I'm a 27-year-old guy working in finance in New York City. I've recently put an emphasis on working out and eating right. Unfortunately, my job is pretty high stress though, so when I unwind on the weekends I do a little bit of cocaine from time to time — basically just to keep up with my friends when we hit the bars and clubs. I haven't felt anything from doing it and I'm definitely not addicted. Is it okay to do a small amount of coke every once in a while? —Lucas B., New York, N.Y.
It always amazes me when people tell me they use cocaine to "unwind." It's a powerful stimulant and as such does the opposite of relaxing you. Think about that when you're sweating and grinding your teeth at 3 in the morning. Coke is also a strong constrictor of blood vessels — like the ones in your heart. I'm no namby-pamby "just say no" type, but this is a drug that can be dangerous or even fatal, even in small doses. The tragic case of Len Bias still haunts me. He reportedly took only one dose of cocaine before he died of a fatal arrhythmia the night after he signed a $3 million dollar endorsement deal with Reebok.
The lack of laboratory standards in street drug production is another thing that bothers me. I know people who rail endlessly about how they don't trust the pharmaceutical industry, but think nothing of ingesting a drug that was produced in a basement lab somewhere. What you're taking could literally be anything, and that skeeves me out as much as the danger of the drug itself.
I understand the allure of cocaine. When I was in medical school, we unknowingly inserted cocaine-soaked swabs into each others' noses when we were practicing nasal endoscopy. We all wondered why going on hospital rounds that afternoon was just so much damned fun. When it hit us what had happened, there were a few in the class who conspired to break into the ENT lab and steal some of the magical solution. Think about it — if they'd been caught it would have ended their careers. One dose of cocaine did this to them. Fortunately, they came to their senses before doing anything stupid, but it was illustrative of the seductive abilities of cocaine.
The National Center for Health Statistics estimates approximately 1081 deaths from cocaine per year. It's old data (1981-1996), but still disturbing, so therefore I can't condone it. Sorry, bro. (Did you really think a doctor would just say, "Sure, it's okay. Have fun!"?).
If you find you can't stop despite declaring that you're "definitely not addicted," please seek help from a medical professional immediately. Even if you can stop, there may be people reading this who can't and this is for them. If you tell your health care provider you have a drug problem, you will not be judged. This is one of those things that you can, and should, be totally honest with your doctor about. There is help out there. Ok, maybe I do sound like a "just say no" type, but I'm still no namby-pamby.
Dr. Steve is The Opie & Anthony Show's resident medical expert and the host of his own Sirius XM Radio program, Weird Medicine.