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Cocaine Addiction

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Cocaine is a powerfully addictive stimulant drug in the form of 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

What is Cocaine Addiction?

People struggling with cocaine addiction begin to use cocaine in a way that is compulsive (feeling an irresistible urge to use) even if they may experience harmful consequences.18 While addiction is a chronic brain condition, it is treatable and recovery is possible.18

Cocaine addiction and misuse can be caused by cocaine’s reinforcing high that mainly comes from how it works on the dopamine neurotransmitter system in the brain.1,2 Dopamine is associated with ‘euphoric’ emotions, the regulation of movement, and the processing of reward cues.1 While people 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.4,5,6

These negative effects may lead people to regularly use cocaine in order to avoid uncomfortable withdrawal symptoms, which may 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.3,4


Signs of Cocaine Addiction

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. Crack cocaine addiction involves the use of free base cocaine (or “crack”) that looks like small rocks that are a whitish color.


Cocaine Withdrawal Symptoms

As a person’s brain adapts to the dopamine surges related to their cocaine use, they aren’t as sensitive to it. 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.

Adverse Effects of Cocaine Use

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

There are a number of potentially dangerous effects of cocaine. One particular 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

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.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 Addiction Treatment

There are many treatment options available for people struggling with a cocaine addiction. 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.

Outpatient treatment offers a similar range of therapeutic interventions to their inpatient counterparts but does not require on site residence.

Behavioral Therapies

group therapy

Behavioral therapies are 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 substance abuse and helps to alter maladaptive ways of thinking and acting that may be contributing to the cocaine abuse issue.13-15

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 to find a program best suited to the treatment needs and preferences of the individual person. In addition, a person may want to know:

  • 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 cocaine relapse and bolster recovery) will be available or arranged for upon completion of a program.

Resources, Articles, and Information About Cocaine

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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