It’s a classic of weekend hospital rounds: the patient is brought in early in the morning by his fellow revelers, some scared and others giggling childishly. The young man has pupils like two black holes, is sweaty, tachycardic and cannot stop moving. Behaviorally, he is provocative, defiant, looking for a fight. At one point, at the slightest frustration—a short wait to be seen by medical staff or a request for a urine toxicity test, for example—he raises his voice, hurling insults, belittling everyone present, and brutally lashing out. a vital signs monitor. . He doesn’t know the cost, nor does he care. He is approached by a nurse who tries to calm him down, but instead he escalates, sometimes pretending to be offended: “Don’t touch me!” he repeated. One I remember noticed the young medical intern who was with me and made a series of rude and sexist remarks to her. “I’m going to rip your head off,” he told me.

These nocturnal scenes are not pleasant and require a lot of patience, dedication and a calm spirit on the part of the medical staff. But the most shocking thing is to visit the patient the next morning and find a helpless lamb, wrapped in sheets, dizzy from little sleep, crying and repentant.

Cocaine it is by far the most widely used illegal psychostimulant in the world, with an estimated 23 million users and a number that is growing. Cocaine triggers extracellular concentrations of dopamine, noradrenaline and serotonin in the brain, acting particularly on the reward pathways. This is why it initially produces increases in energy, positive emotions and confidence. It is highly addictive and can have serious medical, psychosocial and psychiatric consequences. Half of all users develop psychotic symptoms during their lifetime, including paranoid reactions, terrifying visual or tactile delusions or hallucinations.

It is also associated with panic attacks, depression and emotional dysregulation. But another effect of cocaine is particularly relevant to the coexistence and health of the victims: it is strongly associated with irritability, aggression, dominant behavior and criminality. In a drunken state, primal instincts are unleashed, along with verbosity, grandiosity, and a desire for dominance, and can be ferociously applied against the people closest to them.

Domestic violence it’s frighteningly common: one in five American women has experienced it. And some studies indicate that 92% of men who assaulted their partners had used substances on the day of the attack, of which 67% had consumed the explosive mixture of cocaine and alcohol. A derivation of the theme is assaults facilitated by drugs administered to the victim, usually large amounts of alcohol.

In a Spanish study of 1,600 young womenhalf reported being victims of unwanted sexual acts, comments or advances, from verbal harassment to forced penetration, with toxic substances involved. The risk increases in foreign women, women with a low level of education, and non-heterosexual women. The snapshot of the study shows that alcohol use by the victim and use of alcohol and cocaine by the abuser are breeding grounds for sexual violence. Of course, it’s not just a chemical effect. Contexts associated with drug trafficking, poverty, social exclusion and lack of opportunity increase the likelihood of violence. Think of the shocking cocktail of cocaine and prostitution, where women are considered sex objects and violence against them is normalized.

Alcohol, cannabis and cocaine use is dramatically ingrained in our society. Someone would have to give me many convincing arguments to accept that tolerating or encouraging drugs is left-wing: it destroys the lives of the most vulnerable. In the 1980s, the “old professor” Enrique Tierno Galván – admirable, from what people say, in everything else – encouraged the masses with his comment that “he who is not tall should stand up”. The devastating epidemic of heroin and crime had already broken out in working-class neighborhoods, much to the misery of suffering mothers. The cocaine boom was to follow, with the illusory label of a winner’s drug and for generating that hyper-activation so conducive to the frenetic pace of our times. With cannabis, we still have political parties that minimize its harm, compared to the available scientific evidence, and it is consumed by 28% of Spanish teenagers; all with developing brains. Socially, drug use seems to be a sign of being cool, having fun, and feeling part of a group.

Anti-drug discourse, on the other hand, sounds puritanical, retrograde and punitive. So let the party go on, shall we? It depends on what we care about, for example mental health issues, the phenomenon of gender-based violence or child abuse, where alcohol and cocaine seem to be relevant. Preventing the use of these substances would reduce exposure to traumatic experiences, which are a risk factor for the development of serious mental disorders. If we as a society are truly committed to prevention, one of the goals must be to try to reverse this distorted social perception of drugs, to openly inform citizens about their neurobiological effects or the long-term consequences of their use, and to provide treatment and help. dependent people.

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