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Maybe. But if we're comparing like to like cocaine is by far the most dangerous central stimulant in common use. It's much easier to overdose on cocaine due to

Maybe. But if we're comparing like to like cocaine is by far the most dangerous central stimulant in common use. It's much easier to overdose on cocaine due to its effects on sodium channels leading to cardiac arrest, whereas amphetamine and methamphetamine are pretty hard to have a lethal overdose on. I guess MDMA is pretty dangerous in overdose too. Alcohol definitely takes the victory in terms of long term damage though. It's hard to think of an organ system that isn't damaged by chronic alcohol abuse.

hammock 4y ago
Most cocaine overdoses these days are caused by fentanyl contamination
chimeracoder 4y ago
> Maybe. But if we're comparing like to like cocaine is by far the most dangerous central stimulant in common use. That's... debatable at best. Contamination with fentanyl notwithstanding, it's relatively rare to have a fatal overdose on cocaine or methamphetamine. However, methamphetamine causes a lot of acute damage which cannot be dismissed. Neither one is "safe", but methamphetamine causes more acute and long-term harm than cocaine does - in part due to the contexts in which it's used, but in part due to the pharmacokinetics of the drug itself.
- mtlmtlmtlmtl 4y ago
  I was only talking about lethal overdose, where cocaine has a significantly lower threshold than meth. For acute damage, cocaine also has a lot of that, like the potential for rhabdomyolysis and acute kidney damage. Usage patterns have an effect for sure, but that was not a part of my analysis. I think if we're including real world patterns, we also have to include adulteration with other drugs, and in that case I think cocaine is the more dangerous. While adulteration with other phenethylamines is a very common thing with amphetamines, especially in Europe, the more dangerous ones like PMMA and 4-FA seem to be fairly rare these days. More common are 2/3-FA and various cathinones.

hammock 4y ago

Most cocaine overdoses these days are caused by fentanyl contamination

chimeracoder 4y ago

> Maybe. But if we're comparing like to like cocaine is by far the most dangerous central stimulant in common use. That's... debatable at best. Contamination with fentanyl notwithstanding, it's relatively rare to have a fatal overdose on cocaine or methamphetamine. However, methamphetamine causes a lot of acute damage which cannot be dismissed. Neither one is "safe", but methamphetamine causes more acute and long-term harm than cocaine does - in part due to the contexts in which it's used, but in part due to the pharmacokinetics of the drug itself.

mtlmtlmtlmtl 4y ago
I was only talking about lethal overdose, where cocaine has a significantly lower threshold than meth. For acute damage, cocaine also has a lot of that, like the potential for rhabdomyolysis and acute kidney damage. Usage patterns have an effect for sure, but that was not a part of my analysis. I think if we're including real world patterns, we also have to include adulteration with other drugs, and in that case I think cocaine is the more dangerous. While adulteration with other phenethylamines is a very common thing with amphetamines, especially in Europe, the more dangerous ones like PMMA and 4-FA seem to be fairly rare these days. More common are 2/3-FA and various cathinones.