<Li> <P> Delphic analysis regarding 20 popular recreational drugs based on expert opinion . Cocaine was ranked the 2nd in dependence and physical harm and 3rd in social harm . </P> </Li> <P> Delphic analysis regarding 20 popular recreational drugs based on expert opinion . Cocaine was ranked the 2nd in dependence and physical harm and 3rd in social harm . </P> <P> Chronic cocaine intake causes strong imbalances of transmitter levels in order to compensate extremes . Thus, receptors disappear from the cell surface or reappear on it, resulting more or less in an "off" or "working mode" respectively, or they change their susceptibility for binding partners (ligands)--mechanisms called downregulation and upregulation . However, studies suggest cocaine abusers do not show normal age - related loss of striatal dopamine transporter (DAT) sites, suggesting cocaine has neuroprotective properties for dopamine neurons . Possible side effects include insatiable hunger, aches, insomnia / oversleeping, lethargy, and persistent runny nose . Depression with suicidal ideation may develop in very heavy users . Finally, a loss of vesicular monoamine transporters, neurofilament proteins, and other morphological changes appear to indicate a long term damage of dopamine neurons . All these effects contribute a rise in tolerance thus requiring a larger dosage to achieve the same effect . The lack of normal amounts of serotonin and dopamine in the brain is the cause of the dysphoria and depression felt after the initial high . Physical withdrawal is not dangerous . Physiological changes caused by cocaine withdrawal include vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite and psychomotor retardation or agitation . </P> <P> Physical side effects from chronic smoking of cocaine include coughing up blood, bronchospasm, itching, fever, diffuse alveolar infiltrates without effusions, pulmonary and systemic eosinophilia, chest pain, lung trauma, sore throat, asthma, hoarse voice, dyspnea (shortness of breath), and an aching, flu - like syndrome . Cocaine constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure . It can also cause headaches and gastrointestinal complications such as abdominal pain and nausea . A common but untrue belief is that the smoking of cocaine chemically breaks down tooth enamel and causes tooth decay . However, cocaine does often cause involuntary tooth grinding, known as bruxism, which can deteriorate tooth enamel and lead to gingivitis . Additionally, stimulants like cocaine, methamphetamine, and even caffeine cause dehydration and dry mouth . Since saliva is an important mechanism in maintaining one's oral pH level, chronic stimulant abusers who do not hydrate sufficiently may experience demineralization of their teeth due to the pH of the tooth surface dropping too low (below 5.5). Cocaine use also promotes the formation of blood clots . This increase in blood clot formation is attributed to cocaine - associated increases in the activity of plasminogen activator inhibitor, and an increase in the number, activation, and aggregation of platelets . </P>

What comes after an 8 ball of coke