Cocaine Abuse and Treatment Options
According to the most recent National Survey on Drug Use and Health, 1.5 million people were currently using cocaine in 2014.
Approximately 14.8 million people 12 and older have used cocaine at some point in life.
While these numbers are lower than they have been in past years, cocaine use still constitutes a major part of the struggle with substance abuse and addiction in the US.
Cocaine abuse is persistent and can quickly lead to addiction. However, there are treatment options available that can help people who are struggling with cocaine abuse to recover. With proper care, people can learn to manage the persistent triggers and cravings that are the hallmarks of addiction to this substance. By understanding the nature of cocaine use and addiction, it is possible to find a path out of cocaine abuse and manage this condition for life.
What Is Cocaine?
Cocaine – also known as coke, snow, blow, freebase, or crack – is a notorious street drug. A nervous system stimulant used illicitly as a recreational drug, cocaine is described by Drugs.com as a powerful psychoactive substance that creates a euphoric state with feelings of increased energy and alertness.
Cocaine is found in two forms:
- Hydrochloride salt: This white, powdery form of cocaine is the most common form. It can be dissolved in liquid and injected, or inhaled into the nose – referred to as snorting Snorting results in the substance being absorbed through the nasal membranes.
- Base form: The rock-crystal form of cocaine, known as freebase or crack, is processed using ammonia or baking soda and water, and then heated to remove the hydrochloride salt. This creates a hard, crystal substance that will not dissolve in water. The crystal is heated and the resulting vapor is smoked.
Snorting cocaine takes longer to feel the effects; however, the feelings of euphoria and alertness can last up to 30 minutes. Smoking and injecting cocaine result in a faster, more intense high, but it doesn’t last as long – only about 10 minutes.
The History and Development of Cocaine
According to the National Institute on Drug Abuse (NIDA),
cocaine is extracted from a type of plant in Peru and Bolivia called the coca bush, the leaves of which have been chewed and consumed in various ways for thousands of years.
By the late 1800s, this purified extract became popular as an ingredient in many medicines and elixirs that were sold to treat various types of illnesses. These included wines mixed with the drug and sodas – such as colas – made using the coca extract.
A report in the Journal of Clinical Pharmacology states that the highly addictive nature of this substance began to cause concern by the early 20th century, and its use became regulated in 1914 under the Harrison Act. In the late 20th century, a resurgence of illicit cocaine use reached a peak, particularly in the 1980s and 1990s. When Bolivia and Peru began to remove the plants due to this epidemic use, Colombia became the primary producer of the drug.
Cocaine continues to be tightly regulated in the US as a Schedule II substance, meaning that it can be used in some medical applications. However, it is almost never used medically, as other substances have risen to take its place in this setting.
How Cocaine Abuse Develops
Cocaine use, as with many other drugs, often starts with experimentation in youth. This can result from a variety of factors, including:
- Peer pressure from friends and family with permissive attitudes toward drugs
- Family history of substance abuse
- Unstable home life, neglect, or abuse
- Difficulties in school or with social relationships
Cocaine use may also begin in adulthood based on pressure or exposure from friends or social circles, or as a self-medicating response to severe stress or other issues at home or work.
Research demonstrates that the younger a person is when drug use begins, the more likely it is that abuse will develop. However, a study in Drug and Alcohol Dependence shows that there is a 5-6 percent risk of developing dependence on cocaine within the year following first use. This indicates that the main reason cocaine abuse develops is simply through use. Men are more likely to use cocaine than women, and they are also slightly more likely to become dependent on the drug.
Abuse and Addiction
People who regularly abuse cocaine for its euphoric effects are likely to develop psychological dependence on the drug based on its euphoric effects.
Simply, the pleasurable feelings produced make a person want to use it again, creating a pattern of use.
According to an article in Addiction Science & Clinical Practice, even initial use of cocaine can cause changes in the structure of the brain that lead to continued desire for the drug. This is what creates the risk for continued abuse. While some of these changes are temporary and can quickly return to normal, others are more persistent. This means that a craving for the drug can develop even after use has been discontinued for some time, creating a high risk of relapse even in people who have been treated for cocaine abuse.
Scientists are still studying the exact mechanism of cocaine addiction, but it is recognized that some people are more likely to become dependent on cocaine than others. This is most likely due to genetic elements. In fact, use of cocaine has been shown in the above study to produce changes in genetic expression, which in turn create changes in the ways the brain’s pleasure and reward systems operate. These genetic shifts can contribute to long-term addiction.
Signs and Symptoms of Cocaine Abuse
It is possible to recognize when a person is abusing cocaine. The signs that someone is abusing cocaine include:
- Loss of interest in activities that were formerly enjoyed in favor of substance use
- Relationship issues based on cocaine use
- High level of focus on obtaining or using the substance
- Trouble keeping up with responsibilities
- Inability to stop using the substance, even while experiencing negative consequences
According to NIDA, the specific symptoms of cocaine abuse may include:
- Increases in blood pressure and heart rate
- Runny nose or frequent sniffing
- Periods of extreme talkativeness
- Fidgeting or restlessness
- Decrease in sleep and eating
- Sensitivity to light and sound
Sometimes, high doses or continued use of cocaine can lead to erratic or violent behavior, paranoia, panic attacks, and anxiety. Between uses, the person may sometimes appear fatigued or sleepy and experience depression.
Risks of Abuse
Cocaine abuse can lead to detrimental physical and psychological effects.
- High blood pressure and heart arrhythmia
- Loss of sense of smell
- HIV or hepatitis infections due to shared needles
- Respiratory infections or failure
- Addiction or dependence
- Anxiety, panic disorder, paranoia, or psychosis
- Aggression and violent behavior
In addition to these physical and psychological consequences of cocaine abuse, impurities are often found in cocaine. Sometimes, drug dealers will cut powdered cocaine with other substances to be able to make a better profit, and these other substances may be toxic. Crack cocaine is sometimes laced with other psychoactive substances like methamphetamine to increase addictive qualities or intensify the effects. This can result in more adverse physical reactions and lead to death.