Derived from the South American coca plant, cocaine is a powerful stimulant and euphoric drug. It may be used medically as a topical respiratory anesthetic, however, the Drug Enforcement Administration (DEA) reports that it is rarely used for this in the United States. It is largely considered an illegal drug of abuse.
Sold illicitly as a white powder or in a free-base, processed rock-like form called “crack,” cocaine is usually smoked, snorted or injected to produce an intense high. Cocaine can take effect very quickly, within minutes, and the high often wears off rather quickly as well. This causes people to often abuse it in a binge pattern, where they take multiple doses back to back to prolong the high.
As a central nervous system stimulant, cocaine speeds up heart rate and blood pressure, raises body temperature, and increases energy, alertness, and happiness levels. It also decreases sleepiness and appetite. The “crash” when it processes out of the body can have opposite effects, leaving a person feeling lethargic, depressed, and sluggish.
Cravings for cocaine can be significant, and the drug is considered to be extremely addictive. In 2014, an estimated 1.5 million American adults were reported by the National Survey on Drug Use and Health (NSDUH) to be current users of cocaine. Over 900,000 adults in the United States were considered to be suffering from addiction to cocaine in 2014.
Cocaine is dangerous drug with unpredictable side effects and high rates of serious health risks and addiction associated with its use.
Spotting Cocaine Abuse
As a stimulant, when someone is under the influence of cocaine, they are likely highly energized, talkative, happy, alert, and mentally focused. They may appear hypersensitive to touch, light, and sound. Individuals are more liable to make poor choices when abusing cocaine, engaging in behaviors that may be deemed hazardous or unsafe. Mood swings, from high to low, are common indicators of cocaine abuse.
When large amounts of cocaine are taken, a person can become agitated, paranoid, and suffer from delusions. They may become violent, aggressive, and unpredictable. Irregular sleeping and eating habits may also indicate cocaine abuse as can the presence of drug paraphernalia, such as crack pipes; burned spoons from heating the rocks; drug injection materials; shoelaces or rubber tubing to tie off veins for injection; rolled-up paper, open pens, or straws used to snort the powder; as well as credit cards and razors to arrange it into lines. Evidence of cocaine powder may be visible on a person’s nose and mouth or on their clothes, and/or a person may suffer from burns to the hands or fingers.
A person who is abusing cocaine may refer to it by slang names, such as crack, blow, snow, and rock.
Overdose and Other Dangers of Cocaine Abuse
Cocaine can speed up a person’s heart rate and blood pressure to dangerously high levels, which can result in stroke, seizures, or heart attack. A cocaine overdose occurs when the drug reaches toxic levels in the bloodstream, which can happen in as little as one use.
Cocaine is often cut with other products or drugs before it is sold on the street, and these additives can increase possible negative and unpredictable reactions. Cocaine may be intentionally mixed with other drugs, such as heroin in a combination known as a “speedball.” Drug combinations increase the odds for a potentially life-threatening overdose.
A cocaine overdose can cause an irregular heart rate, sweating and elevated body temperature, mental confusion, tremors, twitching, and seizures, nausea and vomiting, restlessness, dilated pupils, and constricted blood vessels. Unlike with opioid drugs, there is no specific reversal medication for a cocaine overdose, and some of the effects may not be reversible. Overdose is typically treated by attempting to stabilize the individual medically, by stopping the seizures, reestablishing blood flow, and restoring oxygenation.
Cocaine abuse resulted in the most emergency department (ED) visits of any other illicit drug in 2011, as over a half-million Americans needed ED treatment for an adverse reaction to the drug, the Drug Abuse Warning Network (DAWN) reports. In addition to the short-term effects, cocaine abuse can have lasting consequences. The American Heart Association calls cocaine the “heart attack drug,” as its use can cause heightened blood pressure, thickened heart muscle walls, and stiffer arteries that can all contribute to heart attack. Other long-term health risks of cocaine abuse include the potential development of a movement disorder, such as Parkinson’s disease, malnutrition due to extended appetite suppression, mood changes, and possible lasting damage to the brain and its reward center, the National Institute on Drug Abuse (NIDA) warns.
How a person abuses cocaine can cause specific side effects, too. For instance, snorting it can create issues swallowing, cause distortions to the sense of smell, or lead to a chronic runny nose or nosebleeds. Swallowing cocaine can cause bowel decay, and injecting it can increase the risk for contracting an infectious disease like HIV/AIDS or hepatitis as well as potentially lead to collapsed veins and skin infections. Chronic abuse of cocaine also raises the risk for addiction.
High Risk for Cocaine Addiction
Cocaine interferes with the way dopamine is reabsorbed back into the brain. Dopamine is a chemical messenger that is produced by the brain and influences how a person feels pleasure. Cocaine increases levels of dopamine in the brain by keeping it from being naturally reabsorbed, therefore creating a flood of the neurotransmitter. High levels of dopamine contribute to the intense euphoric high that the drug produces. When dopamine levels drop after the drug wears off, moods are significantly impacted.
Cravings for cocaine can be intense. The drastic interference of how dopamine is naturally transmitted causes it to be a highly addictive drug. It can take time for dopamine levels to return to normal after cocaine use, thereby creating dependence on the drug. It can become difficult to feel balanced or normal without it. A person may need to take more cocaine and higher doses to keep feeling the drug’s desired impact as well; this is called tolerance.
Cocaine dependency is typically thought to be more emotional than physical as the psychological withdrawal symptoms can be fairly intense. Anxiety, depression, suicidal thoughts and behaviors, irritability, agitation, difficulties concentrating and thinking clearly, sleep disturbances, and cravings signify cocaine withdrawal.
In addition to tolerance, withdrawal symptoms, cravings, and drug dependence are signs of cocaine addiction. Additional signs include:
- Trying to stop cocaine use more than once but not being able to
- Taking cocaine for longer or in higher doses than initially intended
- Spending a lot of time getting and using cocaine, experiencing cocaine intoxication, and recovering from the cocaine crash
- Continuing to use cocaine even with the knowledge that doing so will be harmful to one’s physical or mental health
- Spending less time doing activities that do not involve cocaine use or abuse
- Doing cocaine in potentially dangerous situations
- Inconsistent attendance to regular obligations, including those involving family, school, or work
- Continuing to use cocaine despite obvious social and behavioral issues that are attached to the drug abuse
A person who is struggling with addiction involving cocaine may pay less attention to their personal hygiene as well. Unemployment, financial strain, interpersonal relationship issues, and homelessness are potential side effects of cocaine addiction.
Addiction is a brain disease that has a long reach into many parts of a person’s life; fortunately, it can be treated with specialized care.
Getting Help for Cocaine Addiction
Cocaine withdrawal can be emotionally intense. A medical detox program with around-the-clock medical care, supervision, encouragement, and support can help to minimize potential episodes of relapse. After a few days to a week in a detox program, a comprehensive addiction treatment program is a positive way to promote abstinence and enhance recovery.
Behavioral therapies are often considered the frontline treatment for cocaine addiction, as they can help individuals learn coping skills and tools for dealing with potential triggers and managing and reducing relapse. Contingency Management (CM) programs that offer small rewards for clean drug tests can also beneficial for sustaining sobriety during cocaine addiction treatment and recovery.
There are no specific medications for treating cocaine addiction; however, pharmacological tools may still be useful in mitigating withdrawal symptoms and helping to diminish cravings. Drugs like topiramate, which is technically an anticonvulsant drug, may be used off label to manage cocaine cravings during addiction treatment, Science Daily publishes. Antidepressant and sleep aids may help to stabilize low moods and enhance sleep, as well.
Peer support groups and 12-Step programs like Cocaine Anonymous (CA) can provide a healthy peer network that can offer encouragement and tips for sustaining long-term recovery.
Addiction is a personal and complex disease, and there are a wide range of treatment options to choose from. Each person and their family should work with a professional and highly trained treatment consultant to determine which program is right for them. With the right help, recovery is within reach.