted up from my shoulders.
03:00I just felt really confident.
03:05There's nothing unusual in these two planning a modest party for friends.
03:10But they are just part of a huge, illicit global business.
03:14Last year, the U.S. government spent over $15 billion fighting drugs like cocaine.
03:21But it's a tough war to win, because the drug is so effective in giving us pleasure.
03:26You just chop it up with a card.
03:30As Damien snorts tonight's first line of cocaine, what goes on inside his body?
03:35The coke flies into his nose at up to 100 miles an hour, the fine powder ripping up through his nostrils.
03:44It coats the mucous membranes, lining his sinuses.
03:49Up to 60% of the powder gets absorbed through the nasal membranes, straight into his bloodstream via small capillaries, beginning a journey through his body.
03:58The capillaries feed into bigger veins.
04:03Soon, the drug reaches Damien's heart.
04:06From there, it's pumped to the lungs and back to the heart, which starts to beat faster as the cocaine takes effect.
04:14Now, the drug payload is carried on to the other major organs in his body.
04:21And a lot of it goes to the brain.
04:26Here, the cocaine molecules can leach through the blood vessels.
04:30Soon, they reach the billions of nerve cells that make up Damien's brain.
04:34There are the cells that control every aspect of how he behaves.
04:41Beautiful.
04:41All right.
04:43That's how you do coke.
04:45Yeah, it's quite nice.
04:46It's a good feeling.
04:49Cocaine basically creates a euphoric feeling.
04:53And that is a high.
04:54And that's what makes people want to use cocaine over and over again, is in search of that euphoria type of feeling.
05:01It was my Superman drug.
05:03I could talk to any girl.
05:05I could answer any question.
05:07I could do anything if I had to coke in it.
05:11But it's also the physical intensity of the cocaine rush that keeps users wanting more.
05:16When I tried coke for the first time, it was like heart jumping up in my throat, pounding out of my chest.
05:23It's like climbing that water tower that's, you know, 15 stories in the air and you're just standing on the ladder.
05:28That kind of, you know, rush of excitement.
05:33The speed with which a cocaine hit takes effect has helped the drug become ever more popular.
05:40For some, cocaine powder is an essential part of a big night out.
05:46Ryan has just left the army and enjoys a coke session every couple of months.
05:50It's just a nice feeling.
05:53It's good when you're having a drink and socialising.
05:55I like it.
05:57Put you in the mood.
06:03Today, he and his friends are planning a big blowout.
06:06And they don't want to wait until the evening to get started.
06:08So what's going on inside Ryan's head?
06:22The billions of nerve cells in our brains form networks that carry messages.
06:32Where cells connect, there are tiny gaps.
06:35Here, chemical messengers carry the signal from cell to cell.
06:38One network of nerves is dedicated to making us feel good when we do something essential to our survival, such as eat, drink, or have sex.
06:48In this network, messages are carried across the gap between cells by the chemical dopamine.
06:58Dopamine crosses from one nerve cell to receptors on its neighbor, triggering a chain reaction, which makes you feel good.
07:05The dopamine then returns to the nerve cell that released it to be recycled and used again.
07:10That's what happens before cocaine gets to work.
07:20The drug sends the network into overdrive.
07:28Cocaine triggers the release of massive amounts of dopamine across the gaps and sets off a torrent of feel-good messages through the brain.
07:35And cocaine also stops the dopamine from returning to be recycled.
07:43It means more and more builds up.
07:47It really causes a rush of dopamine.
07:49And this rush of dopamine is really related to a sense of sensation.
07:53The more cocaine that gets in the brain, the more dopamine that gets released.
07:57The more pleasure, the more rush, the more hot.
07:59The flood of dopamine makes the user more animated and talkative.
08:07It creates a sense of euphoria and self-assurance.
08:10You snort it and you instantly get this rush in your nose.
08:15This rush in your head where the back of your, like your whole sinus cavity starts to drain on you.
08:20And you're doing this and you're swallowing and you're standing there.
08:24And the next thing you know, your heart gets to beating faster.
08:26And you might sweat a little bit and your mouth gets a little dry.
08:30And you get a little fidgety and you're starting to move around.
08:33And the next thing you know, boom, here comes confidence.
08:35I could do anything.
08:40It didn't matter what it was.
08:41If I wanted to fly, I probably thought I could.
08:46The stimulating effects of the drug were exploited thousands of years ago in South America,
08:51where they chewed the leaves of the coca plant.
08:55Then, in the 1860s, the leaves were first processed to make the modern crystalline drug.
09:01At first, cocaine was perfectly legal.
09:04It was used in medical treatments.
09:07Coca-Cola even derived its name from coca leaves.
09:10It's reported they used to pack 60 milligrams of cocaine into every serving.
09:16Today, the drug is made in makeshift labs deep in the heart of the rainforest.
09:21Coca leaves are processed with highly toxic substances,
09:25including sulfuric acid and kerosene.
09:27The result, a pure white crystal.
09:33When it's made, a kilo is worth several hundred dollars.
09:37By the time it reaches Western markets, it can fetch $175,000.
09:43The demand for cocaine means smuggling is big business.
09:48Millions of kilos are seized worldwide as governments attempt to stifle the supply.
09:52Taking the battle out of the street, police forces are tasked with tracking down users and dealers.
10:02And now, they're using advanced technology to help.
10:06New scanners are showing there's more cocaine out there than you'd imagine.
10:09As the authorities fight to control cocaine crossing borders,
10:23and as it spreads onto the street, they're bringing in new technology to help.
10:28Scanners like this one are being used to detect tiny amounts of the drug.
10:33It's looking for traces of drugs rather than bulk amounts.
10:36And traces of coke spread easily from notes to note.
10:39If you took ten notes off the street,
10:41the likelihood here is you'd come back with at least nine of them that were contaminated with cocaine.
10:44It contaminates everything.
10:48This means you have it.
10:52The scanner relies on the fact that every substance is made of molecules with a distinctive size and shape.
10:59This machine can detect particles of cocaine down to a billionth of a gram.
11:04Because money bills are used to snort coke and then go back into circulation,
11:08it's estimated that 90% of U.S. bills are contaminated with cocaine.
11:14And that's not all.
11:15When passed from nose to nose, they are an effective way to spread bacteria and viruses.
11:20There are even concerns that blood-borne diseases such as hepatitis have been caught this way.
11:30When the authorities strike lucky and intercept large quantities of the drug,
11:34they test it to check out the quality.
11:36Often, dealers mix it with other look-alike powders.
11:43It's something these former users have experienced many times.
11:46I'd be wanting something so bad, I'd go down and I'd pull up to a corner,
11:51don't even know who the guy is, and come out.
11:53He'd hand me something, I'd drive away, and I'd go in, I'd stuff it in the stem,
11:56and I'd light it up, and it tastes like ivory soap.
11:59I remember snorting stuff like that.
12:00I mean, man, it burnt the whole way.
12:02I mean, from word go to word end.
12:04I mean, you know, you blow bubbles at your mouth, you know,
12:08you think, oh, well, that's nothing wrong with that.
12:15Forensic scientists check what's being mixed with cocaine for good reason.
12:20It makes it cheaper to buy, but it can also make it much more dangerous to consume.
12:26On a typical day, this lab examines 100 kilos of cocaine worth nearly $8 million.
12:31Just a small fraction of the 800 tons seized annually around the world.
12:40Cocaine seized as it's being smuggled into the country is relatively pure.
12:45This is a bag of approximately a kilogram of cocaine powder.
12:49It actually contains 79% cocaine and is good importation quality.
12:55But when they test cocaine from the street, seized from dealers and users,
12:59they find it's much less pure.
13:01The typical street range of cocaine is perhaps 3 to 30%, commonly 10 to 20%.
13:08But we have actually seen cocaine powders containing perhaps only 1% cocaine.
13:14Dealers cut cocaine with bulking agents to increase their profit margin.
13:19Most of the white powder sold as cocaine is actually made up of something else that looks like it.
13:24Sugars such as lactose or glucose or anesthetics such as benzocaine or lignocaine.
13:29Damien's house party is now in full swing.
13:35He's no scientist, but he has a wealth of knowledge about cocaine and what gets mixed with it.
13:41Yeah, this stuff here is like 40 pounds a gram and it's got quite a lot of benzocaine or novocaine in it or even cruritine.
13:52You can tell the difference because this is like more powdery.
13:55Then this stuff here is like 80 quid of grams.
13:58The good stuff is really rocky and you can see a little shine in it.
14:04This would be like 70% stuff.
14:06This will do a better job and last longer.
14:10Just chop it up.
14:11There is also one test that Damien can perform that no lab machine can.
14:21And that's the good stuff.
14:23You can taste the difference.
14:25It's more of a diesel-y smell you can taste because they make it with diesel.
14:30So the more it tastes like diesel, the better it is.
14:33That was nice.
14:34That cheap stuff, it kind of hurts your nose.
14:39But this stuff, it doesn't at all.
14:41It just goes up there nice and smoothly.
14:44But snorting drugs does more than hurt the nose.
14:47It can cause long-term damage.
14:49Even pure cocaine has a toxic effect, destroying nasal tissue.
14:54You know, it burns a little bit.
14:56You know, that's why I have a hole in my nose today.
14:58You know, I went to blow my nose and it was like...
15:04Scabs came out and then I went to look at it.
15:09And I could see from this side to that side,
15:12about a light just shined on the other side.
15:14So, and I realized it was there.
15:19As cocaine is snorted,
15:21it causes blood vessels in the delicate lining of the nose
15:24to constrict and shut down,
15:26depriving the tissue of blood and oxygen.
15:29Eventually, the tissue weakens and dies.
15:34This can cause a hole or perforation to develop in the nose.
15:41An operation is often required to repair this damage.
15:45Consultant surgeon Sandy Pond is a leading specialist in nose reconstruction.
15:57His patient today made a hole in his nose through regular cocaine use.
16:01He's asked to remain anonymous.
16:03As you know, we're going to be sorting out your nasal septal perforation today.
16:07When was the last time you used it regularly, the drug?
16:11Use it regularly?
16:13Part six months previous?
16:15Six months ago.
16:16Okay.
16:16There's certainly no guarantees that we can close the perforation completely.
16:20And certainly after cocaine use in particular,
16:24closure of septal perforations is quite difficult.
16:26The operation to repair the damage requires the patient's nose to be cut open and split in two.
16:34We're going to look in this gentleman's nose now.
16:37We're just going through the nostrils, having a look inside.
16:41And what we can see there, just at the front of the septum, is the hole.
16:45Often, these perforations can progress way beyond the size that we see here.
16:50Knife, please.
16:51Sometimes doing it, there's times where you take a line and you have a real bad burning sensation
16:58from the start of your nose right away to the back of your throat.
17:03It's really painful.
17:04Iris, scissors, please.
17:07In the very worst case scenario, I've seen patients with no discernible septum at all
17:12where the whole middle of the nose has gone effectively
17:14and you've just got one big nasal cavity between the two sides
17:17and everything just collapses inwards.
17:19Okay, so what we see here inside the nose, here's the lining on one side.
17:24You can see the hole through the lining.
17:26So initially, the cocaine would have created a hole in the lining
17:29but not through the cartilage.
17:31But eventually, it would have worked its way through the cartilage
17:34and then eventually through the other side.
17:37The fact that cocaine is often mixed with a lot of contaminants,
17:41all sorts of things including baking soda, glucose,
17:45and in the worst case scenarios, even talcum powder
17:48can cause an intense inflammatory response.
17:52This inflammation can cause the flesh in the nose to die even more rapidly.
17:59Ironically, Dr. Pon actually gives cocaine to the patient to stop bleeding.
18:05Patients don't snort it up beforehand or anything, but we give them a small amount in liquid form.
18:16Okay, so you can see on one side here, the lining has been completely closed
18:20where there was a hole before.
18:23As we look on the other side, similarly, there's no hole there now
18:26where the lining has been closed.
18:28Back at the house party, the guests are getting into the swing of things
18:36with a few more lines of coke.
18:41The damage cocaine could do to these users' noses
18:46doesn't worry them enough to put them off their lines.
18:49But the dangers of cocaine can be far more serious.
18:57Even occasional users can put their lives at risk
19:00because of the effect the drug has on the heart.
19:06As Damien and Josie's house party fills up,
19:09Damien makes the most of the event with his evening supply of cocaine.
19:12It must be about 11 o'clock.
19:17Yeah, I've done about four or five lines.
19:21It's just very moral.
19:22You just want to do more and more and more
19:23because the effect wears away quite quickly.
19:26So, yeah, you just have another line, another line, another line.
19:30On one occasion, Damien took one line too many.
19:33The most coke I've done was in a club in Bristol
19:36and we had literally done about an eighth between the three of us before
19:41and then I had a gram left
19:43and I just thought, well, I might as well.
19:46The coke wasn't that good.
19:47So I snuck into the bathroom,
19:50took a line of coke literally that big.
19:52It was a gram.
19:54If it was good coke, I'd probably have died.
19:56But as soon as I took it, just my heart raced.
19:59I started to sweat so much
20:01and literally I just couldn't stand up anymore.
20:04I just had to lie down for at least half an hour.
20:06Damien's heart was racing
20:12because of another dangerous effect that cocaine has on the body.
20:21The drug stimulates the nerve cells
20:23that control the muscles in the heart.
20:25They produce a rush of another chemical messenger, noradrenaline.
20:31Noradrenaline is normally released when you're in danger.
20:33It makes your heart beat faster
20:35so that you can fight or get away from trouble.
20:39It also causes blood vessels to squeeze and constrict.
20:44Pressure starts to rise.
20:49It doesn't take much cocaine to disrupt the heart's function.
20:53Just a couple of lines can have a massive impact.
20:58Even occasional users can be taken by surprise.
21:01Tom is a 19-year-old musician.
21:06He started taking cocaine a couple of years ago.
21:10I was just at a party
21:11and literally someone was doing it
21:15and they just said,
21:16do you want that one?
21:17And I just went, yeah, okay.
21:20And then I was just really good of energy
21:22and just like, whoa.
21:26Do you know what I mean?
21:27From that party, it'd become a thing
21:34where I would do it a few times a week,
21:38mostly at the weekends.
21:39I was probably taking about a gram
21:40over the course of a weekend.
21:48Tom started to get occasional chest pains,
21:50but he continued using cocaine.
21:52A few weeks later, I was just with my friends
21:59and we got some coke
22:02and we took it,
22:04thought nothing of it.
22:06The next day, Tom visited London with his family.
22:09I'd had this pain in my arm all day,
22:11but I didn't really take notice of it.
22:13And then all of a sudden,
22:13the pain just shot up my arm
22:15and my chest started going tight.
22:17And then I lost my breath
22:18and I tapped my mum on the shoulder
22:20to try and get her attention.
22:21And then I just had this breath come up
22:23and I went,
22:24I need to go to hospital.
22:28The cocaine that Tom had taken
22:30caused a clot to form,
22:32blocking blood, getting to his heart.
22:34It slowed to just 28 beats per minute
22:36and he had a heart attack.
22:39What have I done?
22:40That was my exact question to myself.
22:42What have I done?
22:43I didn't realize
22:45the effect that anything would have on people
22:48until you're there
22:49in what you could say, a deathbed, basically.
22:51It could have been your deathbed.
22:53With family next year,
22:55in tears,
22:56the scariest thing ever.
22:59There's nothing worse than thinking
23:00that you could be dead.
23:02Because that's the end.
23:03Once you're gone, you go on.
23:05The damage to Tom's heart
23:06meant that he would need a pacemaker
23:08to keep his heartbeat under control.
23:11That's the battery.
23:13And then the wire
23:15actually comes up here
23:17and then it goes round
23:18and then it goes into your heart
23:21and into the chambers
23:22that aren't working.
23:24And it gives that
23:25electrical shocks
23:27that it needs to work
23:28properly.
23:30It's in there forever.
23:32Without that, I'm not,
23:34I'm not here.
23:35Despite stories like Tom's,
23:40cocaine keeps its appeal.
23:43And users take even greater risks
23:45by mixing cocaine
23:46with other substances.
23:48The most common mixer
23:49is alcohol.
23:51It's like throwing fuel
23:52on a fire.
23:57What's going on, you guys?
23:59Users often combine cocaine
24:01and alcohol
24:02because it helps them
24:03to keep drinking for longer.
24:05Ryan and his friends
24:08are outside a bar
24:09where they've been drinking beer
24:10for a couple of hours.
24:12They begin to share lines of coke
24:13to help sustain their evening out.
24:18But coke and beer combined
24:20carry hidden dangers.
24:24Dr. Tom Costin
24:26and his research team
24:27at Yale Medical School
24:28discovered that alcohol
24:29and cocaine react in the liver
24:31to form a totally new compound
24:33called coca ethylene.
24:37This coca ethylene
24:38is pumped through the blood
24:40up to the brain
24:42where, like cocaine,
24:44it also causes
24:44the release of dopamine,
24:46making you high.
24:49Coca ethylene
24:50has the same effects of cocaine,
24:52but it lasts much longer.
24:54If you're prolonging
24:55the effects of cocaine,
24:57you're increasing
24:58the heart rate for longer.
25:00You're increasing the blood pressure
25:02for a longer period of time,
25:03and that has bad consequences.
25:06The high from coca ethylene
25:08can make you feel less anxious
25:10than just cocaine,
25:11but it also causes nerve cells
25:13in your heart
25:14to produce lots of noradrenaline,
25:16making it beat three times faster
25:17than cocaine alone.
25:20Your blood vessels get tighter,
25:23your blood pressure shoots up,
25:24making you much more likely
25:26to die from a heart attack
25:27and taking cocaine on its own.
25:31The major effects
25:32that you'd have would be
25:33a stroke of the brain
25:34or a heart attack in your heart
25:36and increase the possibilities
25:38for getting cardiac arrhythmias,
25:40so that would lead to sudden death.
25:44Despite the dangers,
25:45coke and alcohol
25:46are often used together
25:47to help prolong binges,
25:49often for more than
25:5124 hours at a time.
25:52You go to a bar
25:55and you drink some more
25:56and then you go out
25:56and you do a couple lines
25:57of coke outside,
25:59you know,
25:59and you come back in,
26:00and that way you can drink
26:01some more because now
26:02you come back up,
26:03you know,
26:04you got that extra oomph,
26:06that extra horsepower
26:07to come back in
26:08to do some more drinking.
26:10The cocaine can keep you
26:11from feeling the effects
26:12of the drunkenness.
26:14It just keeps you
26:14from getting as drunk
26:15as you could be
26:16and lets you go longer
26:18and you're having a good time.
26:19It just keeps the party going,
26:21you know.
26:22At the time,
26:22you think that's a good idea.
26:28After the great high
26:29comes the aftermath,
26:31especially for those
26:33who combined alcohol
26:34and cocaine.
26:36Cocaine has what's called
26:37the cocaine washout syndrome
26:39and it is not uncommon
26:41for the patient
26:42who has been abusing cocaine
26:44for several days
26:45to go into a post-intoxication state,
26:47a cocaine washout state
26:49where they may sleep
26:50for 72 hours.
26:52Does that look like coffee,
26:53does it?
26:56I feel like I could have been drank.
27:03Cocaine users can feel down
27:05the next day
27:05because of the way
27:06in which it made you feel high.
27:09The euphoria of the drug
27:11comes from the release
27:12of large amounts
27:12of the feel-good chemical messenger
27:14dopamine.
27:15Because the drug
27:17blocks the dopamine
27:18from being recycled,
27:20it stays in the gap
27:21between the nerve cells.
27:23But eventually,
27:24it breaks down
27:25and disappears.
27:27It takes several days
27:28for the nerve cells
27:29to replenish
27:30their stocks of dopamine.
27:32Some occasional users
27:33can ride out the low
27:34caused by the dopamine shortage.
27:37For others,
27:38the craving takes over
27:39and becomes an addiction.
27:40How to combat
27:43and reverse the effects
27:44of addiction
27:45has long been a goal
27:46for doctors and researchers.
27:51In Baltimore,
27:52scientists are carrying out
27:53pioneering research
27:54into how cocaine addiction
27:56affects the human brain
27:57and behavior.
27:58We have no real way
28:01of quantifying
28:02and describing
28:03physiologically,
28:04biologically,
28:05what addiction is
28:06and what it does
28:06to the brain.
28:08Dr. Stein wants to see
28:09how cocaine affects
28:10users' ability
28:11to understand
28:12the consequences
28:13of their actions.
28:15And unusually,
28:16he administers cocaine
28:17to human subjects
28:18in the laboratory.
28:20An individual
28:20who's a chronic cocaine user
28:22who's been screened
28:23by us medically
28:24and psychiatrically
28:25will be coming down
28:26into the magnet.
28:27They'll have an IV line
28:28in one of their veins
28:29and then we'll have cocaine
28:31delivered on board.
28:32The goal of the experiments
28:33is to give enough cocaine
28:34to get the individual
28:35intoxicated,
28:36to be able to look
28:37at the consequence
28:38of alterations
28:39in brain processing
28:40under the influence
28:41of the drug
28:41but not necessarily
28:43the same acute high
28:44that they get
28:45on the street.
28:46So this is one part
28:47of a larger program
28:48to understand
28:50the neurobiology
28:51of the brain,
28:52how it changes
28:53as a course of addiction.
28:54Right now,
28:55our success rate
28:56in treating any
28:57of the addictions
28:58is rather abysmal.
28:59And so part of that,
29:01the hypothesis being
29:02that part of that
29:02is we really don't
29:03understand the disease
29:04well enough
29:05to be able to target
29:06the treatment.
29:08Today's volunteer,
29:09who we're not allowed
29:10to identify,
29:11will be placed inside
29:12an MRI scanner.
29:15She's part of a group
29:16who will have their brain
29:17scanned while performing
29:18computer-based tasks.
29:20The task involves
29:23pressing a button
29:24as fast as they can
29:25in response to an image
29:26of winning
29:27or losing money.
29:28In other words,
29:29good and bad outcomes.
29:31They are told
29:32they can take home
29:3310% of their winnings.
29:35The test will measure
29:36their brain's response
29:37to these winning
29:38and losing events
29:39while on cocaine.
29:41Because of the dangers
29:43of using cocaine,
29:44the volunteer's blood
29:45and heart rates
29:46are constantly monitored.
29:49In a few minutes,
29:49the subject will get
29:50the first injection
29:51of cocaine.
29:52Yes, very good.
29:54The technician begins
29:55to scan the cocaine
29:56addict's brain.
29:57Three, two, one, go.
30:00So the cocaine injection
30:02is going in right now.
30:02You can see how much
30:04has gone in.
30:05Two mLs of the 10
30:06that we're totally
30:07giving her over three minutes.
30:09We'll expect to see
30:10the heart rate
30:11and the blood pressure
30:11go up.
30:13We're pulsing
30:14her heart rate.
30:15Yes, her blood pressure's up.
30:17What you see on the screen
30:18now are a series
30:19of axial images,
30:21the actual
30:22echoplanar raw data,
30:24the blood flow data
30:24coming in now
30:25every two seconds.
30:26We have what's called
30:27a repetition time,
30:29a TR of two seconds.
30:30So you see these images
30:31being refreshed
30:32every two seconds.
30:33In post-processing,
30:34these are the data
30:35that we then analyze
30:36to look at significant
30:37changes or changes
30:39in the brain
30:39as a function
30:40of the experiment.
30:42Although in its infancy,
30:44the study shows
30:45that in cocaine users,
30:46a key area of the brain
30:48is activated less
30:49by the thought
30:50of losing money
30:51than by the thought
30:52of winning.
30:54The non-users respond
30:56quite the reverse.
30:57What we actually see here
30:59is less activation
31:00in this region
31:02in the presence
31:03of cocaine
31:03when one anticipates
31:06losing
31:06as opposed to winning.
31:07If this kind
31:09of result holds up
31:11as we continue
31:12the experiment,
31:13this kind
31:14of a less activation
31:16in anticipating a loss
31:18would be consistent
31:19with cocaine individuals
31:21not really learning
31:23from negative outcomes.
31:25So all of the consequences,
31:26the negative consequences
31:27in their family life,
31:28in their personal life,
31:30as a consequence
31:30of being a drug addict,
31:31doesn't seem
31:32to be sufficient
31:32in changing their behavior.
31:34And this kind
31:35of data
31:36would be suggestive
31:37of a neurobiological mechanism
31:39to explain
31:40that behavioral outcome.
31:42While some long-term users
31:44show signs
31:45of changes in behavior,
31:46not everyone does.
31:49Some seem to escape
31:50the worst of the drug.
31:57Damien and Josie's
31:58house party
31:58is still going strong.
32:01Although no stranger
32:02to cocaine,
32:03Damien certainly
32:03doesn't see himself
32:04as an addict.
32:06These days,
32:08I don't take coke
32:09that often.
32:10But last year,
32:12for instance,
32:12I was taking it
32:13pretty much every day.
32:16Now it'd be
32:17special occasions
32:19going out.
32:22The party goes on
32:23through the night.
32:25By 4 o'clock,
32:27the supplies have run out.
32:30But Damien
32:30is not quite done
32:31with the drug.
32:33Yeah, the coke's
32:35worn down around.
32:37Just need some more.
32:38More!
32:40And that's
32:41the coke user's problem.
32:45The average
32:45cocaine high
32:46lasts about 20 minutes.
32:49And this drives users
32:50to want more and more.
32:52Once I tried
32:53that first time,
32:54I just wanted more.
32:56Couldn't get enough.
32:58Once the first one
32:59is in me,
32:59I need more.
33:00I need more.
33:02But the more hits
33:02you take,
33:03the less effect
33:04they have.
33:05You're always looking
33:06for that first time
33:07that you did it.
33:08You're always looking
33:09for that sensation
33:10and it never comes back.
33:11The brain will try
33:12to counteract
33:13and regulate itself.
33:15And this regulation
33:16over time
33:17means that
33:17it's going to prepare
33:19itself for larger
33:20and larger doses
33:21of cocaine
33:22because
33:22the same dose
33:24that produced
33:25the high
33:25a month ago
33:26is going to be
33:27less effective
33:28and the user
33:28has to take
33:29more and more
33:29cocaine
33:30to get the same high.
33:35Harley-Davidson
33:36enthusiast Leo
33:37is a recovering addict.
33:41He was introduced
33:42to cocaine powder
33:43as a young man
33:44and quickly became
33:45a serious user.
33:46He eventually
33:51lost his home
33:51and family
33:52to the drug.
33:55But after going
33:56into recovery,
33:57Leo pulled his life
33:58back together
33:58and formed
33:59a bike chapter
34:00for recovering addicts.
34:05When I was around
34:0620 years old,
34:08I was at a friend's house
34:09and he said,
34:10here,
34:10you got to try this.
34:12You'll love it.
34:13And I did.
34:14And I loved it
34:16for another
34:1713 and a half years.
34:19Right from the get-go,
34:20couldn't get enough.
34:22The body wants more.
34:24That's where
34:24the addiction runs
34:25and it's like,
34:26you know,
34:27you swear you're
34:28not going to do
34:28any more,
34:29but you got to
34:30get some more.
34:32Your body's telling you.
34:34Your mind's telling you.
34:36I'd tell myself
34:37all the time,
34:38oh, man,
34:39I'm not going to
34:40do this no more.
34:40And later that day,
34:42you know,
34:42two hours later,
34:43I'm at the
34:44dope man
34:44getting some more.
34:47At the height
34:48of his addiction,
34:49it was costing
34:49Leo $2,000 a week.
34:52The cocaine
34:53would override
34:55everything else.
34:56I mean,
34:56you know,
34:57the care of my children,
34:58my wife at the time
35:00or girlfriend at the time,
35:02that was all secondary.
35:06Despite binging
35:06on cocaine
35:07almost every day,
35:09Leo was still able
35:10to work as a
35:10commercial plumber,
35:11funding his expensive habit,
35:13but concealing it
35:14from his family.
35:16I would snort
35:17so much cocaine
35:18through my nose
35:18that my nose
35:19would get sore
35:20to where I would
35:20start sucking it
35:22down my throat.
35:22Any way to get it in me,
35:24it didn't matter.
35:25I'd sprinkle it
35:26in a cup of coffee
35:27and keep using
35:28that same cup of coffee
35:30over and over again
35:31just to get anything
35:32that might have stuck
35:32to the side of the cup.
35:34Sprinkle it on
35:34a piece of pizza
35:35and eat the pizza,
35:37you know,
35:37just to get it
35:38in my body.
35:40Any way, shape,
35:41or form,
35:41it wouldn't have mattered.
35:43You know,
35:43if somebody would have
35:44told me you could
35:44drop it in my eye
35:45and it would get me high,
35:47I would have tried it.
35:49After long-term abuse,
35:51a cocaine addict's brain
35:52becomes desensitized.
35:55It's because
35:56the brain starts to adapt.
35:57It actually kills off
36:01the dopamine receptors
36:02on the nerve cells.
36:04With fewer receptors,
36:06it's much harder
36:07for the brain
36:07to send enough messages
36:08through the feel-good network.
36:16After a while,
36:17people need a line of cocaine
36:18not to feel high,
36:20but to generate enough dopamine
36:21just to feel normal.
36:27Like a lot of users,
36:29Leo drank alcohol as well.
36:31And in the end,
36:33this led him
36:33to giving up the drug.
36:35I got arrested
36:36for, uh,
36:37actually for drinking
36:38and driving.
36:39Physically, mentally,
36:40I was, I was done.
36:43I couldn't do anymore.
36:45Why am I living like this?
36:46I mean,
36:47laying in bed,
36:48um, late at night,
36:49you know,
36:49ready to go to sleep
36:50and, you know,
36:51your heart speed up
36:52and it feels like
36:54it's ready to bounce
36:54out of your chest.
36:56You know,
36:56I thought it was
36:56going to kill me.
36:57In fact,
36:58it would have,
36:59um, you know,
37:01if I had to keep
37:03on using
37:03for the last 13 years
37:06that I've been,
37:06I've been clean,
37:07I'd probably be dead.
37:10But scientists
37:11may soon be able
37:12to offer hope
37:13to addicts.
37:14Dr. Tom Costin's
37:16latest research
37:17has developed
37:18a unique treatment
37:18for chronic users,
37:20a vaccine.
37:22The vaccine
37:23is designed
37:23to block the effects
37:24of the cocaine high,
37:26like a vaccine
37:26would block a virus.
37:27The idea is simple.
37:32In the bloodstream,
37:33the vaccine stimulates
37:35the production
37:35of antibodies,
37:36which latch
37:37onto cocaine particles.
37:40They would then
37:41be too big
37:42to pass through
37:43the blood vessel walls
37:44into the brain,
37:45and the dopamine network
37:47of nerve cells
37:47could not be affected.
37:48In Tom Costin's laboratory,
37:57specially bred mice
37:58are used to test
37:58the effectiveness
37:59of the vaccine.
38:00There will be two groups
38:05of mice that we will be
38:06injecting with cocaine.
38:09One of them
38:09has been vaccinated
38:10over the last couple
38:11of weeks
38:12and has developed
38:13antibodies.
38:16The other animal
38:17was given
38:18a placebo vaccination
38:19so that that animal
38:20did not develop antibodies
38:21to cocaine.
38:23We'll then inject
38:24the animals
38:24with cocaine,
38:25and what happens
38:26is that the animal
38:28that had the vaccination,
38:30with those antibodies,
38:31the cocaine effect
38:32is going to be blocked.
38:34The first mouse,
38:35which was vaccinated
38:36two weeks ago,
38:37is injected
38:38with the liquid cocaine.
38:45After being returned
38:46to its box,
38:47the mouse's behavior
38:48is perfectly normal.
38:53The second,
38:54control mouse,
38:55which hasn't been vaccinated,
38:57also receives
38:57the same dose
38:58of pure liquid cocaine.
39:01But this one
39:02quickly reacts
39:03to the drug
39:04and runs in circles
39:05around the cage.
39:07Meanwhile,
39:11the vaccinated mouse
39:12is hardly moving at all.
39:16The experiment shows
39:18that in mice,
39:18at least,
39:19the antibodies
39:20stimulated by the vaccine
39:21do stop the cocaine
39:23from entering the brain.
39:25But the ultimate goal
39:26for any vaccine
39:28is for it to work
39:29in human subjects.
39:32We did the first studies
39:33of vaccinating
39:34people who were
39:35cocaine abusers
39:36and assessing
39:37whether they,
39:38in fact,
39:38made antibodies
39:39to the vaccine.
39:40We vaccinated
39:42114 people.
39:44Half got a placebo,
39:45half got active vaccination.
39:47And what we showed
39:48in that six-month study
39:49was that the people
39:50who had high antibody levels
39:52who had had
39:52the vaccination,
39:54that those people
39:55had a substantial reduction
39:56in their cocaine use,
39:58while those who got
39:59the placebo
39:59showed no reduction
40:00in their cocaine use.
40:02The vaccine trials
40:04will go on
40:04because helping
40:05chronic users
40:06to overcome
40:07their craving
40:07is vital.
40:08Don't let me move you
40:09at all.
40:10Especially as MRI scans
40:11are now showing
40:12the devastating effects
40:13addiction can have
40:14on the brain.
40:16Most damaging
40:17are the effects
40:18of crack cocaine.
40:20Since the late 80s
40:21and 90s,
40:22crack has been linked
40:22to violence and crime.
40:24It's a more intense
40:25form of the drug,
40:27making users
40:28desperate to get hold of it.
40:29Nothing matters
40:31when you're chasing
40:31and getting hot.
40:32Once you hit that first one,
40:34I need more.
40:35So when all my money gone
40:36and all my ways
40:37and means to get more
40:38is gone,
40:39so I'm coming
40:40to get yours.
40:42And by any means necessary,
40:44I'm coming to take it.
40:46That was my mentality
40:47when I was smoking cocaine.
40:50Crack is made
40:51from powder cocaine
40:52processed with baking soda
40:53to produce a rock
40:54which can be smoked.
40:59See this cute little vial here?
41:04It's crack,
41:04rock cocaine,
41:05the most addictive form.
41:07You think it's
41:08the glamour drug
41:08of the 80s?
41:09Well, that's the point
41:10of this front
41:11little reminder.
41:12It can kill you.
41:14And if you've got
41:14to die for something,
41:16this sure as hell ain't it.
41:20Crack is cheaper to buy
41:21than the powder form
41:22of cocaine
41:22and gives a much
41:23more intense high.
41:25This is because
41:28the area of the lungs
41:29is much bigger
41:30than that of the membranes
41:31of the nose,
41:31so the drug is absorbed
41:33much more quickly,
41:34making the hit faster
41:35and more intense.
41:37Smoked cocaine
41:38is in many ways
41:39much more dangerous
41:40and much more powerful
41:41than powder cocaine
41:42because any drug
41:44that is smoked
41:44is taken in larger volume.
41:47It goes straight
41:47from the lung
41:49into the brain
41:50because oxygen
41:51is taken from the lung
41:52and delivered straight
41:53to the brain.
41:55Ken is one
41:57of many thousands
41:57of former crack
41:58cocaine addicts
41:59now trying to escape
42:00from the grip
42:01of its cheap
42:02but powerful high.
42:04The craving is
42:05you're consumed
42:07mentally,
42:09emotionally,
42:10physically,
42:11environmentally.
42:13His addiction
42:14took over his life.
42:15He lost his wife
42:16and pawned everything
42:17he owned
42:18to feed his insatiable
42:19appetite for crack.
42:22Eventually,
42:23Ken was jailed
42:23for writing bad checks
42:24to fund his habit.
42:26He's now part
42:27of a drug addiction
42:28program in Houston, Texas.
42:29Touch your nose
42:30and put it back.
42:31Perfect.
42:32Open up your eyes.
42:33When I came here,
42:34I was living in a shelter.
42:36I was living on the streets.
42:37I had to walk here
42:38probably maybe
42:39seven, eight miles.
42:41Ken's a valuable part
42:42of the research program
42:43because like many addicts,
42:45his brain cells
42:46suffer from a lack
42:47of the feel-good chemical
42:48dopamine.
42:50It has been depleted
42:51after years
42:52of chronic abuse.
42:54As part of the program,
42:56Ken is enrolled
42:56in a clinical trial
42:57of a drug called L-Dopa.
43:01L-Dopa supplements
43:02dopamine
43:03and it's our belief
43:04that we can help
43:05by giving L-Dopa
43:06and trying to bring
43:07the balance
43:08of dopamine
43:09back up
43:10to normal levels
43:11to help the individuals
43:12both feel
43:13and behave
43:14in ways closer
43:15to the way
43:16their brain
43:17was functioning
43:17prior to becoming
43:19addicted to cocaine.
43:20Thank you.
43:21The medics say
43:22that Ken has shown
43:22constant improvement
43:23over the course
43:24of the trial
43:25and he's still clean
43:26of crack cocaine.
43:27The trials continue
43:29with other clients
43:30like Ken
43:30achieving similar success.
43:33Piecing together
43:34how cocaine works
43:35in the brain
43:35helps scientists
43:37as they work
43:37to find a cure
43:38for addiction
43:38but there are
43:39some big questions
43:40they still can't answer.
43:42Why can some
43:43individuals take
43:44cocaine at a party
43:45and not become
43:46addicted
43:47while others
43:47instantly become
43:48addicted?
43:50What is it
43:51about the personality
43:52what is it
43:52about the genetics
43:53of those individuals
43:54that makes them
43:55relatively
43:56relatively protected
43:58while others
44:00become instantly
44:01addicted?
44:03For addicts
44:04the drug will
44:05always have
44:06an iron grip
44:06it can override
44:09all other temptations
44:11I will sit there
44:12butt naked
44:13in a room full
44:13of a hundred women
44:14if there's cocaine
44:16there
44:16you better believe
44:18I'm smoking it
44:18I'm getting high
44:20that's what I'm doing
44:21the addictive portion
44:23of it is
44:23my job
44:24is getting in the way
44:25of my high time
44:26my rent
44:27is getting in the way
44:27of my high time
44:28my car
44:29is getting in the way
44:30of my high time
44:31all of those things
44:32go in the cooker
44:32and all of them
44:33will get smoked
44:34because cocaine
44:36as long as there's
44:38supply
44:38there's always going
44:39to be a demand
44:40for cocaine
44:41but the fight
44:42against one of the
44:43most addictive
44:43and dangerous
44:44recreational drugs
44:45is not yet
44:46a lost cause
44:47in the US
44:51the authorities
44:52are bringing down
44:53the amount of cocaine
44:54on the market
44:54and science
44:56is getting us closer
44:57to understanding
44:58and even controlling
44:59what the drug does
45:00to the human brain
45:01many of those
45:05who do coke today
45:06are young
45:06they're casual users
45:08and just love the energy
45:09and buzz they get
45:10but for some
45:13the drug almost destroyed them
45:14and it's their biggest regret
45:16imagine being told
45:17that part of your body
45:18is not working
45:19and it's your fault
45:20because you took cocaine
45:21others will keep snorting
45:25and stop only
45:26when they feel ready
45:27I'll probably stop
45:30doing coke
45:31when I'm like
45:3440 or something
45:35probably 50
45:37yeah when I'm
45:40when I'm not mobile anymore
45:41and I can't do much
45:42and I'll stop doing coke