Cocaine: dependence, symptoms and treatment
Last reviewed: 23.04.2024
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High doses of cocaine can cause euphoric agitation and schizophreniform symptoms. Psychological and physical dependence can lead to severe addiction.
Most people who use cocaine take it periodically for entertainment and voluntarily stop using it. However, in North America, cocaine use and the development of addictive behavior are increasing, despite recent data on their decline. The availability of highly biologically active forms, such as crack, exacerbates the problem of cocaine dependence.
Although, as a rule, cocaine is inhaled in the US, smoking of cocaine has also been described many times. Hydrochloride salt is converted into a more volatile form, usually by adding NaHC0 3, water and heat. The converted material is burnt and the combustion products are inhaled. The onset of the effect is faster, the intensity of narcotic intoxication increases. The use of crack does not apply to the suburbs or urban middle class: its main consumers continue to be Americans with low incomes.
There is a tolerance to cocaine. Abolition in the case of expressed consumption is characterized by doubt, increased appetite and depression. There is a pronounced tendency to continue taking the drug after the withdrawal period.
[Symptoms of Cocaine Dependence
Acute intoxication. Effects vary depending on the mode of administration. With injection or smoking, cocaine causes hyperstimulation, alertness, euphoria, a sense of competence and strength. Excitement and narcotic intoxication are similar to those caused by injectable amphetamines. Sensations of inhaling cocaine powder are less intense and destructive.
Overdose can lead to tremors, convulsions, delirium. Death can occur as a result of myocardial infarction, arrhythmias, heart failure. In patients with severe clinical toxicity, the activity of serum cholinesterase, the enzyme necessary for cocaine elimination, can be atypically reduced at a genetic level. Combined use of cocaine and alcohol leads to the formation of a condensed product, cocaine, which has stimulating properties and can exacerbate toxicity.
Chronic use. Since cocaine is a very short-acting drug, some patients can inject it or smoke every 10-15 minutes. Such repetition causes toxic effects, such as tachycardia, hypertension, mydriasis, muscle twitching, insomnia and pronounced nervousness. May develop hallucinations, delusions of persecution, aggressive behavior, which can make a person dangerous. Pupils maximally expanded, sympathomimetic properties of the drug increase the frequency of respiration and heartbeat, blood pressure.
Severe toxic effects are observed with compulsive heavy consumption. The rarely repeated inhalation 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.
Treatment of dependence on cocaine
Treatment of acute intoxication with cocaine is usually not required, since this drug is extremely short-acting. If an overdose requires intervention, intravenous barbiturates or diazepam may be used, but careful monitoring and supportive care is appropriate. Anticonvulsants do not prevent seizures due to an overdose of cocaine. It is necessary to treat hyperthermia or significantly increased blood pressure, which is rare.
The cessation of long-term use requires significant help, and the depression that may develop as a result requires careful monitoring and treatment. There are many options for nonspecific therapy, including support and self-help groups, cocaine hotlines. Perhaps very expensive inpatient treatment.