(Cocaine Abuse; Cocaine Dependence)
Definition
Definition
Cocaine use disorder is when the use of cocaine harms a person’s health or social functioning, or when a person becomes dependent on cocaine. The powdered form of cocaine can be snorted or dissolved in water and injected. Crack is cocaine in a rock crystal form. It can be heated so its vapors can be smoked.
Cocaine use disorder is treatable. But, it takes hard work. Talk to your doctor if you think you have this condition.
Causes
Causes
Cocaine stimulates the brain to release large amounts of the hormone dopamine. Dopamine results in the euphoria commonly reported by cocaine abusers. As a person continues to use cocaine, a tolerance is developed. This means that higher doses and more frequent use are needed to maintain the euphoria.
Release of Dopamine in the BrainThe dopamine connecting to the receptors causes a euphoric feeling. This occurs naturally, but cocaine causes an exaggerated response that can lead to addiction.
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When a cocaine user stops using abruptly, a crash or withdrawal occurs. This results in an extremely strong craving for more cocaine. It also results in fatigue, loss of pleasure in life, depression, anxiety, irritability, suicidal thoughts, and sometimes paranoia. These withdrawal symptoms often prompt the user to seek more cocaine.
Risk Factors
Risk Factors
Cocaine use disorder is more common in young men and in those aged 18-25 years old. However, cocaine use disorder can occur in anyone at any age.
Symptoms
Symptoms
Symptoms associated with cocaine use disorder include:
-
Short-term effects include:
- Euphoria
- Increase in energy
- Excessive talking
- Being mentally alert
- Decreased need for food and sleep
- Dilated pupils
- Increased temperature
- Increased heart rate
- Increased blood pressure
- Bizarre, erratic, or violent behavior
- Vertigo
- Muscle twitches
- Paranoia
- Restlessness, irritability, and anxiety
- Heart attack
- Seizures
- Sudden death
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Long-term effects include:
- Cravings that can’t be controlled or predicted
- Increased tolerance
- Increased dosing
- Use of cocaine in a binge
- Increased irritability, restlessness, and paranoia
- Paranoid psychosis
- Hearing sounds that aren’t there
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Medical complications include:
- Heart rhythm abnormalities
- Heart attack
- Chest pain
- Respiratory failure
- Stroke
- Seizure
- Headache
- Abdominal pain
- Nausea
- Chronic runny nose or septal perforation
Diagnosis
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will ask specific questions about your cocaine use, including how long you have been using the drug and how often.
Treatment
Treatment
Talk with your doctor about the best treatment plan for you. Treatment programs may be inpatient or outpatient and may:
- Require that you have already stopped using cocaine
- Involve a detoxification program
Medications
There are currently no medications to specifically treat cocaine use disorder. Treatment with medication focuses on the symptoms of euphoria and craving. Medications that have shown some promise include:
- Modafinil—wakefulness promoting agent
- N-acetylcysteine
- Topiramate—seizure medication
- Disulfiram
- Agonist replacement therapy
- Baclofen
- Antidepressants—may be helpful for people in the early stages of stopping cocaine use
Behavioral Therapy
Behavioral therapies to help people quit using cocaine are often the only available, effective treatment for cocaine use disorder. Therapies include contingency management. With this program, people receive positive rewards for staying in treatment and remaining cocaine-free. Also, cognitive behavioral therapy helps people to learn how to abstain and remain abstinent from cocaine.
Rehabilitation Programs
In rehab programs, people with cocaine use disorder stay in a controlled environment for 6-12 months. During this time, they may receive vocational rehab and other support to prepare them to return to society.
Prevention
Prevention
The best way to prevent cocaine use disorder is to never use cocaine. It is highly addictive and illegal.
RESOURCES:
CANADIAN RESOURCES:
Native Alcohol and Drug Abuse Counseling Association of Nova Scotia http://nadaca.ca/
References:
Carson-DeWitt R, ed. Encyclopedia of Drugs, Alcohol, and Addictive Behavior. 2nd ed. New York, NY: MacMillan Reference Books; 2000.
Cocaine abuse. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated February 15, 2013. Accessed February 20, 2013.
Degenhardt L, Hall W. Extent of illicit drug use and dependence, and their contribution to the global burden of disease. Lancet. 2012;379:55-70
DrugFacts: Cocaine. National Institute on Drug Abuse website. Available at:
http://www.drugabuse.gov/publications/drugfacts/cocaine
Accessed. Updated March 2010. Accessed February 20, 2013.
Karila L, Reynaud M. Therapeutic approaches to cocaine addiction. [article in French] Rev Prat. 2009;59(6):830-834.
Research report series: Cocaine. National Institute on Drug Abuse website. Available at:
http://www.drugabuse.gov/publications/research-reports/cocaine/letter-director
Updated September 2010. Accessed February 20, 2013.
Last Updated: 2/10/2014