Cocaine Addiction Treatment Options

What is Cocaine?

Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. Although health care providers can use it for valid medical purposes, such as local anesthesia for some surgeries, cocaine is an illegal drug. As a street drug, cocaine looks like a fine, white, crystal powder. Street dealers often mix it with things like cornstarch, talcum powder, or flour to increase profits. They may also mix it with other drugs such as the stimulant amphetamine.

How do people use cocaine?

People snort cocaine powder through the nose, or they rub it into their gums. Others dissolve the powder in water and inject it into the bloodstream. Some people inject a combination of cocaine and heroin, called a Speedball.
Another popular method of use is to smoke cocaine that has been processed to make a rock crystal (also called “freebase cocaine”). The crystal is heated to produce vapors that are inhaled into the lungs. This form of cocaine is called Crack, which refers to the crackling sound of the rock as it’s heated.
People who use cocaine often take it in binges—taking the drug repeatedly within a short time, at increasingly higher doses—to maintain their high.

What are the health effects of cocaine use?

Short-term health effects of cocaine include:

  • extreme happiness and energy
  • mental alertness
  • hypersensitivity to sight, sound, and touch
  • paranoia—extreme and unreasonable distrust of others

Some long-term health effects of cocaine depend on the method of use and include the following:

  • snorting: loss of sense of smell, nosebleeds, frequent runny nose, and problems with swallowing.
  • consuming by mouth: severe bowel decay from reduced blood flow.
  • needle injection: higher risk for contracting HIV, hepatitis C, and other bloodborne diseases. However, even people involved with non-needle cocaine use place themselves at a risk for HIV because cocaine impairs judgment, which can lead to risky sexual behavior with infected partners

Can a person overdose on cocaine?

Yes, a person can overdose on cocaine. An overdose occurs when the person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death. An overdose can be intentional or unintentional.
Death from overdose can occur on the first use of cocaine or unexpectedly thereafter. Many people who use cocaine also drink alcohol at the same time, which is particularly risky and can lead to overdose. Others mix cocaine with heroin, another dangerous—and deadly—combination.

Some of the most frequent and severe health consequences leading to overdose involve the heart and blood vessels, including irregular heart rhythm and heart attacks, and the nerves, including seizures and strokes.

How can a cocaine overdose be treated?
Because cocaine overdose often leads to a heart attack, stroke, or seizure, first responders and emergency room doctors try to treat the overdose by treating these conditions, with the intent of:

  • restoring blood flow to the heart (heart attack)
  • restoring oxygen-rich blood supply to the affected part of the brain (stroke)
  • stopping the seizure

How does cocaine use lead to addiction?

As with other drugs, repeated use of cocaine can cause long-term changes in the brain’s reward circuit and other brain systems, which may lead to addiction. The reward circuit eventually adapts to the excess dopamine brought on by the drug. As a result, people take stronger and more frequent doses to achieve the same high and feel relief from initial withdrawal. Withdrawal symptoms include:

  • depression
  • fatigue
  • increased appetite
  • unpleasant dreams and insomnia
  • slowed thinking

How can people get treatment for cocaine addiction?

Behavioral therapy may be used to treat cocaine addiction. Examples include:

  • cognitive-behavioral therapy
  • contingency management, or motivational incentives—providing rewards to patients who remain substance-free
  • therapeutic communities—drug-free residences in which people in recovery from substance use disorders help each other to understand and change their behaviors

While no government-approved medicines are currently available to treat cocaine addiction, researchers are testing some treatments, including:

  • disulfiram (used to treat alcoholism)
  • modafinil (used to treat narcolepsy—a disorder characterized by uncontrollable episodes of deep sleep)
  • lorcaserin (used to treat obesity)