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Comment by quickthrower2 | Hacker News Reader

One could argue cocaine is less dangerous than alcohol.

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.

> 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.

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.

Most cocaine overdoses these days are caused by fentanyl contamination

IRL cocaine is about as safe as caffeine and can be consumed in beverages (tea, Coca-cola, etc.) by healthy people without any real negative issues.

Right now in 2023 we as adults should have two options for beverage stimulants, caffeine and cocaine. Basically the beverage market has been artificially cut in half for no good reason.

https://www.tni.org/en/primer/coca-leaf-myths-and-reality

Outside the US it is possible to get coca leaf for use in tea. It is an interesting different type of morning boost. Certainly not something to make a big deal of

Yeah, if you powdered pure caffeine and did a line you'd be in a bad way too I'd guess? The ld50 for caffeine is only roughly double that of cocaine. Pure nicotine has half the ld50 of cocaine. It just no one boils down tobacco juice into oil and drips it into their eyes for a bigger hit. At least not more than once. Essentially all plant based recreational substances found in their dilute natural forms absent any breeding programs to concentrate intoxicants, are probably relatively safe. It is the processing that is an issue. The alcohol buzz from eating overripe fruit is probably even innocuous.

Edit: there had to be exceptions, and I think jimsonweed is probably one now that I go looking. The recreational dose even in raw form is way too close to the lethal one.

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