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Cocaine Dependence

Cocaine dependence, or addiction, is a mental desire to use cocaine often. This is different from infrequent cocaine use because it requires long-term cocaine use for months or more. In cocaine addicts cocaine use continues even with damaging mental, physical and emotional effects[1]. The “high” created by cocaine use results in a deep feeling of happiness and high amounts of energy. Long-term cocaine use can result in withdrawal, overdose, and even death. With long-term cocaine use changes are seen in the reward and motivation center of the brain[3].

Numbers

Illegal drugs use costs the United States close to 200 billion dollars every year, due to crime, work loss, and health care[2]. Every day 5,000 people try cocaine for the first time[2]. Cocaine is responsible for more U.S. emergency room visits than any other illegal drug[2]. Deaths from cocaine use are around 6,000-10,000 every year[1]. A recent study looking at people in the United States over the age of 12 found 14.5 percent have used cocaine in their lifetime[11]. This percentage is higher than any other illegal drug except marijuana. Another recent study reported that 75% of all people who use cocaine will become addicted at some point in their lives[11].

Risks

There are many risk factors effecting a persons chance of developing a cocaine addiction. Different mental illness can play a large role in an individual’s chance of becoming cocaine dependent[3]. Other things like environment, health, and income can also effect an individuals chances of becoming cocaine dependent[3]. Gender is another factor which effects a persons chances of becoming cocaine dependent[4]. A recent study found women are 3.3 times more likely than men to become cocaine dependent[4]. Another factor is the age at which cocaine use begins. One study found people who started using before age 14 were 4 times more likely to become addicted than those who started after age 20[4]. Lastly there are biological risk factors. Some people born with certain genes are more likely to develop an addiction than people without those genes[10].

Signs and Symptoms

Some signs of cocaine use are increased heart rate, high amounts of energy, increased body temperature, fast talking, and wide pupils[3]. Many long-term cocaine users display manic behaviors including aggression, paranoia, insomnia, and anxiety[1][6]. Cocaine use may also cause nosebleeds and unhealthy decreases in weight[2]. Cocaine dependence has many bad effects on the body. Cocaine increases heart rate while tightening arteries that are supplying blood to the body and brain[3]. This can lead to heart attack, seizure, or stroke[3]. Long-term cocaine use can also cause an irregular heartbeat which can lead to death[3]. Cocaine dependent individuals may also experience kidney failure[1].

Dependence in the Brain

Cocaine dependence has strong effects on the brains ability to process natural rewards[10]. Natural rewards are things like food, sugar, and exercise. The reward system of the brain is activated by increases in dopamine[10]. Reward is strongly linked to desire and motivation. When an activity is done and is rewarding, it is strengthened in the brain as a good activity. Cocaine turns on this pathway in the same way as a natural reward, but at a much more intense level. With long-term cocaine use the brain produces changes that cause natural rewards to decrease in their ability to turn the reward pathway on[10][11]. This decrease in value of natural rewards causes the brain to increase its desire for cocaine as the only way to produce reward[10][11].

Tolerance

Cocaine dependence results in tolerance. Cocaine tolerance means needing more cocaine to reach the same "high" the user normally feels[18][19]. Cocaine tolerance is a big sign of addiction. Tolerance increases if cocaine use is continued at the same rate, however tolerance is reversible. Reversible tolerance means if an individual stops using cocaine their tolerance will decrease[18].

Withdrawal

Long-term cocaine use can make it very difficult to stop using. If a cocaine dependent individual stops taking cocaine they may experience withdrawal symptoms. Withdrawal is often referred to as the "crash". Withdrawal symptoms include intense desire for cocaine, paranoia, anger, psychosis, and depression[14]. Some cocaine users may experience withdrawal symptoms like stomach or body aches. Cocaine withdrawal symptoms usually last anywhere from 1 week to a month[14]. The mental desire to use cocaine may not fully go away, or may disappear only temporarily. About 30-40 percent of cocaine addicts will use other drugs after stopping cocaine use[14]. While its difficult to say how many cocaine addicts relapse after quitting, a recent study estimates as high as 90 percent[14].

Treatment

Currently there is no medicine proven to treat cocaine dependence[22][23]. Many options are available for people struggling with cocaine addiction. Some options include psychotherapy, cognitive-behavioral therapy, and cocaine anonymous[15][22][24]. Cocaine anonymous is program where cocaine addicts come together, without sharing names, and provide emotional support to one another.

References

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4. O'Brien MS, Anthony JC (2005). "Risk of becoming cocaine dependent: epidemiological estimates for the United States, 2000–2001.". Neuropsychopharmacology 30 (5): 1006–1018. doi:10.1038/sj.npp.1300681. PMID 15785780.
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10. Ian Sample (2009-11-11). "All in the family - scientists discover gene for cocaine addiction". The Guardian.
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