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Cocaine Addiction

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Cocaine is a powerfully addictive stimulant drug that comes in the form of a white powder that is commonly snorted, smoked, or injected.1 Its popularity as a recreational substance is in part due to its perceived positive effects on mood, motivation, and energy—heightening concentration, increasing sociability, decreasing shyness, and more.2

In this article, we will talk about cocaine addiction, how addictive it is, the signs and symptoms of addiction, and cocaine’s effects and withdrawal symptoms. We’ll also go over mixing cocaine with other drugs, as well as the different types of addiction treatment for cocaine.

What Is Cocaine Addiction?

People who are struggling with cocaine addiction will begin to use cocaine in a way that is compulsive (feeling an irresistible urge to use) even if they may experience harmful consequences.3 While addiction is a chronic brain condition, it is treatable and recovery is possible.3

Cocaine addiction and misuse can be caused by cocaine’s reinforcing high that is primarily a result of how it works on the dopamine neurotransmitter system in the brain.1, 4 Addiction to cocaine can be triggered in many people after only using it once, since it affects the brain’s reward pathway immediately.1

Why Is Cocaine So Addictive?

Dopamine is associated with ‘euphoric’ emotions, the regulation of movement, and the processing of reward cues.1 While individuals using cocaine may feel these highs for a time, once the drug begins to leave the system, they may experience unpleasant reactions, including anxiety, confusion, irritability, and agitation.2

These negative effects may lead people to regularly use cocaine in order to avoid uncomfortable withdrawal symptoms, which can drive the development of tolerance. Tolerance occurs when more frequent and/or escalated use is needed to achieve the same level of positive effects (or high) and temporarily decrease the negative effects of cocaine withdrawal.2, 5

Signs and Symptoms of Cocaine Use

Typical signs and symptoms of current cocaine use include:1, 2, 5

  • Increased agitation.
  • Effusive enthusiasm.
  • Disinhibition.
  • Increased movement (i.e. hyperactivity).
  • Signs of involuntary movements (i.e. muscle twitches).
  • Changes in concentration and focus.

If your cocaine use or that of a loved one has escalated into addiction, according to the American Society of Addiction Medicine, those who are addicted to cocaine continue to engage in drug misuse despite the harmful consequences that come from it.3 Work, family, home, and/or school obligations can become negatively impacted due to the effects of cocaine use disorder.

Adverse Effects of Cocaine Use

There are several potentially dangerous effects of cocaine use. One serious risk of cocaine abuse is heart damage.5, 6 Both acutely and over time, cocaine can result in several cardiovascular issues, such as ischemic heart disease, aberrant heart rhythms, hypertension, and cardiomyopathy. Intravenous cocaine use can result in infection and inflammation of the heart valves and lining of the heart chambers (endocarditis).6

Other symptoms of cocaine-induced cardiotoxicity include:6

  • Inflammation of heart muscle (myocarditis).
  • Aortic rupture.
  • Severe declines in health and life quality due to chronic reductions in cardiac function.

Cocaine-induced heart failure or damage may also increase the risk of stroke or brain damage resulting from interruptions in the blood supply available to the brain.2

Cocaine addiction is also associated with kidney damage. The prolonged use of cocaine is thought to be related to the inflammation of important microstructures within this organ.7

Even users who regard their use as recreational may be at risk of neurological changes that affect their lives. Long-term use is also associated with deficits in cognitive performance, attention, and decision-making abilities.1, 8

Other risks stemming from abuse include bloodborne infectious conditions such as HIV or hepatitis C (HCV). These risks are primarily related to the injection of cocaine and the adverse effects of non-sterile needle use.1, 5, 9

Cocaine Withdrawal Symptoms

Symptoms of cocaine withdrawal can occur when an individual decreases or discontinues using cocaine. As the body becomes used to having cocaine in the system, physical dependence develops, causing the brain to desire cocaine to function.

As a person’s brain adapts to the dopamine surges related to their cocaine use, they aren’t as sensitive to them. This may lead a person to use more of the drug or use it more frequently to prevent uncomfortable withdrawal symptoms, which may include:1

  • Fatigue.
  • Depression.
  • Increased appetite.
  • Insomnia.
  • Unpleasant dreams.
  • Delayed thinking.

No medications have been developed by the Food and Drug Administration (FDA) to manage cocaine withdrawal symptoms.10 Since withdrawal from stimulants like cocaine usually does not involve intense patient discomfort or medical danger, the need for medications is not as high as it is for drugs such as alcohol and opioids.10

Mixing Cocaine With Other Drugs

Sometimes people use cocaine with other substances such as alcohol, heroin, or marijuana. These combinations can be dangerous, and even deadly. Using more than one drug at a time (or within a short timeframe) is known as polysubstance use and can occur intentionally (e.g. the user wants to experience the effects of cocaine and another substance) or unintentionally (e.g. in cases where a drug is laced with another drug and the user is not aware).11

Dangerous effects can occur due to polysubstance use. Mixing cocaine with another stimulant, such as ecstasy, can lead to heart attack, brain injury, liver damage, and stroke.11

It has been found that individuals who misuse cocaine often combine it with alcohol.12 Drinking alcohol can increase one’s desire to use cocaine, as well as the effects, which can lead to overdose. Combining cocaine and alcohol can also increase your risk of serious damage to the brain, heart, and other organs.11

More recently, fentanyl is being mixed with cocaine. The Centers for Disease Control and Prevention (CDC) states that fentanyl is 50 times more potent than heroin and 100 times more potent than morphine.13 If individuals use cocaine laced with fentanyl, the risk for overdose is very high.

Cocaine Addiction Treatment

There are many addiction treatment options available to help people struggling with cocaine addiction. Treatment can take place in an inpatient or residential center that provides room and board and around-the-clock supervision and support. Outpatient treatment offers a similar range of therapeutic interventions to its inpatient counterpart but does not require onsite residence.

Behavioral Therapies

Behavioral therapies are psychosocial treatments that address the reasons, motivations, and possible underlying psychological issues associated with a person’s substance misuse. Behavioral therapy techniques are particularly effective in helping patients affected by cocaine abuse and dependence.10, 14, 15, 16

An example of a behavioral treatment associated with effectively promoting abstinence from cocaine use is 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.1, 14, 15

Another form of behavioral treatment, cognitive behavioral therapy (CBT), may be used. This type of treatment addresses the reasons behind substance abuse and helps to alter maladaptive ways of thinking and acting that may be contributing to the cocaine misuse issue.14, 15, 16

Find Treatment for Cocaine Addiction

Seeking treatment for substance addiction is one of the first phases on the path to lasting recovery. This may require some research in order to find a program best suited to the treatment needs and preferences of the individual person. In addition, a person may want to know:

You may also want to find out what types of aftercare programs will be available or arranged upon completion of a program. Your aftercare regimen could include post-treatment counseling, support groups, wellness activities, and other lifestyle modifications to help prevent cocaine relapse and bolster recovery.

To find a rehab near you, you can search the drugabuse.com directory for inpatient treatment or outpatient treatment centers located across the country. You can also instantly verify your insurance coverage for cocaine use disorder treatment. Call our free, confidential helpline at to speak with a caring admissions navigator about your rehab and treatment options.

Levels of Care in Cocaine Addiction Treatment

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For more information, see the following articles:

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Senior Medical Editor
Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating him to seek a clinical psychiatry preceptorship at the San Diego VA Hospital’s Inpatient Alcohol and Drug Treatment Program. In his post-graduate clinical work, Dr. Thomas later applied the tenets he learned to help guide his therapeutic approach with many patients in need of substance treatment. In his current capacity as Senior Medical Editor for American Addiction Centers, Dr. Thomas, works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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