THIS week, Dr Zak talks about the dangers of underestimating the dangers of cocaine use.

IT starts as a minor habit. Something you to do unwind after a stressful day. You justify it to yourself that you’re not doing any harm and that it is your way of letting off steam.

It may even feel it glamorous. Fuelled by the unrealistic portrayal of film stars in blockbuster movies, where maladaptive ways of coping are not only normalised but even made into something to aspire to, you continue the journey.

In reality, this is the start of a road that may lead to full blown addiction, perhaps much quicker than ever imagined. You lose your job and as a result struggle to pay bills. Your partner can no longer bear to watch you self-destruct and finally walks out. Children who are your dependents end up being removed from your care. Health problems set in. They aren’t the type that disappear in a week, or can be righted by a quick visit to your GP. In the end you become a shell of your former self, both physically and mentally. You may even die due to overdose, misjudging a situation, self-neglect or homelessness.

If this is uncomfortable reading, it is the sad reality of drug addiction. Alcohol and cocaine, particularly in combination, have made the headlines yet again. The Football Association has advised that much of the violence at games is fuelled by this deadly cocktail.

Cocaine is endemic in the UK, particularly the capital, where over half a million lines are consumed on a daily basis. This is more than Amsterdam, Barcelona and Berlin combined. There isn’t even a noticeable increase at the weekend. Consumption is relentless and climbing.

Statistics show that half of those who regularly use cocaine also consume alcohol in harmful quantities.

In 2018 there were over fifteen thousand cocaine related hospital admissions in the UK with six hundred and thirty-seven deaths. It is not just the “young trendies” who are consuming cocaine; use by those over fifty has trebled in the last decade.

Alcohol is a depressant. It stimulates increased production of the brain chemical gamma aminobutyric acid, often shortened to GABA. Initially this allows us to relax and feel less anxious.

Cocaine on the other hand is a stimulant. It boosts levels of the chemical dopamine in the brain. This causes feelings of alertness, joy and even euphoria.

However, the effects of cocaine are often short lived. Tolerance develops rapidly. Users crave larger amounts at shorter intervals to create the same effect and also to avoid the unpleasant come down once the drug wears off.

The most publicised effects of cocaine are on the nostrils of those who regularly snort the product. This can cause not only complete collapse of the nose but also the roof of the mouth. Perhaps less well known is that cocaine causes surges in blood pressure and heart rate. As a result, it is one of the leading causes of heart attack and sudden cardiac death in the under 30 age group.

When cocaine and alcohol are combined, they form the deadly by-product cocaethylene. This remains in your system much longer. The toxic effects of the drugs on the vital organs are prolonged with potential for greater damage.

The lethal effects of the two together have also been linked to increased risk of suicide. This has been highlighted by the tragic deaths of two reality stars in the television series “Love Island”. Alcohol and cocaine individually cloud judgement and can raise levels of agitation and distress. Together this effect appears to be magnified, with some US researches suggesting that it may make users sixteen times more likely to take their own lives.

The vast bulk of cocaine is produced by cartels in Latin America. This involves virtual enslavement of workers, who may endure savage beatings or even die at the hands of their employers. Due to how lucrative it is, organised criminals have declared war on each other in order or to gain control over a region or supply line.

Cocaine addiction is a recognised illness with support dedicated solely to its treatment. Cocaine Anonymous was founded in 1982 and follows a 12-step programme similar to that of Alcoholics Anonymous, though the two organisations are unrelated.

The first step to any recovery is admitting there is a problem. This can often be the most difficult hurdle, yet those who have survived addiction report literally being given their life back.