Cocaine Use Disorder
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Cocaine Use Disorder

En Español (Spanish Version)

Definition

Cocaine use disorder is when the use of cocaine harms a person’s health or social functioning, or when a person becomes dependent on cocaine. The powdered form of cocaine can be snorted or dissolved in water and injected. “Crack,” which is cocaine in a rock crystal form, can be heated and its vapors smoked.

Cocaine use disorder is treatable, but it takes perseverance and determination. Talk to your doctor if you think you have cocaine use disorder.

Causes

Cocaine stimulates the brain to release large amounts of the hormone dopamine, which, when amassed in sufficient quantities, results in the euphoria commonly reported by cocaine abusers. As a person continues to use cocaine, a tolerance is developed, and this means that higher doses and more frequent use are required to maintain the euphoria.

Release of Dopamine in the Brain

neurotransmitter

The dopamine connecting to the receptors causes a euphoric feeling. This occurs naturally, but cocaine causes an exaggerated response that can lead to addiction.

© 2008 Nucleus Medical Art, Inc.

Furthermore, when a cocaine user stops using abruptly, they experience a crash or withdrawal. This results in an extremely strong craving for more cocaine, as well as fatigue (being tired), loss of pleasure in life, depression , anxiety , irritability, sleepiness, and sometimes paranoia. These symptoms often prompt the user to seek more cocaine to alleviate these symptoms of withdrawal.

Risk Factors

The following factors increase your chances of developing cocaine use disorder. If you have any of these risk factors, tell your doctor:

  • Age: 18-25
  • Sex: men

Symptoms

The symptoms below are associated with cocaine use disorder. If you experience any one of them, see your physician.

  • Short-term effects of cocaine use:
    • Euphoria
    • Increase in energy
    • Excessive talking
    • Being mentally alert
    • Decreased need for food and sleep
    • Dilated pupils
    • Increased temperature
    • Increased heart rate
    • Increased blood pressure
    • Bizarre, erratic, or violent behavior
    • Vertigo
    • Muscle twitches
    • Paranoia
    • Restlessness, irritability, and anxiety
    • Cardiac arrest
    • Seizures
    • Sudden death
  • Long-term effects of cocaine use:
    • Uncontrollable or unpredictable cravings
    • Increased tolerance
    • Increased dosing
    • Use of cocaine in a binge
    • Increasing irritability, restlessness, and paranoia
    • Full-blown paranoid psychosis
    • Auditory hallucinations
  • Medical complications of cocaine use:
    • Heart rhythm abnormalities
    • Heart attack
    • Chest pain
    • Respiratory failure
    • Stroke
    • Seizure
    • Headache
    • Abdominal pain
    • Nausea

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. He or she will ask you specific questions about your cocaine use, such as how long you have been using cocaine and how often you use it.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment programs may be in- or outpatient. They may require that you have already stopped all cocaine use, they may involve a detoxification program, or they may begin working with you even though you are still actively using cocaine.

Medications

There are currently no medications available to treat cocaine use disorder specifically, but topiramate, modafinil, and baclofen have shown some promise in treating cocaine use disorder. In addition, antidepressant drugs may benefit people who are in the early stages of cocaine abstinence.

Behavioral Therapy

Behavioral therapies to help people quit using cocaine are often the only available, effective treatment for cocaine use disorder. Such therapies include contingency management, in which people receive positive rewards for staying in treatment and remaining cocaine-free. Also, cognitive-behavioral therapy helps people who are addicted to cocaine learn to abstain and remain abstinent from cocaine.

Rehabilitation Programs

In rehabilitation programs, people with cocaine use disorder stay in a controlled environment for 6-12 months, during which they may receive vocational rehabilitation and other support to prepare to move back into society.

Prevention

The best way to prevent cocaine use disorder is to never use cocaine, since it is highly addictive.

RESOURCES:

American Council for Drug Education
http://www.acde.org

National Institute on Drug Abuse
http://www.nida.nih.gov

The Partnership for a Drug-Free America
http://www.drugfree.org

CANADIAN RESOURCES:

Alberta Alcohol and Drug Abuse Commission
http://www.aadac.com

Narconon Drug Rehabilitation Center
http://www.narconon.ca

References:

Carson-DeWitt R ed. Encyclopedia of Drugs, Alcohol, and Addictive Behavior . 2nd ed. New York: MacMillan Reference Books; 2000.

NIDA InfoFacts: crack and cocaine. National Institute on Drug Abuse website. Available at: http://www.nida.nih.gov/Infofacts/cocaine.html. Accessed September 27, 2006.

Research report series: cocaine abuse and addiction. National Institute on Drug Abuse website. Available at: http://www.drugabuse.gov/ResearchReports/Cocaine/Cocaine.html . Accessed September 27, 2006.



Last reviewed February 2008 by Rosalyn Carson-Dewitt, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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