Cocaine abuse is now the fastest-growing drug problem among the middle classes. A Police Foundation report last month tells us that there are 120,000 regular users and 360,000 occasional users of cocaine, with 180,000 taking crack cocaine.

Last week it was reported that cocaine users have hearts twice the age of non-users - and the damage does not stop there. Here, in a chilling dossier that every parent, teacher and teenager should read, John Henry, Professor of Accident and Emergency Medicine at St Mary’s Hospital, London, describes how the drug destroys the body.

Mental problems
Although cocaine is used because it causes euphoria, regular high dose users develop short-term bouts of uncontrolled behaviour, impaired judgment, impulsive behaviour and hypersexuality. Some users develop persecutory delusions and hallucinations, often of being followed by the authorities.

The user lacks insight and may become violent. Muscle twitching and convulsions (fits) are also a risk with heavy use, especially in adolescents who smoke crack, a pure and highly addictive form of the drug. Coma, breakdown of muscles and kidney failure can also occur.

Nose
Cocaine powder is ‘snorted’ into the nostrils, and although it is rapidly absorbed into the bloodstream, the drug also causes the blood vessels in the lining of the nose passages to shrink. Shortly after use, the blood vessels widen again, and the red, runny stuffed-up nose of the recent user can be a telltale sign.

Repeated cocaine use leads to loss of blood supply to the septum (the thin bony dividing wall between the nostrils) which becomes damaged, leaving a hole between the two nose passages. The bridge of the nose may even collapse.

Liver
Alcohol is often used with cocaine, and the feeling of the ‘high’ is more marked after using both than after drink on its own.

The effect of cocaine is also longer lasting. The reason for this is that a new chemical is formed in the liver which has similar effects to cocaine but which is longer lasting in the body.

However, this practice has its dangers. Liver damage is more common, and the risk of sudden death is 18 times greater, when alcohol and cocaine are used together than when cocaise is used on its own.

Chest pain
One of the most common reasons for requiring emergency treatment is the enormous tightening of blood vessels, in the coronary arteries and the rest of the body. This deprives the heart of its normal blood supply, putting the user at risk of a heart attack or a heart rhythm disturbance which might cause you to drop dead suddenly.

The shape of the pattern on the electrocardiogram (heart trace) can look worrying to the doctor, especially as it can change from minute to minute. But in most cases it settles down and no major harm results.

Blood pressure
Cocaine releases massive amounts of noradrenaline from the nerve endings, which causes blood vessels right through the body to narrow. This leads to a major surge in blood pressure. To the onlooker, the user looks pale and staring, but there may be no other outward signs of the enormous rise in blood pressure.

The rise in blood pressure is not permanent, but may cause a heart attack or stroke, and repeated use causes long-term damage to the blood vessels.

Blood vessels
One area damaged by long-term cocaine use is the aorta, which is the body’s main blood vessel. A surge in blood pressure following cocaine use forces the blood between the inner and outer casings of the aorta and each time the heart pumps this false passage becomes longer and more liable to block off a branch vessel or to burst, with possibly fatal results.