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Cocaine Abuse

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Cocaine is a powerfully addictive stimulant drug

Overview of Cocaine Abuse

Cocaine is a powerfully addictive stimulant drug; its use-reinforcing high derives primarily from its actions on the dopamine neurotransmitter system in the brain.1,2 Dopamine is associated with the generation of ‘euphoric’ emotions, the regulation of movement, and the processing of reward cues.1 However, cocaine use may also increase the risk of several adverse health issues including stroke, seizure, and multiple organ damage.3

Cocaine is a white powder that is commonly snorted, smoked, and injected.1,5,6 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.4,6 But, once the drug begins to leave the system, users may experience unpleasant reactions—including anxiety, confusion, irritability, and agitation.4,5,6 These negative effects may lead to the regular use of cocaine, to avoid the negative symptoms, and that may drive the development of tolerance—where more frequent and/or escalated use is needed to achieve the same level of positive effects as well as to temporarily mitigate the negative effects of withdrawal.3,4

Signs and Symptoms

Typical signs and symptoms of current cocaine use include:1,3,4,5,7

  • Increased agitation.
  • Effusive enthusiasm.
  • Disinhibition.
  • Increased movement (i.e. hyperactivity).
  • Signs of involuntary movements (i.e. muscle tics).
  • Changes in concentration and focus.
What does cocaine look like?

Maybe you are concerned that your loved one is abusing cocaine, but don’t know what to look for. Most often found in white powder form, cocaine may be “cut” with any number of ingredients, some more harmful than others. Free base cocaine (or “crack”) may look like small rocks that are a whitish color.

Other Adverse Effects

Cocaine-induced heart failure or damage may also increase the risk of stroke, or brain damage

One potentially serious risk of cocaine abuse is heart damage.3,8 Both acutely and over time, cocaine can result in a number of cardiovascular issues such as ischemic heart disease, aberrant heart rhythms, hypertension, and cardiomyopathy. Intravenous cocaine use can result in an infection and inflammation of the heart valves and lining of the heart chambers (endocarditis).8

Other symptoms of cocaine-induced cardiotoxicity include:8

  • 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.4

The abuse of this drug 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.9

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.

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.1,10

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.1,3,11

Cocaine Abuse Treatment

There are many treatment options available for people struggling with a cocaine use disorder. These may be delivered in inpatient facilities, which accommodate the patient for the duration of their treatment. There are many therapeutic offerings and treatment settings available for someone seeking to recover from a cocaine use disorder. Treatment can take place in an inpatient or residential center that provides room and board and round-the-clock supervision and support. Other programs might be outpatient based, which can offer a similar range of therapeutic interventions to their inpatient counterparts, but do not require on site residence.

Behavioral Therapies

group therapy

Behavioral therapies are the psychosocial treatments that address the reasons, motivations, and possible underlying psychological issues associated with a person’s substance abuse. Behavioral therapy techniques are particularly effective in patients affected by cocaine abuse and dependence.12-15

An example of behavioral treatment associated with effective 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.1,13,15

Another form of behavioral treatment, cognitive behavioral therapy (CBT) may be used. This type of treatment addresses the reasons behind the substance abuse and helps to alter maladaptive ways of thinking and acting that may be contributing to the cocaine abuse issue.13-15

Finding 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 to find a program best suited to the treatment needs and preferences of the individual patient. In addition, a patient may have to find answers to questions such as:

  • Will insurance cover some or all of my treatment?
  • What methods of funding can I use for treatment?
  • How long the program will last?
  • Will my treatment program accommodate any special needs?
  • What types of aftercare programs (a regimen of post-treatment counseling, support groups, wellness activities and other lifestyle modifications to better prevent relapse and bolster recovery) will be available or arranged for upon completion of a program.

Teen Cocaine Abuse

Cocaine use is relatively common among adolescents. In 2018, 1.4% of 8th graders, 2.6% of 10th graders, and 3.9% of 12th graders reported use of the drug at some point in their life, per the National Institute on Drug Abuse’s Monitoring the Future Study.16

Initiating use at a younger age can increase one’s risk of addicition.17 It is also thought to be related to increased risks of other serious problems in later life.17 To prevent drug abuse in your teen, it’s important to talk to him or her about substance abuse at a young age and continue the conversation. Make sure they understand the dangers of both illicit and prescription drugs, and monitor their behavior, friends, and habits for sudden changes.

Resources, Articles, and More Information

For more information, see the following articles:

You can also join the conversation on cocaine abuse and addiction by visiting our Forum today.

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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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