Cocaine Use Disorder
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 this condition.
Causes
Cocaine stimulates the brain to release large amounts of the hormone dopamine. Dopamine results in the euphoria commonly reported by cocaine abusers. As a person continues to use cocaine, a tolerance is developed. This means that higher doses and more frequent use are required to maintain the euphoria.
Release of Dopamine in the Brain
When a cocaine user stops using abruptly, he experiences a crash or withdrawal. This results in an extremely strong craving for more cocaine. It also results in fatigue (being tired), loss of pleasure in life, depression, anxiety, irritability, and sometimes paranoia. These withdrawal symptoms often prompt the user to seek more cocaine.
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: males
Symptoms
The symptoms below are associated with cocaine use disorder.
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Short-term effects include:
- 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
- Heart attack
- Seizures
- Sudden death
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Long-term effects include:
- 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
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Medical complications include:
- 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. He will also do a physical exam. The doctor will ask specific questions about your cocaine use, like how long you have been using the drug and how often.
Treatment
Talk with your doctor about the best treatment plan for you. Treatment programs may be inpatient or outpatient and may:
- Require that you have already stopped using cocaine
- Involve a detoxification program
Medications
Treatment with medicine centers on the symptoms of euphoria and craving. But, there are currently no medicines to specifically treat cocaine use disorder. Medicines that have shown some promise include:
- Modafinil
- N-acetylcysteine
- Topiramate
- Disulfiram
- Agonist replacement therapy
- Baclofen
- Antidepressants—may be helpful for people 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. Therapies include contingency management. With this program, people receive positive rewards for staying in treatment and remaining cocaine-free. Also, cognitive behavioral therapy helps people to learn how to abstain and remain abstinent from cocaine.
Rehabilitation Programs
In rehab programs, people with cocaine use disorder stay in a controlled environment for 6-12 months. During this time, they may receive vocational rehab and other support to prepare them to return to society.
Prevention
The best way to prevent cocaine use disorder is to never use cocaine. It is highly addictive.
Resources:
Cocaine Anonymous
National Institute on Drug Abuse
Canadian Resources:
Cocaine Anonymous
Native Alcohol and Drug Abuse Counseling Association of Nova Scotia
References:
Carson-DeWitt R, ed. Encyclopedia of Drugs, Alcohol, and Addictive Behavior. 2nd ed. New York, NY: MacMillan Reference Books; 2000.
Karila L, Reynaud M. Therapeutic approaches to cocaine addiction. [article in French] Rev Prat. 2009;59(6):830-834.
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/C...ine/Cocaine.html. Accessed September 27, 2006.
Last reviewed January 2010 by Theodor B. Rais, 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.