Cocaine Use Disorder

(Cocaine Abuse; Cocaine Dependence)

by Cynthia M. Johnson, MA

Definition

Cocaine use disorder is when a person keeps using cocaine despite the cognitive, behavioral, and physical problems it causes. It may also cause a person to become dependent.

The powdered form of cocaine can be snorted or dissolved in water and injected. Crack is cocaine in a rock crystal form. It can be heated so its vapors can be smoked.

Causes

The cause is not known. Things like genetics, the environment, and peer pressure may play a role.

Cocaine causes the brain to release large amounts of a chemical called dopamine. This chemical causes feelings of joy. Over time, more cocaine is needed to cause the same release of chemicals. This leads to misuse.

How it Affects the Brain

Cocaine helps release a chemical in the brain that causes joy.

Risk Factors

Things that may raise the risk of this problem are:

Having anxiety, depression, loneliness, and past or current alcohol use disorder
Misuse of medicines
Family history of drug use or acting without thinking

Symptoms

Cocaine use disorder can lead to:

Being unable to stop or limit use
Craving cocaine
Making a habit of using cocaine even though it causes problems
Rapid increase in the amount of cocaine needed
Use that gets in the way of doing normal things
Using a lot of effort to get more cocaine

With regular use, the body begins to need cocaine to get through the day. A person may get sick when they stop or use less cocaine. It may result in irritability, exhaustion, nausea, vomiting, shaking, and sweating. This can make it harder to stop using.

Diagnosis

The doctor will ask about your symptoms and health history. You will also be asked about your cocaine use. A physical exam will be done. This is often enough to make the diagnosis.

Blood, urine, saliva, sweat, and hair may also be tested to look for signs of cocaine use.

Treatment

The first step is to stop using cocaine. This is also known as detox. The second step is to change behaviors to stop from using the drug again.

It can take some time to recover. Treatment may be given in a rehabilitation program. Many people may need to be treated several times. It may include one or more of the following:

Medications

Medicines may be given to ease withdrawal symptoms and lower the risk of using again. Common ones are:

Antidepressants
Topiramate and gabapentin to lower the risk of seizures
Methylphenidate—a stimulant
Baclofen—a muscle relaxant
Modafinil to improve alertness
Disulfiram to reduce abuse, especially in those who also use alcohol

Therapy

Therapy can help a person learn about the issues and lifestyle choices that lead to cocaine use. This can help a person learn coping and problem-solving skills. A person can also learn how to replace cocaine use behaviors with healthier choices. Therapy sessions may be one on one or with a person's family.

Support Groups

Narcotics Anonymous is a 12-step program. It helps to support people who are recovering from cocaine use disorder.

Prevention

The best way to prevent cocaine use disorder is to never use cocaine.

RESOURCES:

Cocaine Anonymous
http://www.ca.org

National Institute on Drug Abuse
https://www.drugabuse.gov

CANADIAN RESOURCES:

Native Alcohol and Drug Abuse Counseling Association of Nova Scotia
http://nadaca.ca/

Southern Ontario Cocaine Anonymous
http://ca-on.org

References:

DrugFacts: Cocaine. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/drugfacts/cocaine. Accessed November 17, 2020.

Kampman K, Jarvis M. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. J Addict Med. 2015 Sep-Oct;9(5):358-367.

Opioid abuse and dependence. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/opioid-abuse-and-dependence. Accessed November 17, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 4/14/2021

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