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Cocaine Use Disorder

Definition:
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,” which is cocaine in a rock crystal form, can be heated and its vapors smoked.

Cocaine use disorder is treatable, but it takes perseverance and determination. Talk to your doctor if you think you have cocaine use disorder.

Causes:
Cocaine stimulates the brain to release large amounts of the hormone dopamine, which, when amassed in sufficient quantities, results in the euphoria commonly reported by cocaine abusers. As a person continues to use cocaine, a tolerance is developed, and this means that higher doses and more frequent use are required to maintain the euphoria.

Furthermore, when a cocaine user stops using abruptly, they experience a crash or withdrawal. This results in an extremely strong craving for more cocaine, as well as fatigue (being tired), loss of pleasure in life, depression, anxiety, irritability, sleepiness, and sometimes paranoia. These symptoms often prompt the user to seek more cocaine to alleviate these symptoms of withdrawal.

Risk Factors:
The following factors increase your chances of developing cocaine use disorder. If you have any of these risk factors, tell your doctor:
  • Age: 18-25
  • Sex: men
Symptoms:
The symptoms below are associated with cocaine use disorder. If you experience any one of them, see your physician.
  • Short-term effects of cocaine use:
    • Euphoria
    • Increase in energy
    • Excessive talking
    • Being mentally alert
    • Decreased need for food and sleep
    • Dilated pupils
    • Increased temperature
    • Increased heart rate
    • Increased blood pressure
    • Bizarre, erratic, or violent behavior
    • Vertigo
    • Muscle twitches
    • Paranoia
    • Restlessness, irritability, and anxiety
    • Cardiac arrest
    • Seizures
    • Sudden death
  • Long-term effects of cocaine use:
    • Uncontrollable or unpredictable cravings
    • Increased tolerance
    • Increased dosing
    • Use of cocaine in a binge
    • Increasing irritability, restlessness, and paranoia
    • Full-blown paranoid psychosis
    • Auditory hallucinations
  • Medical complications of cocaine use:
    • Heart rhythm abnormalities
    • Heart attack
    • Chest pain
    • Respiratory failure
    • Stroke
    • Seizure
    • Headache
    • Abdominal pain
    • Nausea
Diagnosis:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. He or she will ask you specific questions about your cocaine use, such as how long you have been using cocaine and how often you use it.

Treatment:
Talk with your doctor about the best treatment plan for you. Treatment programs may be in- or outpatient. They may require that you have already stopped all cocaine use, they may involve a detoxification program, or they may begin working with you even though you are still actively using cocaine.

Medications
There are currently no medications available to treat cocaine use disorder specifically, but topiramate, modafanil, and baclofen have shown some promise in treating cocaine use disorder. In addition, antidepressant drugs may benefit people who are in the early stages of cocaine abstinence.

Behavioral Therapy
Behavioral therapies to help people quit using cocaine are often the only available, effective treatment for cocaine use disorder. Such therapies include contingency management, in which people receive positive rewards for staying in treatment and remaining cocaine-free. Also, cognitive-behavioral therapy helps people who are addicted to cocaine learn to abstain and remain abstinent from cocaine.

Rehabilitation Programs
In rehabilitation programs, people with cocaine use disorder stay in a controlled environment for 6-12 months, during which they may receive vocational rehabilitation and other support to reintegrate into society.

Prevention:
The best way to prevent cocaine use disorder is to never use cocaine, since it is highly addictive.
 
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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