Cocaine Addiction: Symptoms and Treatment

Cocaine, a stimulant, comes from the coca plant, which is mainly grown in South America.1,2 This Schedule II drug could be used medically in America, for instance for local anesthesia, although in America medical use is uncommon.1,2,3 It is not legal to use this drug for recreation.2 There is a high abuse potential and it’s very addictive.2,3

Cocaine might be used by an individual in “rock” form (“crack”) via smoking or in powdered form via injecting (dissolving it first) or via snorting, or it might be used a different way by an individual.1,2,3,4,5 There is a weaker, slower, and longer high from snorting cocaine, compared to smoking or injecting it.2

It was estimated that, in America in 2018, over 1.9 million individuals 12 years old and older had used cocaine in the last month and that over 40.1 million individuals 12 years old and older had used cocaine in their lives.6

Why is Cocaine Difficult to Stop Using?

Dopamine is believed to contribute to getting people to do again things that bring pleasure.7 Cocaine is able to cause there to be more dopamine outside the cells by impeding the reabsorbing of dopamine.1,2 This happening in the reward circuit of an individual’s brain could greatly reinforce cocaine use.2

Alterations in the reward circuit as well as in additional brain systems are able to arise from using cocaine over and over, and this might prompt addiction.2

A drug-misusing individual’s brain may decrease how many neurotransmitters it makes within the individual’s reward circuit or decrease how many receptors that are able to receive signals there are, which could consequently lead to the individual being less able to feel pleasure from doing things that are rewarding naturally.7

An individual might be unable to feel a normal reward amount without continuing to use drugs, worsening the issue.7

Impairment of the frontal cortex region of the brain could make it harder for an individual to resist urges to use cocaine.8

If an individual does stop using cocaine or decrease use, the individual might experience withdrawal.9 Some possible symptoms that an individual experiencing withdrawal might have include being depressed, feeling anxious, being irritable, having cravings, being tired, being paranoid, and having trouble sleeping.1,2 An individual might become suicidal.9,10 An individual might overdose.9

Call 911 or a suicide hotline if you or someone else is suicidal. Call 911 if you or someone else might have overdosed.

Possible Effects of Cocaine Use

Stimulant drugs might bring about increased activity, dizziness, fever, and/or other effects.3

Cocaine might give energy, heighten focus, cause appetite loss, and/or cause trouble sleeping.1,2,3,11 Cocaine might cause an individual to be paranoid, be excited, develop psychosis, be more talkative, become aggressive, be energetic, be restless, and/or feel irritable.1,3,11 An individual might feel panicked.11 An individual might act violently.1,2,11

An individual who uses cocaine might also have issues including:1,2,3,5

  • Cardiovascular problems: heart not beating regularly, rupture of the aorta, cardiac arrest, chest pain, heart becoming less able to contract, blood vessels constricting, higher blood pressure
  • Neurological concerns: hemorrhaging in the brain, seizures, stroke
  • Other issues: nauseousness, throwing up, trouble sleeping, decreased weight, malnourishment

The way cocaine is used might cause or increase the risk of certain problems, for instance:1,2,5

  • Injecting cocaine:
    • Scars
    • Hepatitis C and HIV (increased risk for getting these)
    • Veins collapsing
  • Smoking cocaine:
    • Respiratory distress
    • Fingers and lips being burned by pipe
    • Exacerbation of asthma
    • Infections like pneumonia (increased risk of these)
    • Lungs being harmed
    • Cough
  • Ingesting cocaine orally:
    • Serious decay of bowels
  • Snorting cocaine:
    • Swallowing difficulties
    • Decreased sense of smell
    • Nasal septum being irritated
    • Being hoarse
    • Nose running often
    • Nosebleeds

An individual still might get hepatitis C and/or HIV if the individual uses cocaine in a way that does not involve needles; cocaine is able to worsen judgment, and this might result in sexual activity that is risky.2,12

The method used to take cocaine impacts how long it takes for effects to begin, with injection, snorting, and smoking being faster than oral ingestion; cocaine’s effects might begin almost right away or might take an hour.1

Effects may endure for five minutes, for an hour or two, or for another length of time.1 To stay high, an individual may use cocaine via a “binge”, using it over and over in bigger and bigger doses.2,5 A “crash” after binging might involve feeling tired, cravings, feeling depressed, and/or other issues.1,3,9

Using cocaine over and over may cause heightened displeasure if the individual does not use it, and the sensitivity of the individual’s reward circuit to natural reinforcers may decrease; these might encourage the individual to use cocaine.5,7

Depression, anxiousness, and difficulties sleeping are a few possible symptoms of withdrawal from cocaine.1,2 An individual could become suicidal and/or overdose.9,10

It was estimated that, in America, 9,401 emergency department visits in 2015 were for poisonings connected to cocaine and that over 18,800 hospitalizations in the same year in America were for this.13

Someone who overdoses on cocaine might experience things including:1,2

  • Hallucinating
  • Throwing up
  • Having seizures
  • Having a high temperature
  • Feeling anxious
  • Having a blood pressure that is high
  • Heart beating irregularly
  • Having trouble breathing
  • Heart beating quickly
  • Having a stroke
  • Becoming unconscious
  • Having a heart attack

The National Institute on Drug Abuse (NIDA) conveys that there were over 13,900 overdose deaths in 2017 in America that had cocaine involved.14

Cocaine poisoning can lead to heart attack, seizures, cardiovascular collapse, and other effects.15

Overdosing might kill an individual the first time cocaine is used.2

Call 911 if you or someone else might have overdosed.

Mixing cocaine with alcohol or a different drug could be especially hazardous and might kill an individual.2

Signs of Cocaine Addiction

A cocaine use disorder is a stimulant use disorder in which cocaine is the stimulant used.16

For a stimulant use disorder, there are multiple possible symptoms, including:16

  • Craving stimulant
  • Even though stimulant’s effects brought about or made worse interpersonal or social issues that repeatedly occur or are lasting, still using stimulant
  • Expending a large amount of time doing things that are needed for using or getting stimulant or for recuperating from stimulant’s effects
  • In circumstances where using stimulant is dangerous physically, using it repeatedly
  • Not fulfilling responsibilities at home, school, or work that are important due to repeated use of stimulant
  • Experiencing stimulant withdrawal* (and/or to alleviate or evade symptoms of withdrawal, using stimulant or using another substance that is similar)
  • Due to use of stimulant, decreasing doing or no longer doing things that are important and are related to recreation, are social, or are related to work
  • Trying to control or lessen use of stimulant but not succeeding, or persistently wanting to control or lessen use of it
  • Even though knowing stimulant probably brought about or made worse a mental or physical issue that repeatedly occurs or is lasting, still using stimulant
  • Frequently using more stimulant or using stimulant for more time than intended
  • Experiencing tolerance* (still using a consistent stimulant amount has significantly reduced impact, and/or getting the effect wanted or becoming intoxicated requires significantly more stimulant)

*If someone only is using stimulant medicines under medical oversight that is suitable, neither withdrawal nor tolerance are considered symptoms of a stimulant use disorder.16

Getting Treatment

Unfortunately, no medicines right now have the U.S. Food and Drug Administration’s approval for treating addiction to cocaine; however, research is ongoing.2,17 Eventually, it might be most efficacious to combine pharmacological and behavioral treatments.17 Medication might possibly help an individual who is in withdrawal.9,10

An individual’s addiction to cocaine might be treated with behavioral therapy, for instance motivational incentives and/or cognitive-behavioral therapy (CBT).2,17 One way CBT might assist an individual is it might help the individual become able to cope better with issues connected to drug use.17

Someone who has an addiction ought to be evaluated for additional mental illnesses, and if that person has co-occurring disorders, all ought to be addressed by treatment.18

The setting(s) where an individual participates in treatment might be residential, outpatient, and/or inpatient.9,17,18

To make sure someone’s needs get met even if they change, there ought to be continual evaluation of the person’s treatment plan and it ought to be altered as needed.18

Aftercare after inpatient or residential treatment could assist a person to stay abstinent.17,18

 

Sources:
  1. Couper, F. J. & Logan, B. K. (2014). Drugs and human performance fact sheets.
  2. National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. (2018). DrugFacts: Cocaine.
  3. Drug Enforcement Administration; U.S. Department of Justice. (2017). Drugs of abuse: A DEA resource guide: 2017 edition.
  4. National Institute on Drug Abuse. (2016). Cocaine: How is cocaine used?.
  5. National Institute on Drug Abuse. (2016). Cocaine: What are the long-term effects of cocaine use?.
  6. Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed tables.
  7. National Institute on Drug Abuse. (2018). Drugs and the brain.
  8. Nestler, E. J. (2005). The neurobiology of cocaine addictionScience & practice perspectives3(1), 4–10.
  9. A.D.A.M., Inc. (2019). Cocaine withdrawal. In A.D.A.M. Medical Encyclopedia.
  10. Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment: A treatment improvement protocol: TIP 45.
  11. National Institute on Drug Abuse. (2016). Cocaine: What are the short-term effects of cocaine use?.
  12. National Institute on Drug Abuse. (2016). Cocaine: Why are cocaine users at risk for contracting HIV/AIDS and hepatitis?.
  13. Centers for Disease Control and Prevention. (2018). 2018 annual surveillance report of drug-related risks and outcomes: United States.
  14. National Institute on Drug Abuse. (2019). Overdose death rates.
  15. Heard, K., Palmer, R. & Zahniser, N. R. (2008). Mechanisms of acute cocaine toxicityThe open pharmacology journal, 2(9), 70–78.
  16. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
  17. National Institute on Drug Abuse. (2016). Cocaine: How is cocaine addiction treated?.
  18. National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (third edition).
About The Contributor
Sophie Stein, MSN
Clinical Editor
Sophie Stein received her master’s of science in nursing from Vanderbilt University School of Nursing. She previously worked as an advanced practice registered nurse at an outpatient psychiatric practice providing mental health care for children,... Read More
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