Cocaine use disorder is when the use of cocaine harms a person’s health or social functioning, or when a person becomes dependent on cocaine. The powdered form of cocaine can be snorted or dissolved in water and injected. Crack is cocaine in a rock crystal form. It can be heated so its vapors can be smoked.
Cocaine use disorder is treatable. But, it takes hard work. Talk to your doctor if you think you have this condition.
Cocaine stimulates the brain to release large amounts of the hormone dopamine. Dopamine results in the euphoria commonly reported by cocaine abusers. As a person continues to use cocaine, a tolerance is developed. This means that higher doses and more frequent use are needed to maintain the euphoria.
Release of Dopamine in the Brain
The dopamine connecting to the receptors causes a euphoric feeling. This occurs naturally, but cocaine causes an exaggerated response that can lead to addiction.
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When a cocaine user stops using abruptly, a crash or withdrawal occurs. This results in an extremely strong craving for more cocaine. It also results in fatigue, loss of pleasure in life,
anxiety, irritability, suicidal thoughts, and sometimes paranoia. These withdrawal symptoms often prompt the user to seek more cocaine.
Cocaine use disorder is more common in young men and in those aged 18-25 years old. However, cocaine use disorder can occur in anyone at any age.
Symptoms associated with cocaine use disorder include:
Short-term effects include:
EuphoriaIncrease in energyExcessive talkingBeing mentally alertDecreased need for food and sleepDilated pupilsIncreased temperatureIncreased heart rateIncreased blood pressureBizarre, erratic, or violent behaviorVertigoMuscle twitchesParanoia
Restlessness, irritability, and
anxietyHeart attackSeizuresSudden death
Long-term effects include:
Cravings that can't be controlled or predictedIncreased toleranceIncreased dosingUse of cocaine in a bingeIncreased irritability, restlessness, and paranoiaParanoid psychosisHearing sounds that aren't there
Medical complications include:
Heart rhythm abnormalitiesHeart attackChest painRespiratory failureStrokeSeizureHeadacheAbdominal painNauseaChronic runny nose or septal perforation
Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will ask specific questions about your cocaine use, including how long you have been using the drug and how often.
Talk with your doctor about the best treatment plan for you. Treatment programs may be inpatient or outpatient and may: Require that you have already stopped using cocaineInvolve a detoxification program
There are currently no medications to specifically treat cocaine use disorder.
Treatment with medication focuses on the symptoms of euphoria and craving. Medications that have shown some promise include: Modafinil—wakefulness promoting agentN-acetylcysteineTopiramate—seizure medicationDisulfiramAgonist replacement therapyBaclofenAntidepressants—may be helpful for people in the early stages of stopping cocaine use
Behavioral therapies to help people quit using cocaine are often the only available, effective treatment for cocaine use disorder. Therapies include contingency management. With this program, people receive positive rewards for staying in treatment and remaining cocaine-free. Also,
cognitive behavioral therapy
helps people to learn how to abstain and remain abstinent from cocaine.
In rehab programs, people with cocaine use disorder stay in a controlled environment for 6-12 months. During this time, they may receive vocational rehab and other support to prepare them to return to society.
The best way to prevent cocaine use disorder is to never use cocaine. It is highly addictive and illegal.
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Last reviewed January 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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