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Cocaine Addiction Treatment

Cocaine (C, coke, coca, snow, powder or blow, flake, bump, candy, rock and toot) is a highly stimulating drug derived from the leaves of the coca plant, which grows both naturally and under human cultivation in various highland areas of South America. An illicit and extremely addictive drug, the two chemical forms of cocaine subject to abuse are a water-soluble hydrochloride salt and water-insoluble cocaine base (or freebase). The street name crack refers to freebase cocaine, and the characteristic crackling sound it makes when the mixture is smoked.1 The drug presents a serious risk for the onset of physical dependence and addiction, yet not all people who use cocaine develop these problems.

Cocaine addiction, like other forms of addiction, is a complex disease that imparts physical, mental and spiritual damage on the addict. Viewing addiction as a chronic disease reinforces the theory that addicts have little if any control over their behaviors. Biologically oriented research suggests a genetic component to alcohol and other addictions and points to physiological changes in the brain resulting from drug use. Currently, a specific pharmacological treatment does not exist for cocaine addiction. Nonetheless, medically supervised detox is advised. In order to achieve long-term recovery, treatment interventions must also incorporate physical, mental and spiritual aspects.2

Cocaine Addiction and Abuse

Regardless of the method of consumption (injection, smoking or nasal inhalation), the drug rapidly increases the brain’s dopamine supply. Dopamine plays a critical role in an area of the brain called the limbic system, which triggers pleasurable sensations in response to certain actions and behaviors. When levels of this chemical rise, feelings of pleasure generated in the limbic system increase. In turn, this increase creates a rewarding feedback loop that reinforces the likelihood of future participation in the action or behavior in question.3,4

Physical dependence on cocaine (or any other common drug of abuse) occurs when the brain starts to treat its altered dopamine levels as the normal or default situation. When dopamine levels fall below this new normal, withdrawal symptoms kick in, and the severity of these symptoms typically gives the user a strong incentive for continued drug use. Addiction occurs when this incentive becomes compulsive, with cocaine or other drugs an obsessive focal point of daily existence.3,4

Stats and Facts

  • In 2014, there were an estimated 1.5 million current (past-month) cocaine users ages 12 or older in the U.S., of which 913,000 met the Diagnostic and Statistical Manual of Mental Disorders criteria for stimulant use disorder.5
  • In the same time period, people ages 18 to 25 used cocaine more than any other age group, with 1.4% of young adults reporting past-month cocaine use.5
  • There has been a significant decline in 30-day prevalence of powder cocaine use among 8th-, 10th-, and 12th-graders from peak use in the late 1990s.5
  • In 2015, 6,784 people died from a cocaine overdose (4,885 males and 1,899 females).6
  • A family history of substance abuse directly correlates both with the development of cocaine abuse and with earlier age of abuse onset.7

Relapse Prevention

A common trigger for addiction relapse is the experience of craving due to exposure to cues associated with prior drug use. A study involving 76 adult cocaine addicts indicated relapse vulnerability was most acute one to six months after abstinence. This timeframe coincides with the discharge window of most addiction treatment programs. These findings suggest individuals addicted to cocaine may benefit most from targeted intervention during this timeframe, as well as heightened vigilance, given most addicts are unaware of triggers.8

Animal research implies a single dose of cocaine can change brain architecture and lead to stress-induced relapse. In rat studies, cocaine drove a “wedge” between two key brain proteins, interrupting the communication between them. Restoring the broken interaction has the potential for minimizing stress-induced relapse.9

  1. What is Cocaine? National Institute on Drug Abuse website. https://www.drugabuse.gov/publications/research-reports/cocaine/what-cocaine Updated May 2016. Accessed December 10, 2016.
  2. An Individual Drug Counseling Approach to Treat Cocaine Addiction: Chapter 1. National Institute on Drug Abuse website. https://archives.drugabuse.gov/TXManuals/IDCA/IDCA3.html  Accessed January 10, 2017.
  3. Cocaine Abuse. Drug Abuse website. http://drugabuse.com/library/cocaine-abuse/ Accessed January 10, 2017.
  4. Cocaine (powder). Center for Substance Abuse Research website. http://www.cesar.umd.edu/cesar/drugs/cocaine.asp Accessed January 10, 2017.
  5. What is the scope of cocaine use in the United States? National Institute on Drug Abuse website. https://www.drugabuse.gov/publications/research-reports/cocaine/what-scope-cocaine-use-in-united-states Updated May 2016. Accessed January 10, 2017.
  6. Overdose Death Rates. National Institute on Drug Abuse website. https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates Updated January 2017. Accessed January 10, 2017.
  7. Cocaine-Related Psychiatric Disorders Clinical Presentation. Medscape website. http://emedicine.medscape.com/article/290195-clinical#b5 Updated April 14, 2016. Accessed January 10, 2017.
  8. Timing of Cocaine Relapse Pinpointed. Medscape website. http://www.medscape.com/viewarticle/868566 Published September 8, 2016. Accessed January 10, 2017.
  9. Cocaine causes ‘profound changes’ in brain that makes addicts more likely to relapse, scientists warn. Daily Mail website. http://www.dailymail.co.uk/news/article-3059715/Cocaine-causes-profound-changes-brain-makes-addicts-likely-relapse-scientists-warn.html Published April 28, 2015. Accessed January 10, 2017.
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