Cocaine: addiction, symptoms and treatment

High doses of cocaine can cause euphoric excitement and schizophreniform symptoms. Psychological and physical dependence can lead to severe addiction.

Most cocaine users use it occasionally for recreational purposes and voluntarily stop using it. However, in North America, cocaine use and addictive behavior are increasing, despite recent evidence that they are declining. The availability of highly biologically active forms such as crack exacerbates the problem of cocaine addiction.

Although cocaine is typically inhaled in the United States, smoking cocaine has also been described many times. The hydrochloride salt is converted to a more volatile form, usually by adding NaHC03 _, water, and heat. The converted material is burned, and the combustion products are inhaled. The onset of effects is quicker, and the intensity of the drug's effects is greater. Crack use is not confined to the suburbs or urban middle class; low-income Americans continue to be its primary users.

Cocaine tolerance occurs. Withdrawal from heavy use is characterized by somnolence, increased appetite, and depression. There is a strong tendency to continue taking the drug after the withdrawal period.

[ 1 ], [ 2 ]

Symptoms of Cocaine Addiction

Acute intoxication. Effects vary depending on the route of administration. When injected or smoked, cocaine produces hyperstimulation, alertness, euphoria, and feelings of competence and power. The excitement and narcotic intoxication are similar to those produced by injected amphetamines. The sensations from snorting cocaine powder are less intense and disruptive.

Overdose may result in tremors, convulsions, and delirium. Death may occur as a result of myocardial infarction, arrhythmia, and heart failure. Patients with severe clinical toxicity may have atypically reduced activity of serum cholinesterase, an enzyme necessary for the elimination of cocaine, at the genetic level. Combined use of cocaine and alcohol results in the formation of a condensed product, cocaethylene, which has stimulating properties and may aggravate toxicity.

Chronic use. Since cocaine is a very short-acting drug, some patients may inject or smoke it every 10-15 minutes. Such repetition causes toxic effects such as tachycardia, hypertension, mydriasis, muscle twitching, insomnia, and severe nervousness. Hallucinations, delusional ideas of persecution, and aggressive behavior may develop, which can make a person dangerous. Pupils are maximally dilated, sympathomimetic properties of the drug increase respiratory rate, heart rate, and blood pressure.

Severe toxic effects are observed with compulsive heavy use. Rarely repeated snorting of cocaine causes perforation of the nasal septum due to local ischemia. Repeated smoking of volatile crack cocaine in high doses can lead to severe toxic cardiovascular and behavioral consequences.

Cocaine Addiction Treatment

Treatment of acute cocaine intoxication is usually not necessary because the drug is extremely short-acting. If overdose requires intervention, intravenous barbiturates or diazepam may be used, but close observation and supportive care are the appropriate approach. Anticonvulsants do not prevent seizures due to cocaine overdose. Hyperthermia or markedly elevated blood pressure, which is rare, should be treated.

Stopping long-term use requires significant help, and the depression that may develop as a result requires careful monitoring and treatment. There are many non-specific treatment options, including support and self-help groups, cocaine hotlines, and potentially very expensive inpatient treatment.