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Cocaine Overview

Cocaine is a powerfully addictive, psychoactive, stimulant drug. On the street it is usually sold as a fine, white powder. The powdered, hydrochloride salt form of cocaine can be snorted or dissolved in water and injected. Freebase, or crack is cocaine hydrochloride that is processed with ammonia or sodium bicarbonate (baking soda solution) and heated to remove the hydrochloride salt. This ‘freebase’ form of cocaine is not water-soluble; it comes in a rock crystal that can be heated and its vapors smoked. Crack may be processed with a high percentage of impurities. The term "crack" refers to the crackling sound heard when it is heated prior to smoking. Cocaine use in the U.S. is illegal when used as recreational drug. In the U.S. cocaine is classified as a Schedule II drug, meaning it has a high potential for abuse but can be administered by a physician for legitimate medical uses. By prescription, it is available in the U.S. as a solution for local mucosal anesthesia, but is infrequently used due to safer alternatives, such as lidocaine or benzocaine. Cocaine originates from coca leaves, and has been used for centuries in a variety of cultural applications. Pure cocaine is extracted from the Erythroxylon coca bush, found primarily in the South American countries of Peru, Bolivia, and Columbia. Coca-leaf infusions or teas have been used to combat altitude sickness and boost energy in many native tribes of South America.

Cocaine Abuse Treatment

The extensive abuse of cocaine has lead to efforts to develop treatment programs for this type of drug abuse. The majority of abusers seeking treatment programs smoke crack, and are likely to be polydrug abusers. Strategies are needed to address the neurobiologial, social and medical aspects of cocaine addiction. Behavioral and pharmacologic strategies are required. As of December 2011, there were no FDA-approved medications to treat cocaine addiction. One of the National Institute on Drug Abuse's top research priorities is to find a medication to block or greatly reduce the effects of cocaine, to be used as one part of a comprehensive treatment program. The National Institute on Drug Abuse funded researchers are also looking at medications that help alleviate the severe craving that people in treatment for cocaine addiction often experience. Several medications are currently being investigated for their safety and efficacy in treating cocaine addiction. Vigabatrin, modafinil, tiagabine, disulfiram and topiramate show promise in controlled clinical trials. Additionally, in 2011, treatments that target dopamine D3 receptors were being researched for safety in humans. In addition to treatment medications, behavioral interventions - particularly cognitive behavioral therapy - can be effective in decreasing drug use by patients in treatment for cocaine abuse. Providing the optimal combination of treatment and services for each individual is critical to successful outcomes.

Cocaine Signs of Abuse

There are several signs of abuse of cocaine that a person may display if they are becoming addicted to the substance. Here are some of these signs that should raise some red flags on cocaine abuse:

  • Look at their nose. The nasal passage of the person will be agitated by the inhalation of drugs. This will often result in sniffing or rubbing of the nose. Also look at the person's septum (the piece of flesh that divides the nostrils). This will thin with regular cocaine use.

  • Money or paper in rolls. One method used for taking cocaine is to roll up money and inhale the drug through it. If the paper money from this person's wallet is always curled into rolls, then they may have used it to snort cocaine.

  • Powder or dirt along the edge of plastic cards. If someone regularly uses cocaine they will cut and make "lines" of the drug. Using a bank or credit card to do so allows dirt and powder to accrue on the side of the card.

  • Emotional state. If the person experiences erratic mood swings, then they may be using drugs. Early in its use, the cocaine will give the user large bursts of energy. However, with repeated use, the person will eventually feel irritable, paranoid, and restless.

  • Using the restroom more often than usual. If the person does this very often and returns in a more lively mood or is "buzzed," then they have probably been using drugs.

  • Small bags or wraps of paper with powder on lying around or in their pockets.

  • Mysterious phone calls. The person may often take calls in private or try to get you to not hear what they are talking about. If they often take these calls and then suddenly go out to run errands or meet someone, they may be arranging to purchase the cocaine.

Effects of Cocaine Abuse

Cocaine’s effect is described as euphoric with increased energy, reduced fatigue, and heightened mental alertness. Users may be talkative, extraverted, and have a loss of appetite or need for sleep. Cocaine’s psychoactive, pleasurable effects are short-lived without continued administration. Cocaine’s effect occurs in the midbrain region called the ventral tegmental area (VTA). Neuronal fibers from the VTA connect to the nucleus accumbens, an area of the brain responsible for rewards. Animal studies show that levels of a brain chemical (neurotransmitter) known as dopamine are increased in this area during rewards. Normally, dopamine is released and recycled in response to these rewards. The use of cocaine can interfere with this process, allowing dopamine to accumulate and send an amplified ‘reward’ signal to the brain, resulting in the euphoria described by users. Some users of cocaine report feelings of restlessness, irritability, and anxiety. A tolerance to the high may develop - many addicts report that they seek but fail to achieve as much pleasure as they did from their first exposure. Some users will increase their doses to intensify and prolong the euphoric effects. While tolerance to the high can occur, users can also become more sensitive to cocaine's anesthetic and convulsing effects without increasing the dose taken. This increased sensitivity may explain some deaths occurring after apparently low doses of cocaine. Use of cocaine in a binge, during which the drug is taken repeatedly and at increasingly high doses, may lead to a state of increasing irritability, restlessness, and paranoia. This can result in a period of paranoid psychosis, in which the user loses touch with reality and experiences auditory hallucinations.

Cocaine Withdrawal Symptoms

During withdrawal, there can be powerful, intense cravings for cocaine. However, the "high" associated with ongoing use becomes less and less pleasant, and can produce fear and extreme suspicion rather than joy (euphoria). Just the same, the cravings may remain powerful. Primary symptoms may include:

  • Agitation and restless behavior
  • Depressed mood
  • Fatigue
  • Generalized malaise
  • Increased appetite
  • Vivid and unpleasant dreams
  • Headache

Cocaine Abuse Statistics

The National Survey on Drug Use and Health (NSDUH) estimates that in 2010 there were 1.5 million cocaine users aged 12 or older, roughly 0.6 percent of the U.S. population. These estimates were similar to the number and rate in 2009 (1.6 million or 0.7 percent), but were lower than the estimates in 2006 (2.4 million or 1.0 percent). The annual number of cocaine initiates (first time using cocaine) declined from 1.0 million in 2002 to 637,000 in 2010. The number of initiates of crack declined during this period from 337,000 to 83,000. For adults 26 years of age or older, 0.5 percent were estimated as being current users of cocaine in the past year. The average age at first use was for cocaine was 21.2 years old. Use of any illicit drug, especially drugs such as cocaine are of great concern with youth. According to the 2010 Monitoring the Future Survey, a national drug use survey of 8th-, 10th- and 12th-graders in the U.S., the use of cocaine continues to decline compared to previous years. In 2010, 12th-grade use was at 2.9 percent, a decline from 3.4 percent in 2009. Crack use held steady in 2010 compared to 2009, with 1.4 and 1.3 percent, respectively, of high school seniors reporting past year use of crack. According to the NSDUH, 2 out of every 1000 (0.2 percent) youth age 12 to 17 were current users of cocaine. For young adults aged 18 to 25, the current use of cocaine were estimated at 1.5 percent, or 1.5 out of every 100 young adults.

References
http://www.drugabuse.gov
http://www.fda.gov/Drugs
http://www.usa.gov/
http://www.justice.gov/dea/druginfo/factsheets.shtml
http://druginfo.nlm.nih.gov/drugportal/drugportal.jsp

Individualized detox protocols are carefully monitored and tailored to address detox symptoms. As part of our holistic approach, our detox incorporates traditional detox with biofeedback sessions.

Clients being treated in our residential program reside with us for the specific amount of days established in their individualized addiction treatment program.

Our treatment model is rooted in the belief that it is our utmost responsibility to do whatever we can to prepare our clients for life outside of treatment.

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