Cocaine Addiction, Withdrawal and Treatment
- Cocaine Addiction
- Signs & Symptoms of Abusing Cocaine
- Cocaine Withdrawal & Detox
- Treatment for Cocaine Dependency
Cocaine is nervous system stimulant made from South American coca plant leaves. Also called “uppers,” stimulants like cocaine temporarily increase alertness and energy. Street names include coke, coca, snow, flake, and blow. It is available as a fine, white powder, which can be snorted or dissolved in water and injected intravenously. Cocaine is also used to produce crack, which is smoked. Cocaine can also be mixed and injected with other drugs, like heroin, and injected. This is called a “speedball.”
As a Schedule II drug, cocaine is considered to have a high potential for abuse but also some legitimate medical uses, such as local anesthesia for some eye, ear, and throat surgeries. According to a survey by the Substance Abuse and Mental Health Services Administration (SAMHSA), 1.5 million people in the United States used cocaine in 2014. Young adults ages 18-25 are twice as likely to use cocaine than any other age group, and men are twice as likely to use cocaine as women.
The physical effects of cocaine on the body are unique in that cocaine acts as both a local anesthetic and a central nervous system stimulant. The drug increases levels of dopamine, a naturally-occurring chemical in the brain that controls pleasure and movement. Normally, dopamine is released from a cell and then recycled back into the cell once the trigger (like good-smelling food) is over. Cocaine prevents the recycling process and allows the chemical to build up between brain cells. This is what causes a cocaine “high.” Initially, users feel euphoric, energetic, confident, alert, and sexually aroused.
Over time, continued cocaine use changes the brain’s structure and function. In addition to affecting how the brain releases and processes dopamine, it can also affect the brain pathways that are responsible for stress response. Not surprisingly, cocaine addiction and stress-related disorders frequently occur together.
Like most illicit drugs, the use of cocaine brings with it potentially serious consequences. In addition to becoming physically dependent on the drug, users’ judgment is compromised. This places them at risk for diseases like hepatitis, HIV/AIDS, and sexually-transmitted infections due to the common practices of needle sharing and sexual promiscuity. Drug abuse may also have negative effects on a person’s life at home, at school, and in the workplace.
Signs & Symptoms of Abusing Cocaine
Cocaine’s effects are almost immediate, but intensity and duration depend on how the drug is used. When the drug is injected or smoked, users will experience quicker, stronger effects that last 5-10 minutes. When snorted, the effects can last 15-30 minutes.
Cocaine speeds up the entire body, causing symptoms that may help identify someone who is abusing the drug. Commonly, those who are high on cocaine will talk, move, and think faster than usual. A user may shake and twitch, and he or she will likely sleep and eat less than normal. Initially, a user may feel happy and excited but, as the drug wears off, may appear angry, nervous, and/or paranoid.
If the cocaine is being injected, the user may have wounds where the needle was inserted into the body. If the cocaine is being snorted, the person may have a runny or bloody nose. Cocaine users commonly binge on the drug, taking it repeatedly in a short time period and increasing dosage to maintain their “high.” For this reason, users may excuse themselves frequently to take another dose.
With long-term use, the risk of permanent physical and mental damage increases. Cocaine users are at higher risk for cardiovascular disease, stroke, gastrointestinal tears and ulcers, malnourishment, and bleeding on the brain. Years of cocaine use may lead to Parkinson’s disease or cognitive impairments that make it difficult to control impulses, stay attentive, make decisions, recall memories, and perform motor tasks.
When a person takes too much cocaine, they can overdose. The stimulant effects of increased heart rate, blood pressure, and breathing rate can result in extreme body temperature, organ failure, stroke, seizures, or sudden death. During an overdose incident, the user may exhibit the following symptoms: headache, hallucinations or delusions, paranoia, and/or excessive thirst.
Treatment for a cocaine overdose focuses on alleviating the symptoms of the stimulant itself. A health professional may administer benzodiazepines (sedatives) in order to lower the heart rate and blood pressure. The body will also need to be cooled using ice, cold blankets, and/or acetaminophen. With prompt treatment, recovery from overdose is possible with minimal lasting effects.
Cocaine Withdrawal & Detox
A cocaine high is short-lived. As the effects of the drug wear off, the user will “crash.” Withdrawal can occur even while the user still has traces of the drug in his or her system and include physical and emotional symptoms:
- sadness or depression,
- restlessness or insomnia,
- agitation or irritability,
- increased hunger,
- vivid dreams, and/or
In cases of prolonged use or addiction, withdrawal symptoms can last for months and may be accompanied by suicidal thoughts. For this reason, many long-term users choose to detox in a residential or outpatient facility under the supervision of medical professionals.
Treatment for Cocaine Dependency
Cocaine addiction is difficult to treat, as more than half of people who seek treatment for cocaine use other drugs as well. Many times, there are accompanying mental health conditions that must also be addressed.
Currently, there are no medications approved for the treatment of cocaine dependence. However, recovering addicts utilize sedatives, hypnotics, and anti-anxiety medications to treat symptoms. To prevent dependency, these medications should be used for a short period of time and under the supervision of a medical professional.
Researchers are currently developing and testing a cocaine vaccine designed to help reduce the risk of relapse among recovering addicts. The vaccine creates antibodies that bind to cocaine, preventing the drug from getting to the brain. Initial clinical trials showed results, but in a fewer number of patients than desired and for only a short amount of time. More research is required.
Like with most drug dependencies, the combination of medical and behavioral intervention is the most effective approach to recovery. Multiple styles of therapy are available and can take place in residential or outpatient settings. The type of therapy should be selected on a case-by-case basis to best meet the patient’s needs.
Cognitive-behavioral therapy (CBT) teaches recovering addicts to identify and correct behaviors that may lead to relapse. With the help of CBT, patients are able to anticipate triggers, develop coping mechanisms, and exert the self-control to implement them. Skills learned in CBT can also be used to help manage other mental health conditions that often co-occur with substance abuse. There is even an interactive computer program called CBT4CBT that allows patients to participate in multimedia modules that reinforce the tenets of CBT. Studies have shown adding this program to traditional weekly therapy can increase treatment success rates.
Contingency management (CM) is a type of intervention that provides motivational incentives for continued sobriety. Voucher-based reinforcement (VBR) provides a voucher for each negative drug screen. Vouchers can be exchanged for goods and services and usually increase in value over time. Another type of CM awards cash for negative drug screens, program attendance, and completion of assigned activities. In both cases, a positive drug screen resets the incentives.
Therapeutic communities (TCs) are drug-free residences where people in recovery live together and help one another change behaviors. TCs typically require a 6- or 12-month commitment, and commonly address co-existing issues like mental health and vocational services.
Support groups that use a 12-step recovery program, like Cocaine Anonymous, can also help a recovering addict stay clean. In addition to providing fellowship and support from other individuals who are on the same recovery journey, these programs provide members with sponsors who can provide one-on-one support when needed. These programs are free and easy to access at any point of the recovery journey.
Even after long periods of abstinence, recovering cocaine addicts are at high risk for relapse, especially in times of extreme stress. It is important for a person in recovery and his or her friends and family to acknowledge that, while cocaine dependency can be controlled, it may be a lifelong struggle.
Stimulants – Foundation for a Drug-Free World
Cocaine Facts – National Institute on Drug Abuse (NIDA)
Stimulants – Substance Abuse and Mental Health Services Administration (SAMHSA)
Cocaine Research Report – National Institute on Drug Abuse (NIDA)
Cocaine Drug Facts – National Institute on Drug Abuse (NIDA)
Cocaine Overdose – Cocaine.org
Cocaine Withdrawal – MedlinePlus.gov