Cocaine Dependence

What is cocaine dependence?

Dependence on cocaine means that you have a strong emotional, psychological, and physical need to take the drug. You might take more of the drug over longer periods than you intended. Using cocaine may interfere with the rest of your life.

Cocaine is a drug made from the leaves of the coca plant, which grows in South America. It is a stimulant, which means it causes talkativeness, increased breathing and heart rate, increased energy, and sleeplessness. In very high doses, it can cause heart attacks and seizures.

Crack, a less expensive form of cocaine that is smoked rather than snorted, has made cocaine abuse a widespread problem.

Some people are more sensitive than others to cocaine. A small amount of the drug can kill people who are sensitive to it.

Pregnant women using cocaine are at high risk of miscarriage. Babies born to cocaine-dependent mothers are addicted at birth. The infants are jittery and don't respond well to people. Babies have to go through the painful process of withdrawal.

Cocaine dependence can be treated, although it is a long-term process. The most important part of treatment is for you to be in a drug-free environment.

How does it occur?

Cocaine powerfully affects some of the chemicals of the brain that change mood and emotions. At first you feel pleasure, increased energy, and enhanced self-esteem. You also experience decreased anxiety and social inhibitions.

Cocaine also affects sexual behavior. In small doses cocaine increases sexual arousal and makes orgasms and erections easier. In large doses cocaine makes you feel increased sexual desire but you are less able to achieve orgasm. Men may have problems with erectile dysfunction.

Over time, cocaine keeps your brain from storing and using chemical messengers that create these good feelings. Because you lack a way to use these natural chemical messengers, you may feel depressed. As a result, you develop a craving for more cocaine and the good feelings it produces.

As the addiction progresses, you tend to withdraw from friends and spend more time using cocaine. Later, you may lose your job and become isolated from everyone. Family problems and crises occur, such as divorce and financial problems.

What are the symptoms?

If you use cocaine over a long period you feel wired, irritable, and depressed. You can't sleep. You lose your appetite and are not content with life. You may also:

• lose your sex drive
• develop disturbed thinking, such as paranoid delusions (ideas that others are out to get you when they are not)
• get depressed
• in some circumstances, have hallucinations (for example, seeing things that are not there or feeling things, such as bugs under your skin, that are not there)
• feel disoriented

Other symptoms of cocaine dependence include:

• use of the drug all through the day
• episodes of overdose
• problems in social activities and work, such as missing work, fighting, losing friends
• not being able to reduce or stop the use of cocaine

When you stop taking the drug and the level of it in your blood drops, you are said to "crash." Possible effects of crashing include:

• depression
• fatigue
• suicidal feelings
• sleepiness
• decreased level of activity
• increased craving for cocaine

How is it diagnosed?

To diagnose cocaine dependence, your healthcare provider will review your symptoms, examine you, and take a history of drug use. He or she may order an analysis of your urine. Cocaine can remain in urine for many hours after you have used the drug.

How is it treated?

Usually, the first thing your healthcare provider treats are your physical complications. Complications of cocaine dependence may include:

• effects on the heart, including heart attack, disturbances in the rhythm of the heart, and high blood pressure
• effects on the nervous system, including paranoia, hallucinations, lethal high fever, stroke, and seizures

For any treatment to be successful, you must want to give up cocaine. The most important part of treatment is for you to be in a drug-free environment. Treatment for cocaine dependence is long-term and ongoing. You can join a self-help group (for example, Cocaine Anonymous), a support group, a therapy group, or be part of a supervised treatment program. The healthcare providers and counselors in any treatment program will work with you regularly to help you adapt to a life free from cocaine.

While you are withdrawing from cocaine, you may be tempted to use more alcohol and other drugs to reduce your restlessness and anxiety. Seek professional help so that you don't switch to other harmful drugs. Antidepressants and mood stabilizers prescribed by your healthcare provider can help treat both mania and depression that may occur with cocaine withdrawal.

You need to regain general physical health by eating nutritious meals, getting enough sleep, and exercising regularly.

If this therapy does not work, you may need to be hospitalized for treatment.

How can I take care of myself?

The best way to help yourself is to see your healthcare provider and make plans to stop taking cocaine. If you are already seeing a healthcare provider, it is important to take the full course of treatment he or she prescribes.

You may want to call the National Clearinghouse for Alcohol and Drug Information (NCADI) at 1-800-729-6686.

Changing your lifestyle can help you to stop using cocaine. Make the following a regular part of your life:

• Exercise 30 minutes 3 times a week.
• Pursue recreational interests at least once or twice a week.
• Do progressive relaxation exercises daily.
• Imagine, or call to mind, your positive life experiences often.
• Eat a healthy diet.
• Get 7 to 9 hours of rest per night.
• Practice deep breathing exercises during times of high stress.
• Talk with friends and develop other support systems.
• Drink little or no alcohol or caffeine.
• Listen to music to help you relax.
• Develop and maintain an attitude that things will work out.
• Ask for help at home and work when the load is too great to handle.
• Seek professional help to talk through anxiety-producing life events. Ask for help so that you can find positive ways to cope.

How can I avoid cocaine dependence?

Stop using cocaine now and get help. Change your social circle.