Routes of abuse:
(1) intranasal (snorting)
(2) intravenous injection
(3) smoking (crack = freebase)
Topical application results in local anesthesia with numbness and vasoconstriction.
Psychological effects:
(1) euphoria and sense of well-being
(2) increased capacity for physical labor
(3) decreased social inhibitions
Following the period of intoxication there comes the "crash":
(1) irritability
(2) depression
(3) confusion
(4) physical discomfort
(5) exhaustion
Complications:
(1) stroke
(2) seizures
(3) myocardial ischemia or infarction
(4) cardiac arrhythmias
(5) hyperthermia
(6) arterial insufficiency with peripheral ischemia
(7) aortic dissection
(8) ruptured aneurysms
(9) severe psychiatric disorders (depression, psychosis, paranoia, anxiety, hallucinations, other)
(10) respiratory depression
(11) sudden death
These complications may be striking in a young person.
