Cocaine is an addictive stimulant drug that causes changes in the brain’s structure as well as function when used recurrently. There are multiple names for cocaine such as Powder/ Blow/ Snow/ C / Coke. Cocaine dealers frequently “cut”/ mix cocaine with other substances which can be either non-psychoactive or with heroin (called speedball) or procaine or amphetamine. Cocaine when treated with ammonia or baking soda converts to a smokable substance called ‘crack’.
Routes of administration:
Cocaine can be consumed orally by rubbing onto gums or inhaled as powder as well as intranasally and intravenously.
Intoxication and withdrawal:
Cocaine intoxication has physical effects such as tachycardia, bradycardia, arrhythmias, and elevated blood pressure. Chronic administration of cocaine can induce a paranoid psychotic state that can be long-lasting and recurrent. Withdrawals are characterized by dysphoric mood, fatigue, vivid dreams, changes in sleep, and psychomotor agitation. During the late withdrawal phase, a person may experience brief periods of intense, cue-induced drug craving and be at high risk for relapse.
Cocaine’s effect on the brain:
Cocaine induces alterations in the brain. It leads to adaptive changes in the glutamate (neurotransmitter) system within the brain. Using cocaine repeatedly also affects the stress system of the brain located in the Ventral Tegmental Area which results in drug-seeking behavior when the individual is exposed to stress. Long-term cocaine use causes changes in the frontal cortex which leads to impairment in decision-making.
Cocaine-related myocardial ischemia and infarction are the most serious complications of cocaine abuse, and chest pain is the most common symptom in cocaine users presenting to the emergency department. Cardiac risks appear to be unrelated to the amount, route, or frequency of cocaine use.
Cocaine Addiction treatment:
Acceptance of one’s struggle with cocaine addiction is the first step towards recovery. Cocaine addiction should be treated by approaching professional help followed by a detoxification and rehabilitation program in a treatment center offering solutions for cocaine addiction. Dual diagnosis rehabilitation centers offering treatment for cocaine and other substances as well as co-occurring psychological conditions are the ideal and the best option for cocaine de-addiction.
Numerous medications are under clinical trials for research on the pharmacological treatment of cocaine dependence. Disulfiram is one such medication that has shown a promising and positive response in reducing cocaine use.
Also, a cocaine vaccine has been used to treat cocaine addiction, however, it currently provides antibodies for a duration of 2 months and is effective in 38% of patients.
Numerous behavioral interventions and therapies did on an outpatient or inpatient basis help in effectively dealing with cocaine dependence. However, research shows that overlap of pharmacological and behavioral interventions leads to a maximum response in individuals. Cognitive-behavioral therapy and contingency management are effective behavioral interventions targeting cocaine addiction in patients. Inpatient residential rehabilitation programs in Drug rehab centers are effective treatment options for cocaine users which require 3 to 6 to 12 months stay depending on factors such as the severity of dependence, duration of dependence, and personality of the individual. Continuing care or after-care programs following the inpatient rehabilitation treatment are an integral component of relapse prevention in individuals. A 12-step program (Cocaine Anonymous) helps in maintaining sobriety for many persons.