Cocaine Addiction & Treatment
What Is Cocaine?
Cocaine is a powerful stimulant drug with strong addiction potential. The short-term effects of cocaine use include:
- Increased energy.
- Amplified wakefulness.
- Decreased appetite.
In addition to these sought-after short-term effects, there are many acute, negative consequences of abuse, including cardiovascular stress (rapid heartbeat, increased blood pressure), anxiety, and insomnia. Cocaine users may also develop long-term health problems, such as kidney failure, heart disease, or mental health issues. If you or a loved one is struggling with an addiction to cocaine, there are rehab programs available to help.
Cocaine is a stimulant drug extracted from coca leaves native to Central and South America. Cocaine is classified as a Schedule II drug; while it is occasionally used in medical procedures such as dental operations as a local or topical anesthetic, it carries a high potential for abuse and is mainly used illicitly.1 Street names include coke, blow, rock, and snow.
The 4 most common methods of using cocaine are:
- Snorting it.
- Rubbing it into the gums.
- Dissolving cocaine powder into water and then injecting it.
- Heating cocaine to make crack and inhaling the smoke.
Using cocaine can cause serious harm to users and can even be deadly.
How Addictive Is Cocaine?
Cocaine use results in a fleeting increase in dopamine signaling, resulting in feelings of euphoria.2,3 With consistent cocaine use, this artificial boost to dopamine activity can ultimately result in changes within the brain’s reward circuit that lead the user to begin prioritizing cocaine use over other activities. Repeated use will generally lead to a tolerance to cocaine, meaning that euphoric stimulant high is harder and harder to get and requires continually upping the dose to feel the sought-after effects.
Cocaine’s euphoric high brings users back to the drug time and again and is an obvious contributor to addiction.
Chronic or heavy use of cocaine can bring about physical dependence, a state where the body comes to rely on the drug. A dependent person who tries to scale back their use or stop completely will likely experience at least some withdrawal symptoms. Although cocaine withdrawal may not produce the same intense physical effects as heroin or alcohol withdrawal (like vomiting and shaking), it does produce distressing symptoms, such as:2
- Depressed mood.
- Vivid dreams.
- Increase in appetite.
- General feelings of discomfort.
- Intense cravings.
- Suicidal thoughts.
The concept of dependence is often confused with that of addiction. While they are often present alongside each other, they are not the same:
- Dependence indicates a physical reliance on the drug.
- Addiction refers to a compulsive use pattern that continues despite the high probability of or presence of harmful or troubling consequences.
Cocaine’s euphoric high brings users back to the drug time and again and is an obvious contributor to addiction. However, there are many other factors that influence a person’s likelihood of abusing or becoming addicted to cocaine. Factors such as poverty, racism, education level, substance-abusing peer groups, and high stress levels all contribute to a person’s risk.
In addition, genetics play a role; the degree of heritability for developing a cocaine addiction is higher than that of breast cancer, type 2 diabetes, and hypertension.3
Signs and Symptoms of Cocaine Abuse
As a stimulant, cocaine produces a state of euphoria, sexual arousal, increased energy, and mental alertness.4 Some people report that using cocaine helps them socialize and feel confident. However, as a person comes down from their high (crashes), they may feel the opposite effects—anxiety, irritability, insomnia, confusion, and paranoia.3
People may use more and more of the drug in an attempt to keep their high and avoid the crash. This cycle can continue on and on. During binges, users may neglect eating or sleeping and become depressed, paranoid, or aggressive.4
Although there are numerous individual differences between cocaine users, they may share some of the following characteristics:
Physically, they may:4
- Be very thin.
- Neglect personal hygiene.
- Have poor dental health.
- Suffer from vitamin deficiencies.
- Have dermatitis (a skin rash).
Someone using cocaine may begin to act differently as well. They may:
- Experience mood swings.
- Make up excuses to get high.
- Steal to afford more drugs.
- Withdraw from personal relationships.
- Neglect responsibilities like school, work, or child care.
- Ignore basic needs such as clothing, food, or shelter.
Drug paraphernalia associated with cocaine use will vary depending on the route of administration. If a person is snorting cocaine, you may find:
- Rolled up dollar bills.
- White residue on mirrors, CD cases, or keys.
What Are the Effects of Cocaine on the Brain?
In the short term, cocaine’s influence on the dopamine neurotransmitter system results in a rewarding high. Cocaine can flood the brain with so much dopamine that the pleasure from using it can eclipse that of other enjoyable activities like eating or having sex. Once this occurs, addiction is likely close at hand, as cocaine begins to feel better than anything else. Users can ignore once-enjoyed activities or personal responsibilities in favor of recreating the pleasure that now only cocaine can bring.
In addition to its effect on dopamine neurotransmission, using cocaine can lead to long-term changes in the brain. For example, repeated cocaine exposure can cause changes in the functioning of the orbitofrontal cortex (OFC). The OFC is located in the prefrontal cortex region in the frontal lobes of the brain and contributes to learning, decision-making, and impulse control. The OFC also helps us self-reflect and realize how our actions can be harmful.5 Studies suggest that using cocaine weakens the functioning of this area in the brain over time, leading to poor decision-making and a failure to respond to the negative consequences of drug use.5
Long-Term Effects of Cocaine
Taking too much cocaine can have serious, long-term effects on your physical and mental health. Some of these debilitating long-term effects may be the result of acute events such as stroke, seizure, respiratory failure, or heart attack.6 Other long-term consequences could include:7,8
- Physical dependence.
- Kidney failure.
- Heart problems.
- Muscle deterioration.
- Anxiety disorders.
- Brain changes resulting in impaired decision-making and judgment.
Additionally, the route of administration will influence the spectrum of potential long-term effects. For example:9
- Snorting cocaine can lead to a loss of smell, irritated nasal septum, runny nose, trouble swallowing, and nosebleeds.
- Injecting cocaine can cause infection, allergic reactions, and puncture or track marks on the arm. In addition, people who inject cocaine are at an increased risk for contracting HIV/AIDS and hepatitis when sharing needles or other items used for injection.
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Cocaine Use During Pregnancy
Women who use cocaine during pregnancy can harm themselves as well as their children. Babies who are born to mothers who used cocaine during pregnancy are at risk for a number of health problems, including being born at a low birth weight, having a small head circumference, or being born shorter in length. Mothers who use cocaine may experience:10
- Preterm labor.
- High blood pressure/possible preeclampsia.
Cocaine Use and HIV
There is a large amount of research documenting the relationship between drug use and infectious diseases such as HIV and hepatitis C (HCV). People under the influence of and/or addicted to drugs are likely to experience impaired judgment, which can lead to:11
- Sharing needles.
- Performing sexual acts in exchange for cocaine.
- Engaging in risky sexual practices.
Cocaine, specifically, can cause HIV to spread quickly. According to the National Institute on Drug Abuse (NIDA), cocaine can cause an acceleration of HIV in the body by reducing the immune cell function, promoting the replication of the virus, and intensifying the damage that HIV has on the brain and spinal cord’s cells.
Cocaine can cause an acceleration of HIV in the body.
Infection of the HIV virus can also increase the risk of HCV co-infection. HCV infection can lead to chronic conditions such as cirrhosis (liver disease) and cancer. The mortality rate of those with HIV and HCV is higher than that of either infection alone.11
Overdose Signs and Symptoms of Cocaine
In 2015, cocaine was involved in almost 7,000 overdoses.12 Signs of a cocaine overdose include:13
- Markedly large pupils.
- Pressure or pain in the chest.
- Profound confusion.
- Muscle damage.
- Dangerously high body temperature, heart rate, and blood pressure.
- Severe anxiety.
- Signs of mental illness such as depression, mania, or schizophrenia.
Overdose can have serious consequences, including kidney damage, seizures, stroke, or even sudden death.13 If you are near someone who has overdosed on cocaine, dial 911 immediately.
Treatment for Cocaine Addiction
People who have developed significant physiological cocaine dependence may experience an intense withdrawal period when they stop using. The first step in treating a cocaine addiction is detoxification. You can choose to detox at home, but this can be problematic for some users. Cocaine withdrawal produces a number of uncomfortable effects, such as intense cravings and depressed mood, which could lead to self-harm.
The psychological distress that may accompany withdrawal could prompt users to relapse on cocaine to find relief. Detoxing in a supervised environment will ensure your safety and set you up for long-term success in your treatment journey.
Ideally, after completing a detox program, you will transition into the next step of treatment. The most appropriate level of treatment will depend on your personal situation. You might participate in one or more of the following:
- Inpatient program: This is the most intensive option for rehab following detox. If your addiction is relatively severe, this may be the best fit for you. Inpatient programs vary in length but generally last 30 to 90 days. Inpatient rehab requires that you live at the facility for the duration of your treatment. You will have access to on-site doctors and nurses who will monitor your condition. Many inpatient programs provide amenities to improve your well-being and make the stay more comfortable. Luxury treatment centers may have added amenities ranging from gym access and chef-prepared meals to private rooms and pool/spa privileges.
- Outpatient program: These programs offer the advantage of going through treatment while you continue working, attending school, or caring for your children. In general, outpatient programs are less intensive than inpatient programs. People with triggering environments at home or who lack a support network might not find as much success with this option.
- Intensive outpatient program (IOP): IOPs are more intensive than traditional outpatient treatment offerings. Group sessions are at the core of most IOPs. In addition to group therapy, 30- to 50-minute individual counseling sessions will usually occur at least once per week at the start of treatment.14
- Partial hospitalization (PHP): PHP programs allow you to seek treatment for the better part of the day at a facility and return home in the evening. While at the facility, you may participate in a variety of activities such as individual counseling, group sessions, and holistic treatments like art therapy.
In treatment, you will likely participate in behavioral interventions such as:
- The Matrix Model: This approach is widely used in treating addictions to stimulants such as cocaine. Your therapist will resemble a coach or teacher. This model utilizes many different therapeutic strategies to improve your self-worth and decrease your drug use. People who participate in this type of therapy show improvements in their psychology and tend to have reductions in risky sexual behaviors.15
- Contingency Management (CM): This approach uses vouchers to motivate you to stay drug-free. If you produce a drug-free urine sample, for example, you may receive a voucher for rewards like cash or other prizes.
- Cognitive-behavioral therapy (CBT): CBT helps you recognize patterns in your thinking that may be harmful. Oftentimes, these negative thoughts fuel your addiction. Through CBT, you will learn how to change your thinking and cope with stressors without cocaine.
During treatment, you will work with a therapist or counselor to develop an aftercare plan. Aftercare will look different for every individual but may include finding a therapist, volunteering in the community, attending 12-step groups, serving as a sponsor, and practicing self-care. These are all tools that will prepare you to stay sober after treatment.
At any point in the treatment process, you can access 12-step and non-12-step groups in your community. These groups are free and can provide an enormous amount of support during your recovery from cocaine addiction. Support group options include:
Tips for Avoiding Relapse
Although the goal of rehab is to transition out of treatment and remain abstinent from cocaine, the reality is that relapse is a possibility. If you relapse after treatment, you are not a failure. In fact, many people relapse several times during their efforts to establish long-term sobriety.
To help prevent relapse:
- Avoid triggers. Triggers could be people, places, or things that remind you of using cocaine. Working with a therapist will help you identify what your triggers are so that you can avoid them and, when it’s not possible to avoid them, respond to them in a healthier manner.
- Practice relaxation techniques to reduce stress. Experiencing high levels of stress may lead you to use cocaine. You can practice small exercises every day to help de-stress and relax. This could include meditation and/or focused deep breathing.
- Exercise. Feeling physically healthy can have many positive effects on your mental health.
- Stay engaged in therapy. Seeing a therapist on a weekly or monthly basis can help you stay connected to your thoughts and emotions. The benefits of therapy are vast. A therapist can help you reflect on your progress and process things as you move beyond treatment.
There are so many options to help you get sober. Don’t wait another day to overcome your cocaine addiction.
- Drug Enforcement Administration Museum. (n.d.). History: The Origins of Coca.
- U.S. National Library of Medicine. (2015). Cocaine Withdrawal.
- Nestler, E. J. (2005). The Neurobiology of Cocaine Addiction. Science & Practice Perspectives, 3(1), 4–10.
- Substance Abuse and Mental Health Services Administration. (1999). Chapter 2—How Stimulants Affect the Brain and Behavior.
- National Institute on Drug Abuse. (2016). What are some ways that cocaine changes the brain?
- Chastain, Z. (2014). Cocaine: The Rush to Destruction. Simon and Schuster.
- U.S. National Library of Medicine. (2015). Cocaine Intoxication.
- Morton, W. A. (1999). Cocaine and Psychiatric Symptoms. Primary Care Companion to The Journal of Clinical Psychiatry, 1(4), 109–113.
- National Center of Continuing Education. (n.d.). Substance Abuse.
- National Institute on Drug Abuse. (2016). What are the effects of maternal cocaine use?
- National Institute on Drug Abuse. (2016). Why are cocaine users at risk for contracting HIV/AIDS and hepatitis?
- National Institute on Drug Abuse. (2017). Overdose Death Rates.
- U.S. National Library of Medicine. (2015). Cocaine Intoxication.
- Substance Abuse and Mental Health Services Administration. (2006). Chapter 4. Services in Intensive Outpatient Treatment Programs.
- Substance Abuse and Mental Health Services Administration. (1999). Chapter 3 – Approaches to Treatment.