Cocaine addiction or dependency is characterized by an intense desire or urge to use cocaine regularly. It is a psychological disorder and can lead to extensive brain and cardiovascular damage with prolonged use resulting in the narrowing or constriction of blood vessels supplying major organs of the body, as well as heart attacks, strokes and other conditions of the central nervous system.
Some of the conditions that are associated with prolonged cocaine use include elevated blood pressure, frequent mood swings, insomnia or disturbed sleeping patterns, tachycardia, abrupt changes in the personality, panic attacks, paranoia, psychosis (delusions, hallucinations and losing touch with reality), impairment of cognition, and difficulty in retrieving memories. Various other sudden changes can result in erratic, unusual, compulsive, sometimes aggressive and also criminal behavior depending upon the extent of addiction and substance abuse.
How is Cocaine Used?
Cocaine users can be of any age group or socio economic strata. Usually teenagers or young adults are known to abuse the drug. Cocaine is taken in various ways including by inhaling, intravenously and orally as well. A person gets addicted to the drug usually after a few days of taking it.
Abusers of cocaine develop symptoms that resemble those exhibited by patients of schizophrenia and amphetamine psychosis, in the form of transient manic-like disorders. People who present with a history of addiction to cocaine show symptoms such as aggressive behavior, extreme paranoia, hallucinations which are mostly tactile in nature (the sensation of having insects under one’s skin, crawling sensation, also known as “coke bugs” or formication), as well as frequent cravings in the form of binges.
The use of cocaine either inhaled or injected produces instantaneous and rapid effects. This is because the substance exhibits rapid absorption through the tissues of the respiratory tract, and hence cocaine snorting, which is the most popular method of using the drug is preferred by those addicted to it. Regardless of the mode of administration, cocaine has the ability to enter the bloodstream and rapidly travels to the brain and produces its effects.
The main effect of cocaine on the brain is its interference with the chemical messengers, or the neurotransmitters which allow the nerves and the messages that are being sent through them to be communicated with each other. Cocaine has a blocking effect on neurotransmitters such as dopamine, serotonin and nor-epinephrine and prevents them from being reabsorbed. This gives rise to the sensation of a ‘high’ which is actually a feeling of extreme euphoria that results from the chemical buildup caused by the substance.
So what exactly drives so many people to use cocaine? What is so addictive about being ‘high’? Some regular users of the substance have described the feeling induced by cocaine addiction as:
- Elevated levels of alertness and enhanced energy
- Better mood and higher spirits
- An overall feel of supremacy
Along with these, many people have also described a few other feelings that may be present alongside the euphoria, which include agitation, anxiety, irritability, a significant degree of paranoia and restlessness. Some classical signs of cocaine abuse include dilated pupils upon inspection, elevated levels of energy and enhanced activity, excited, giddy behavior as well as exuberant speech. Even though the effects of cocaine are instantaneous, they begin to wear off after half an hour to 2 hours. Most cocaine abusers prefer to smoke or inject the drug because it produces better and more rapid effects as compared to when the drug is snorted.
Some of the symptoms associated with cocaine withdrawal, also known as “crash”. These are: depression and anxiety, dysphoria, weakness that maybe both physical as well as psychological, pain, and cravings. Addiction to cocaine was formerly known as “cocainism”.
Cocaine users inevitable become addicted to the substance after just a few days of taking it. If the drug is stopped immediately, it can make the user go through withdrawal symptoms or a “crash”. These symptoms include:
- Paranoia and Obsession
- Irritability and Mood swings
- Nausea and Vomiting
- Exhaustion and Fatigue
- Coke bugs (a feeling as if insects are crawling on the skin)
Some cocaine abusers have been reported to having symptoms similar to schizophrenia and patients state that they feel that their mind is “lost”. Withdrawal symptoms can last from a few weeks to months at a time. Even after the drug abuse has stopped, many patients have reported that they crave the drug even years after they have stopped taking it. Usually such addicts turn to other things such as alcohol or medicines after stopping cocaine use. Cocaine withdrawal should be done under medical supervision and with the help of medicines that help in easing the withdrawal symptoms.
Cognitive Behavioral Therapy in combination with Motivational Therapy has proven to help in the treatment of alcohol and drug addictions. There are also cocaine vaccines that are being researched that may be successful in stopping the effects of the drug.
The National Institute of Drug Abuse (NIDA) is researching modafinil, a mild stimulant and a narcolepsy drug, as a possible cocaine treatment drug. They have had some success in the treatment with modafinil. 12 step programs that have been modeled on Alcoholics Anonymous and known as “Cocaine Anonymous” are also helpful for participants in achieving abstinence that is long-term. These programs are not statistically measurable and depend upon the abusers desire and will to participate and remain goal oriented.
William R. Flynn, M.D. Cocaine Addiction: Theory, Research, and Treatment
APA: Practice guide-line for the Rx of patients with substance abuse disorders: cocaine, alcohol, opioids. Am J Psychiatr