Cocaine Dependence is defined as a psychological desire to use cocaine regularly.
“You believe that coke will increase your perceptions, that it will allow you to surpass yourself, that you will be able to control things. It’s bloody nonsense. After a while you don’t pay your bills anymore, you don’t wash yourself anymore, you give up your friends, your family. You will become defenseless and alone.” —Nigel
Cocaine is a powerful stimulant drug made from the leaves of the coca plant native to South America. Also known as coke, its highly addictive. It is usually sold as a fine white powder. Cocaine is attractive as a recreational substance due to the perceived positive effects on mood, motivation, and energy.
Cocaine is also an FDA-approved Schedule C-II drug. This means cocaine can be prescribed by a healthcare provider, but the process is strictly regulated. The worry about cocaine is that it is unsafe and highly addictive.
Cocaine was originally developed as a painkiller. It acts as a local anesthetic: The powder is usually mixed with substances such as corn starch, talcum powder and/or sugar or other drugs such as procaine (a local anesthetic) or amphetamines.The principal routes of cocaine administration are oral, intranasal, intravenous, and inhalation. Snorting cocaine occurs when the cocaine powder is inhaled through the nose. There, cocaine is absorbed through the nasal tissue to the bloodstream.
Injecting cocaine, or IV cocaine use, releases the drug directly into the bloodstream and heightens the intensity of its effects. Smoking involves inhaling the cocaine vapor or smoke into the lungs. The absorption after smoking cocaine is as fast as by injection.
Cocaine creates the greatest psychological dependence of any drug. It stimulates key pleasure centers within the brain and causes extremely heightened euphoria.
A tolerance to cocaine develops quickly—the addict soon fails to achieve the same high experienced earlier from the same amount of cocaine.
“I had no more future. I did not see how I could escape my cocaine dependence. I was lost. I was ‘exploding’ and unable to stop myself from continuing to seriously abuse cocaine. I had hallucinations that animals were crawling under my skin. I felt them each time I shot up and scraped myself with the point of my syringe until I started bleeding in order to make them leave. I was once bleeding so heavily from this I had to be taken to the hospital.” —Susan
When teens were surveyed to find out why they started using drugs in the first place, 55% replied that it was due to pressure from their friends. They wanted to be cool and popular. Dealers know this.
Drug dealers, motivated by the profits they make, will say anything to get you to buy their drugs.
Here are some of the reasons young people have given for taking coke:
•To fit in
•To escape or relax
•To relieve boredom
•To seem grown up
They think taking coke is a solution but eventually, the coke becomes the problem.
“My friends and I would go to the mall after school; we said we were getting chicken fingers, but I’d meet the drug dealer and spend $50 on a gram, then a longtime housekeeper would pick us up. We didn’t even have our licenses, but there we were, doing coke at each other’s houses. The rest of my friends’ moms went through their stuff, but my mother trusted me, so I hid everyone’s stash in my closet. But because I had access to it, I started doing coke by myself. I’d get high in the school bathroom or at home before writing a paper.”. CHRISTINA HUFFINGTON
Signs of Addiction
Cocaine addiction is often marked by:
- Taking risks you would not ordinarily take, such as driving while high or stealing to have enough money for drugs.
- Abandoning and neglecting life priorities.
- Experiencing troubled relationships due to more emphasis on abusing cocaine.
- Entanglements with the legal system.
- Continuing to use cocaine despite significant negative consequences.
Cocaine abuse is also associated with changes in brain chemistry over time. These changes are associated with the increased ‘need’ for cocaine over time, as well as behavioral abnormalities that may result from taking cocaine.
Coke makes you feel active, enthusiastic, at alert with lot of energy and confidence but it also puts pressure on your heart and there is a risk of heart failure.
Effects of Cocaine Dependency.
Short term effects:
•Edginess and a craving
•Amnesia: Disturbed sleep patterns.
•Cocaine also causes vasoconstriction, thus reducing bleeding during minor surgical procedures.
•Loss of Appetite: Cocaine can often cause reduced food intake, many chronic users lose their appetite and can experience severe malnutrition and significant weight loss.
• Physical and moral decadence.
• Stroke, seizure or respiratory failure.
• Dilated pupils
• Nausea and Hyperstimulation
• Mood Swing
• Increased agitation.
• Increased movement (i.e. hyperactivity).
• Nose bleed.
• Paranoia: Extreme, irrational distrust of others.
Long Term Effects:
• Psychiatric disorders
• Heart and muscle damage.
• Brain damage
• Disease: liver and kidney diseases, HIV, Hepatitis C.
• Loss of focus: lack of interest in other areas of life.
“With coke, you are like a moth stuck on a light. It attracts you more and more and you can’t stop it. It’s not physical. It’s in your head. The more you have it, the more you take it. I have injected it in myself every ten minutes. I borrowed money from the bank to buy it. One day I became unemployed. It was worse. I used to shoot up all the time. This thing made me insane. I knew it, but I continued. I became a total failure.” —Marilyn
If you’ve been taking cocaine for a longer period of time, chances are that your body has gotten used to its presence and will protest when you stop. Why? Cocaine works on the brain as a stimulant and causes the body to over-produce depressant effects in order to balance out. So once you stop using cocaine, these effects become noticeable. And when cocaine is no longer in the system, the central nervous system’s adapted functions only gradually normalize over time.
During the period when cocaine starts to exit the body – also known as withdrawal – you can expect to experience a set of symptoms commonly referred to a withdrawal symptoms or crash.
After a period of regular use, the body needs time to “figure out” how to regain homeostasis. So, when you stop taking cocaine… symptoms follow.
Symptoms include paranoia, depression, exhaustion, anxiety, itching, mood swings, irritability, fatigue, insomnia, an intense craving for more cocaine, and in some cases nausea and vomiting, formication: a feeling of a crawling sensation on the skin also known as “coke bugs”. These symptoms can last for weeks or, in some cases, months. Even after most withdrawal symptoms dissipate most users feel the need to continue using the drug; this feeling can last for years and may peak during times of stress. About 30–40% of individuals with cocaine dependence will turn to other substances such as medication and alcohol after giving up cocaine
Cocaine Abuse Treatment
The cravings that accompany cocaine withdrawal can be intense, but can be treated with proper care and support. Treatment can take place on an inpatient, residential, or outpatient basis.
•Inpatient care means that the cocaine addict is in a supervised, residential setting. Often, these settings will be staffed with medical and mental health professionals. Short-termdetoxification may be needed to allow removal of the substance from the body in a safe, monitored environment to decrease withdrawal symptoms.
Residential treatment centers usually have a more home-like atmosphere. Those recovering from cocaine addiction live at the rehab center fulltime and focus exclusively on their recovery. Residential treatment may include individual or group counseling, medical treatment, or other types of therapy.
•Outpatient treatment means that the cocaine addict lives at home and continues his or her daily routines while attending treatment on a regular basis. Again, this treatment will include a range of options including individual and group therapy sessions with a focus on mental health and drug and alcohol issues. By diagnosing and treating any underlying medical conditions, such as depression and attention-deficit disorder, there is a better rate of abstinence from cocaine and a higher likelihood of successful and long-term recovery.
There are many treatment options available for cocaine dependence and abuse.
1. Behavioral therapies: are psychosocial treatments that address the reasons, motivations and possible underlying psychological issues associated with a person’s substance abuse.
Examples of behavioural treatment include;
I. contingency management (CM). This treatment is based on incentives (e.g. prizes or cash) for abstinence, or other positive parameters, such as improved social interactions.
II. Cognitive behavioral therapy (CBT) may be used. This type of treatment addresses the reasons behind the substance abuse, and helps to alter maladaptive ways of thinking and acting that may be contributing to the cocaine abuse issue.
2. Pharmacological Therapies
Pharmacological (or drug-based) therapies refers to medications administered to treat cocaine dependence by physiological means.
This type of treatment uses medications that may mimic the substance of abuse in question, but to a reduced or different extent. The doses of these medications are reduced (or ‘tapered’) over time, thus ‘weaning’ the patient off drug dependence and allowing them to work on abstinence and recovery from addiction.
An emerging form of pharmacotherapy for cocaine dependence is methylphenidate treatment. This medication is prescribed to treat ADHD, and is similar to cocaine in terms of neurological effects. However, the stimulant effects of methylphenidate act on the brain for a longer duration, but elicit less extreme reactions, compared to cocaine. The hope is to alleviate the ‘need’ for cocaine, and thus dependence, over time.
Also Ibogaine has been under investigation as a treatment for cocaine dependency and is used in clinics in Mexico, the Netherlands and Canada, but cannot be used legally in the United States.
It is important to note that medically assisted treatment of any type is very program specific, and not offered universally.
1. Dürsteler KM, Berger E-M, Strasser J, et al. Clinical potential of methylphenidate in the treatment of cocaine addiction: a review of the current evidence.
2. Substance Abuse and Rehabilitation. 2015;6:61-74.
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4. O’Brien MS, Anthony JC; Anthony (2005). “Risk of becoming cocaine dependent: epidemiological estimates for the United States, 2000–2001”.
#Seeking treatment for substance addiction is the first step to true recovery. I hope this little piece helps someone.