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Why Is Cocaine so Addictive?

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Cocaine comes from the coca bush, which grows primarily in South America. This addictive stimulant is also known as “coke,” “snow,” or “blow” and is sold on the streets as a fine, white powder. In a crystallized, free base form, it is referred to as “crack,” due to the crackling sound it makes when smoked. As a street drug, cocaine is often mixed with other fine, white powders such as cornstarch or sugar to dilute the sold product.

Cocaine continues to be an abused drug, even with the widespread knowledge of its dangers and addictive potential. In fact, the National Institutes on Drug Abuse (NIDA) reports a 42% increase in the total number of deaths involving cocaine from 2001 to 2014.

Addictive Properties of Cocaine

Cocaine is highly addictive, and is a Schedule II substance—meaning it has a high potential for abuse but also an accepted medical use as a local anesthetic for minor surgical procedures.

Repeated use of cocaine over time can lead to the development of tolerance, physical dependence, and symptoms of withdrawal during periods of non-use. Continued use in the face of the adverse consequences such as deteriorating health can signal the arrival of a substance addiction.

The following are a few examples to underscore cocaine’s addictive potential:

  • Cocaine causes a quick, euphoric high that lasts a very short time.
  • The high from cocaine is usually followed by a sharp decline into depression or feeling on edge, which can lead the user to seek out more and more to alleviate these feelings.
  • The use of cocaine, regardless of method, causes extra dopamine stimulation throughout the brain, resulting in rewarding feelings that encourage continued use.

Methods of Use and the Effects of Cocaine

Methods of Cocaine Use

Illicit cocaine is found primarily in two forms – as a powder or in a more crystalline form. All forms of the drug can be used via a variety of routes of administration, including:

  • Insufflation or snorting – cocaine is rapidly absorbed into the bloodstream through the mucosal surfaces of the nasal passages.
  • Oral ingestion – similar to nasal insufflation, cocaine absorbs through the oral mucosa after being rubbed into the gums.
  • Injection – directly into the venous circulation for the most rapid, almost instantaneous onset of effects.
  • Inhalation – cocaine can be heated and vaporized, which is then smoked or inhaled.

Snorting cocaine results in the lowest-intensity, most gradual onset high, while injection produces the fastest high.

To be clear, there is no “safe” way to use cocaine. Even pharmaceutical application under the supervision of a medical professional authorized to prescribe the drug still carries some risks. Cocaine influences the way the brain processes chemicals, and use of this drug will require more and more over time to achieve the same effect—a phenomenon known as tolerance.

Effects of Cocaine

Short-Term Effects

  • Racing thoughts.
  • Temporary surge of energy.
  • Bizarre or erratic behaviors.
  • Disturbed sleep.
  • Decreased appetite.
  • Anxiety.
  • Paranoia.
  • Fleeting psychotic symptoms – e.g., grandiosity, delusions, tactile hallucinations, etc.
  • Increased heart rate and blood pressure.
  • Cardiac arrest.
  • Seizures.
  • Coma.

Long-Term Effects

  • Malnutrition.
  • Severe weight loss.
  • Eventual development of tolerance and addiction.
  • Anxiety and/or panic attacks
  • Persistent psychotic symptoms.
  • Reduced sensitivity of the brain’s reward pathways to natural reinforcers, or inability to experience pleasure without the presence of the drug.
  • Destruction of nasal passages from snorting.
  • Heart disease.
  • Pulmonary disease (secondary to smoking).
  • Reactions at injection sites, such as infection, redness, or sores.

Cocaine abusers frequently exhibit telltale signs of stimulant use—erratic behavior, restlessness, anxiety, and paranoia.

The damage that cocaine use inflicts extends beyond the user themselves, in some cases. For example, cocaine in a user’s system can have adverse effects on fetal development. If a woman uses cocaine during pregnancy, the child may suffer deficits in attention, information processing, and overall cognitive performance.

What does it mean to Be Addicted to Cocaine?

Addiction to cocaine is signaled by an inability to stop using, even when it is consistently causing you harm or distress. Using cocaine recreationally does not necessarily equate to an addiction. However, if your cocaine use is becoming increasingly compulsive, or if you’re finding that you’re experiencing the signs of cocaine addiction such as neglecting your responsibilities in favor or use, experiencing cravings for cocaine, and spending a majority of your time obtaining or using the drug, you may have a problem. Additionally, if you’ve made numerous attempts to try and quit and have been unsuccessful, this is an also a sign that you have a stimulant use disorder.

Signs and Symptoms of Cocaine Addiction

  • Chronic restlessness.
  • Persistent fatigue and general deterioration in health and appearance.
  • Withdrawal from social situations, suspicions of people.
  • Nosebleeds (users who snort cocaine) or constant runny noses.
  • Track marks, or signs of injection on the arms, legs, or neck.
  • Disordered sleep, insomnia, nightmares, etc.
  • Inability to function without cocaine.
  • Increased use of cocaine over time.

Withdrawal from Cocaine

The onset of withdrawal symptoms when cocaine us is stopped or reduced is another sign of a cocaine dependency. These withdrawal symptoms include:

  • Tiredness.
  • Irritability.
  • Hostility.
  • Anxiety.
  • Paranoia.
  • Depression.
  • Suicidal thoughts.
  • Inability to sleep or disturbances in sleep.

While many of the potential symptoms of cocaine can be quite unpleasant, they are seldom life-threatening. However, the presence of a profound depression – with or without suicidal thought – can present a unique set of dangers. Professionally monitored detoxification programs can be very beneficial in such situations—effectively addressing any new mood disorder issues, managing uncomfortable symptoms as they arise and, ultimately, ushering those in withdrawal safely towards lasting recovery.

How to Get Help with Cocaine Addiction

One of the first steps for a cocaine user is to admit they have a problem. Often, people talk about seeking help after hitting “rock bottom”; however, hitting a so-called “bottom” is not necessary to admit a problem and seek help. There are many options for treatment for stimulant use disorders. Treatment can prove beneficial at any point of a cocaine addiction’s progression.

While some prescription medications used to treat other forms of substance abuse (such as alcoholism) have been used to varying degrees of success in the treatment of cocaine abuse – including disulfiram (Antabuse) or modafinil (Provigil) – there are currently no prescription medications specific to the treatment of cocaine abuse. The most effective intervention for cocaine abuse is a combination of behavioral and medical interventions, such as a residential treatment facility that includes intensive psychotherapy.

One type of behavioral intervention that has had success in the treatment of cocaine addiction is contingency management (CM). In residential and outpatient treatment, users can earn rewards, such as chips, tokens, or points, and use those points towards rewards, such as vouchers or even cash.

Cognitive-behavioral therapy (CBT) has also been found to help with recovery from cocaine abuse. CBT helps users identify situations that may tempt them into using again so that they may practice coping skills and avoid relapse.

It is especially important the user find a treatment modality and intervention that is compatible with the individual. The more meaningful the reward system and the more the services match the individual, the more effective the treatment program will replace the need for pleasure fulfillment. With a direct, focused approach, users can find success in recovery.

Finding Help for Drug Abuse and Addiction

You can contact American Addiction Centers (AAC) for free at for information on rehab center locations and helpful treatment-related resources. There are also free drug abuse hotline numbers you can call.

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