Cocaine Dependency

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Cocaine is a powerfully addictive stimulant drug. The powdered hydrochloride salt form of cocaine can be snorted or dissolved in water and then injected. Crack is the street name given to the form of cocaine that has been processed to make a rock crystal, which, when heated, produces vapors that are smoked. The term “crack” refers to the crackling sound produced by the rock as it is heated.

Three routes of administration are commonly used for cocaine: snorting, injecting, and smoking. Snorting is the process of inhaling cocaine powder through the nose, where it is absorbed into the bloodstream through the nasal tissues. Injecting is the use of a needle to insert the drug directly into the bloodstream. Smoking involves inhaling cocaine vapor or smoke into the lungs, where absorption into the bloodstream is as rapid as it is by injection. All three methods of cocaine abuse can lead to dependency and other severe health problems, including increasing the risk of contracting HIV/AIDS and other infectious diseases.

The intensity and duration of cocaine’s effects—which include increased energy, reduced fatigue, and mental alertness—depend on the route of drug administration. The faster cocaine is absorbed into the bloodstream and delivered to the brain, the more intense the high. Injecting or smoking cocaine produces a quicker, stronger high than snorting. On the other hand, faster absorption usually means shorter duration of action: the high from snorting cocaine may last 15 to 30 minutes, but the high from smoking may last only 5 to 10 minutes. In order to sustain the high, a cocaine abuser has to administer the drug again. For this reason, cocaine is sometimes abused in binges—taken repeatedly within a relatively short period of time, at increasingly higher doses.

How Cocaine Affects the Brain

Cocaine is a strong central nervous system stimulant that increases levels of dopamine, a brain chemical (or neurotransmitter) associated with pleasure and movement, in the brain’s reward circuit. Certain brain cells, or neurons, use dopamine to communicate. Normally, dopamine is released by a neuron in response to a pleasurable signal (e.g., the smell of good food), and then recycled back into the cell that released it, thus shutting off the signal between neurons. Cocaine acts by preventing the dopamine from being recycled, causing excessive amounts of the neurotransmitter to build up, amplifying the message to and response of the receiving neuron, and ultimately disrupting normal communication. It is this excess of dopamine that is responsible for cocaine’s euphoric effects. With repeated use, cocaine can cause long-term changes in the brain’s reward system and in other brain systems as well, which may eventually lead to dependency. With repeated use, tolerance to the cocaine high also often develops. Many cocaine abusers report that they seek but fail to achieve as much pleasure as they did from their first exposure. Some users will increase their dose in an attempt to intensify and prolong the euphoria, but this can also increase the risk of adverse psychological or physiological effects.

In 2009, 4.8 million Americans age 12 and older had abused cocaine in any form and 1.0 million had abused crack at least once in the year prior to being surveyed. Source: National Survey on Drug Use and Health (Substance Abuse and Mental Health Administration Web Site). The NIDA-funded 2010 Monitoring the Future Study showed that 1.6% of 8th graders, 2.2% of 10th graders, and 2.9% of 12th graders had abused cocaine in any form and 1.0% of 8th graders, 1.0% of 10th graders, and 1.4% of 12th graders had abused crack at least once in the year prior to being surveyed.(1)

Long-term Effects

Abusing cocaine has a variety of adverse effects on the body. For example, cocaine constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure. It can also cause headaches and gastrointestinal complications such as abdominal pain and nausea. Because cocaine tends to decrease appetite, chronic users can become malnourished as well.(2)

  • Anxiety
  • Paranoia
  • Stroke
  • Damage to the Body

Different methods of taking cocaine can produce different adverse effects. Regular intranasal use (snorting) of cocaine, for example, can lead to loss of the sense of smell; nosebleeds; problems with swallowing; hoarseness; and a chronically runny nose. Ingesting cocaine can cause severe bowel gangrene as a result of reduced blood flow. Injecting cocaine can bring about severe allergic reactions and increased risk for contracting HIV/AIDS and other blood-borne diseases. Binge-patterned cocaine use may lead to irritability, restlessness, and anxiety. Cocaine abusers can also experience severe paranoia — a temporary state of full-blown paranoid psychosis — in which they lose touch with reality and experience auditory hallucinations.(2)

Regardless of the route or frequency of use, cocaine abusers can experience acute cardiovascular or cerebrovascular emergencies, such as a heart attack or stroke, which may cause sudden death. Cocaine-related deaths are often a result of cardiac arrest or seizure followed by respiratory arrest.(2)

Withdrawal Symptoms

When cocaine abuse is stopped, an addicted individual can experience withdrawal over a period of time. Unlike
other drugs and alcohol, cocaine withdrawal most times does not manifest itself with physical symptoms (vomiting, hot/cold flashes, the shakes, hallucinations). One of the strongest of withdrawal symptoms is the intensified craving. Cocaine is a stimulant and suppresses the appetite. When the drug is no longer in the system, adverse withdrawal begins to manifest with feelings of fatigue, relentless behaviors, onsets of depression and an increase of appetite.

  • Intense Cravings
  • Restlessness/Agitation
  • Fatigue
  • Increase Appetite
  • Depression

Without proper help, cocaine abuse and dependency can be fatal. Overdose is always a risk with the abuse of cocaine. Although, cocaine is highly addictive, it is treatable. With the help of a drug treatment center or treatment service one can develop the skills needed to address their cravings to cocaine.

Cocaine Dependency Treatment

The most effective treatment programs for cocaine dependency provide more than one approach to drug treatment. This consists of intensive therapy, behavioral therapies and supportive programs for long-term relapse prevention. Treatment should also be individualized to address the personal needs of the addict. When treatment is completed, continuing programs and services should be in place to offer support and additional treatment. One non-profit worldwide organization that offers additional programming and services for cocaine abuse is Cocaine Anonymous (CA).

References:

(1) National Institute on Drug Abuse NIH. (n.d.). Cocaine. Retrieved from http://www.drugabuse.gov/drugs-abuse/cocaine

(2) National institue on Drug Abuse NIH. (2010). DrugFacts: Cocaine. Retrieved from http://www.drugabuse.gov/publications/drugfacts/cocaine