Cocaine, amphetamines, and other stimulants produce toxicity by activating the sympathetic nervous system. Although cocaine abuse is most prevalent and has dominated reports of stimulant toxicity, amphetamines and other substances that resemble cocaine produce unique toxic complications as well. The regional prevalence of each of these drugs of abuse may help the clinician decide which agent is present in a patient with sympathomimetic findings. The scope of toxicity is broad and includes chest pain following use of cocaine or amphetamines, blunt or penetrating trauma related to cocaine trafficking, and depression associated with chronic cocaine or amphetamine abuse.1 This chapter focuses on cocaine abuse and its multiorgan toxic effects; it highlights unique toxicities associated with amphetamines and other stimulants.
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