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Cocaine was isolated in 1860 and first used as a local anesthetic in 1884. Its first clinical use was by Sigmund Freud to wean a patient from morphine addiction. The fictional character Sherlock Holmes was supposed to be addicted to cocaine by injection.
Patients who cannot swallow may receive nutrition via a parenteral route—usually, a catheter is inserted through the chest into a large vein going into the heart.
Lower drug doses for elderly patients should be used first, with titrations of the dose as tolerated to prevent unwanted drug-related pharmacodynamic effects.
The highest suicide rate in the United States is among people ages 65 years and older. Almost 15% of people in this age group commit suicide every year.
Long-term mental and physical effects from substance abuse include: paranoia, psychosis, immune deficiencies, and organ damage.