Overview, Causes, & Risk Factors

Cocaine is a strongly addictive stimulant drug that comes from the leaves of the coca plant. Some forms of cocaine are used in medicines, such as local anesthetics for eye, ear, and throat surgery. Cocaine is usually sold on the street as a fine white powder. It is generally either sniffed into the nose or injected by needle into a vein. When cocaine is boiled with sodium bicarbonate, it is converted into a freebase form called crack cocaine. This can then be smoked and results in a brief, intense high. Crack is relatively cheap and extremely addictive.

What is going on in the body?

A person can introduce cocaine into the body through these routes:

absorption through the skin after it is rubbed on mucous tissues

inhaled from smoking, which includes crack

injected into the vein, which is called mainlining

intranasally, which means snorting the cocaine through the nose

orally, which is called chewing

After it is introduced into the body, cocaine passes readily into the brain. In the brain, it causes a buildup of dopamine by blocking the normal recycling process. These high levels of dopamine continuously stimulate nerve cells, causing the euphoria, or high.

The effects of cocaine can be felt within seconds. Cocaine provides a dramatic high that lasts 3 to 5 minutes with crack cocaine. The high lasts for up to 30 to 60 minutes when cocaine is snorted or injected. Afterward, the user feels an intense craving for the drug.

Dependency can develop in less than 2 weeks. Some research indicates that a psychological dependency may develop after a single dose of high-potency cocaine. As the person develops a tolerance to cocaine, higher and higher doses are needed to produce the same level of euphoria.

What are the causes and risks of the condition?

Cocaine abuse is more likely if family members or friends abuse drugs or alcohol.

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Symptoms & Signs

What are the signs and symptoms of the condition?

The short-term symptoms of a normal dose of cocaine are as follows:

energetic, talkative, restless behavior

euphoria, or an intense high

increase in heart rate, temperature, and blood pressure

mental alertness, especially to sight, sound, and touch

temporary decrease in the need for food and sleep

In larger doses of several hundred milligrams or more, cocaine may cause these additional symptoms:

bizarre, erratic, and violent behavior

muscle tremors or twitches

paranoia

vertigo, or a sense that the room is spinning around

Following are some of the signs and symptoms of regular cocaine abuse:

auditory hallucinations, or hearing sounds that don't exist

inability to give up cocaine use, despite awareness of its real or possible negative effects

large amount of time spent in activities associated with getting cocaine

neglected daily routine

paranoid thinking and problems with reality testing

restlessness, anxiety, or irritability

tolerance to the drug so that more and more of the drug is needed to produce the desired effect

weight loss

Cocaine withdrawal may occur when the person voluntarily stops the drug or is unable to get a dose. Withdrawal symptoms include:

acute situational anxiety

generalized anxiety disorder

panic disorder

post-traumatic stress disorder

phobias

obsessive compulsive disorders

',CAPTION,'Anxiety Disorders');" onmouseout="return nd();">anxiety, irritability, and isolation

fatigue

headache

intense hunger

muscle tremors and cramps

nightmares and other sleep disorders

severe depression

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Diagnosis & Tests

How is the condition diagnosed?

Diagnosis of cocaine abuse begins with a medical history and physical exam. Blood or urine tests can confirm cocaine use.

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Prevention & Expectations

What can be done to prevent the condition?

More education is needed for people at high risk of dependence on cocaine. This education needs to begin in childhood so that people can form healthy attitudes and understand the risks of drug use. Reducing society's tolerance of drug abuse can also help to deter cocaine use.

What are the long-term effects of the condition?

Serious physical decline will occur with long-term cocaine use. These effects may be due to the drug itself or to the lifestyle associated with the cocaine use. Long-term effects can include:

arrhythmias, or abnormal heart rhythms

breathing problems and respiratory failure

chest pain

chronic abdominal pain and nausea

chronic headaches

cocaine psychosis and other psychiatric disorders

heart attack

hematomas of the nasal septum

increased risk for infectious diseases, such as hepatitis and HIV

neurological problems, including cognitive impairments

stroke

seizures

When an individual takes cocaine and alcohol at the same time, the toxicity of both drugs is increased. The combination of cocaine and alcohol is the leading cause of drug-related deaths from mixtures of drugs.

What are the risks to others?

If a woman uses cocaine during her pregnancy, her baby may be born with cocaine dependency. The infant is also more likely to have a low weight at birth or be born prematurely. Infants can be stillborn or have birth defects. As the child grows up, he or she may have subtle learning and behavior problems.

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Treatment & Monitoring

What are the treatments for the condition?

Treatment begins with helping the person to recognize that there is a problem. People who are dependent on cocaine tend to deny the severity of the problem and to refuse to admit it to others. Once the person has recognized and admitted a problem, the goal is complete abstinence from the drug. Some people may need to be monitored for any medical problems that result from the cocaine use.

There are no medications to treat cocaine abuse specifically. Medicines may be used to treat symptoms of cocaine abuse. For examples, anticonvulsants may be used to control seizures.

anxiety

depression

eating disorders such as anorexia nervosa and bulimia

alcohol and drug abuse problems

',CAPTION,'Cognitive Behavioral Therapy');" onmouseout="return nd();">Cognitive behavioral therapy is often used to help the person change underlying beliefs and behaviors related to cocaine. Recovery programs are helpful for many people after they are medically stable. These programs help people to learn new coping skills and strategies to manage their lives without cocaine. Self-help groups like Narcotics Anonymous and Cocaine Anonymous have been very effective in helping thousands of people stay free of drugs.

Severe depression is common after stopping cocaine use and may last for months or years after the last use of the drug. The use of antidepressants for this depression is common.

What are the side effects of the treatments?

Medications may cause drowsiness, dry mouth, or allergic reactions.

What happens after treatment for the condition?

Those who complete treatment often continue with counseling or self-help groups. It is very important for the person to avoid situations that may lead to returning to cocaine use.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

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