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- General Topics
- EATING DISORDERS
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Cocaine is a potent stimulant that has been in use for centuries, and it has a rich historical background. It was extracted from the coca plant found in South America and was first used for medical purposes. It was also incorporated into everyday products such as tonics and beverages. With time, it was realized that cocaine had some addictive qualities, its use was controlled and later banned. Cocaine is among the most used drugs in the current society, and addiction has been known to have severe physical, psychological as well as social effects.
It is important to know the risks associated with cocaine addiction as it is a major public health issue. Cocaine use can cause severe health complications, mental illnesses, and social vices. By understanding what cocaine is, how it is used, and the possibility of addiction, one can understand the significance of prevention, treatment, and recovery.
Cocaine is a stimulant drug that is obtained from the leaves of the plant called coca, which is grown in South America. Its CNS-stimulating property makes it a very strong substance that enhances energy, alertness, and even the feeling of excitement within the shortest time. Originally, it was applied in folk medicine and was once incorporated into the formula for Coca-Cola in the last 1800s. But, as with most things that are enjoyable, it became addictive and was subsequently banned by law.
Cocaine comes in two primary forms:
Powdered Cocaine: This is the most common form which may be insufflated or dissolved in water and then administered intravenously. It is a white crystalline substance that is usually adulterated with other substances such as corn starch or talc to make it heavier for sale.
Crack Cocaine: Crack is a hard and dense form of cocaine that is made from the processing of powdered cocaine with baking soda or ammonia. It is usually smoked, and its effects are very potent and of short duration. Crack was most rife in the 1980s due to its link with an increase in drug use within the urban areas and the resultant criminal activities [1].
Cocaine falls under Schedule II narcotics in many countries because it has a high potential for abuse, but it has some uses in the medical field in certain circumstances, for example, for use in certain surgical operations where it acts as an anesthetic. However, outside of limited medical uses, cocaine is prohibited due to its extreme potential for dependency and misuse.
Cocaine can be abused in several ways, each associated with different risks and patterns of use:
Snorting: This is the most widespread way of cocaine consumption; the powdered substance is insufflated through the nasal cavity. The drug is absorbed through the nasal tissue and this makes it have a rapid effect on the brain hence causing euphoria [1].
Injecting: This method of dissolving the substance in water and injecting it directly into the bloodstream gives an immediate and powerful rush. However, this method has other dangers that include overdose and the spread of diseases like HIV and hepatitis through the use of needles.
Smoking: Crack cocaine is typically ingested through smoking and the effects are felt almost instantly and are extremely potent. Crack smoking provides a stronger but temporary high than that of snorting or injecting the substance.
The methods of use can affect the chances of developing an addiction. Smoking and injecting cocaine usually results in a more acute and powerful effect, which, because of the rapid transition from pleasure to discomfort, encourages continued use.
Usage patterns may not always be the same. Some people may take an overdose of cocaine, taking it in large quantities within a short span to sustain the high, and then feel very tired and sad. Other factors can also influence the probability of cocaine abuse, including peer pressure, socioeconomic status, and experience of environments where cocaine is available.
Cocaine is a very addictive substance because of the impact it has on the brain’s reward pathways. Whenever a person takes cocaine, there is a high release of dopamine which is a neurotransmitter that is responsible for the feelings of pleasure. Normally, dopamine is released to the brain to reward an individual with something he or she enjoys such as food or companionship, and is then reabsorbed by the cells.
Cocaine distorts this process by preventing the reuptake of dopamine therefore a buildup of the substance leads to extreme happiness. This rush is much more potent than the pleasure that is associated with natural activities, and the brain will keep on yearning for the drug.
Cocaine has several immediate consequences on the body and the mind; these include; happiness, energy, mental focus, and self-esteem. However, these effects are temporary and last for as short as 5-60 minutes only. This is succeeded by a ‘crash’ where the individual feels tired, and sad and experiences a strong urge to take the substance again.
Cocaine use has more serious effects when it is taken on a long-term basis. Long-term use leads to tolerance wherein the user requires higher doses of the drug to get the desired impact. It also has severe psychological and physical side effects if taken for a long time they lead to anxiety, paranoia, hallucinations, and violent behaviors. Long-term use has several physical effects on the body; these include heart attacks, respiratory failure, and neurological effects [2].
Cocaine is said to be addictive in a way that is similar to heroin or methamphetamine. While heroin addiction entails a physical compulsion, cocaine addiction is characterized by an intense psychological hold. The high is typically followed by a very low period, which causes the users to seek the high again and again to get out of the low phase.
Several factors can increase the risk of developing a cocaine addiction:
Genetics: Genetic predisposition to addiction also plays a role in substance abuse because people with such a background are more likely to become addicted.
Mental Health: People with mental illnesses such as depression or anxiety may turn to cocaine for treatment purposes.
Environment: One’s risk of using cocaine is also determined by the environments that are easily accessible and promote the use of cocaine.
Age: Cocaine or any other drug that a person is introduced to at a tender age is likely to make him/her become an addict.
It is difficult to identify the signs and symptoms of cocaine addiction in the early stages and this is why; However, as the addiction increases, some behavioral, physical, and psychological changes become noticeable.
Behavioral Signs
Secrecy and Isolation: People may avoid sharing their activities with other people and even isolate themselves from their families and friends to indulge in drug consumption.
Erratic Behavior: Some of the effects of cocaine include mood swings, aggression, and impulse control.
Neglect of Responsibilities: A cocaine addict is likely to fail to meet his or her obligations at work, school, or home.
Financial Problems: The expenses incurred in the use of cocaine mean that an individual is likely to get involved in several activities that would lead to him or her getting into more debt or even stealing to be able to sustain the habit.
Physical Symptoms
Weight Loss: Cocaine has an effect of minimizing appetite hence users are known to lose a lot of weight within a short period.
Nosebleeds: This is because the constant snorting can lead to bleeding of the nasal tissues and thus cause constant bleeding through the nose.
Dilated Pupils: The users of cocaine experience the dilation of the pupils, an easily noticeable sign.
Insomnia: Cocaine is a stimulant and as such it can cause sleep disorders such as inability to sleep or to wake up at night.
Psychological Symptoms
Paranoia: Over time the effects of the drug are that the user becomes extremely paranoid and can even start hallucinating.
Anxiety and Depression: Sensitivity to withdrawal periods is characterized by increased anxiety and depressive symptoms.
Euphoria and Agitation: The ‘highs’ that users experience are normally followed by a period of restlessness or even anger.
Social Implications And Daily Life And Relationship
Cocaine addiction can have considerable effects on the daily functioning of the person and his or her interpersonal relationships. The use of the drug becomes the most important thing in the life of the addict, and this results in loss of employment, family break-up, and social exclusion. The families of the patients suffering from cocaine addiction are always under emotional and financial pressure.
Cocaine addiction has many effects that are not limited to the physical, psychological, social, and legal aspects of life.
Health Consequences
Cardiovascular Effects: The use of cocaine leads to cardiovascular complications including heart attacks, strokes, and high blood pressure. The drug raises the rate of beats per minute together with the constriction of blood vessels; this puts pressure on the heart.
Neurological Effects: Neurological diseases associated with chronic cocaine use include seizures, headaches, and movement disorders. These patients also tend to have deficits in cognition with prolonged use because of impaired working memory and decision-making as well as gross-motor planning [2].
Respiratory Issues: Crack cocaine has the obvious adverse effect of smoking and causes respiratory complications such as persistent cough, destroyed lungs, and increased incidence of respiratory diseases.
Mental Health Impact
Cocaine dependence is associated with other diseases such as mental health disorders.
Depression: A cocaine low usually results in a downstage of extreme depression, which always makes the victim suicidal
Anxiety Disorders: As an affective disorder, panic attacks are often a consequence of it and can be chronic with ongoing drug use.
Psychosis: Hallucinations, paranoia, and delusions may ensue in a few patients using higher cocaine dosages or those who abuse cocaine over longer periods.
Social And Legal Consequences
Job Loss: Irregular behavior, unreliability, and poor work performance resulting from cocaine addiction can make a person lose their job and get monetary problems.
Legal Issues: In most nations people cannot obtain or utilize these products which are the most common effects of cocaine use and other illegal drugs, leading to exposure to arrest, sanctions, including prison confinement.
Family Impact: Cocaine addiction puts a lot of pressure on a relationship and has been known to cause break-ups, divorce, and even child custody. Family is likely to be affected through stress, both emotionally and financially, by the actions of the addict and the costs of treatment.
Financial Consequences
Cocaine addiction is very expensive and a person can spend all his or her money within a short period. The expenses incurred in acquiring cocaine, the loss of employment, and the cost of treating diseases that are associated with the substance are some of the financial impacts. A person may turn into a criminal to support his or her habit and end up deepening the legal problems.
Cocaine dependence is one of the hardest forms of dependence to break since the substance has a strong impact on the body and the brain. The strength of this drug is the fact that it rewires the reward center of the brain and thus forms a vicious circle of addiction that can be both physiological and psychological.
Neurobiological Mechanisms
Cocaine mainly impacts the brain by raising dopamine, which is a neurotransmitter that is associated with pleasure or reward. Normally dopamine is secreted during enjoyable activities and is then taken back into the neurons. Cocaine interferes with this process in that it blocks the reuptake of dopamine leading to a buildup of the chemical in the brain. This release of dopamine gives the high feeling and the energy that comes with the use of cocaine.
In the long run, the brain becomes accustomed to this unnatural increase in dopamine by lowering the levels of dopamine in the brain and available dopamine receptors [3]. This means that should the drug not be available, the person may feel that he or she cannot find pleasure in ordinary activities, a situation that is referred to as anhedonia. This is because the brain starts to crave cocaine to bring balance to the brain’s chemical composition.
Psychological Dependence And Cravings
Cocaine not only causes physical dependence but also psychological dependence. One of the things that make it difficult for users to quit is that they tend to link cocaine use to certain people, places, and other activities. This means that the individual will have an overwhelming desire to use the substance even when he or she has not used it for some time due to environmental stimuli or stress [4].
The psychological dependence is then fueled by the impact of the drug on the rationality and control centers of the brain. Cocaine impacts the prefrontal cortex which is the part of the brain that is in charge of decision-making and control. This impairment results in drug addiction where the need to use the drug is more important than the effect it will have on the user.
The Cycle of Addiction and Relapse
Cocaine use is characterized by a cycle of use followed by a period of withdrawal. In a binge, an individual is likely to take high doses of the drug to sustain the effect and may not eat, sleep, or perform other normal activities. This binge is then followed by a period of crash where the person feels extremely tired, sad, and moody. To avoid these uncomfortable feelings, a person may take cocaine again and thus the cycle of drug dependency is continued.
Cocaine addiction is characterized by relapse because this drug has strong cravings and alters the brain. While abstaining from drugs and alcohol for some time, stress, or certain stimuli can cause the individual to use drugs again. This cycle makes recovery especially difficult and shows the importance of an integrated treatment plan.
Tolerance is the development of a state in which the initial dose of cocaine no longer produces the same effect as before and can only be treated through the use of higher doses of the substance. To reach the intended high, the users take more quantities and frequency of the cocaine which amplifies the addiction process. This increased dosage also increases the likelihood of serious health effects such as overdose.
Cocaine addiction is not easy to overcome and usually, it involves the help of a specialist and diverse treatment. The treatment must not only focus on the physical dependence on cocaine but also on the mental and social aspects of dependency.
Overview Of Treatment Options
Detox: The first stage of cocaine addiction treatment is the detoxification process in which the patient stops using the substance to eliminate it from their system. Detox should be medically supervised because withdrawal symptoms may include depression, fatigue, and severe food cravings.
Therapy: Behavioral therapies are the mainstay of cocaine addiction treatment. These therapies focus on changing the patient’s perception and behavioral patterns about substance use and on improving the ability to handle stress and other stimuli that can trigger drug use.
Medication: There is no medication approved for the treatment of cocaine dependence, but some medications can be useful in managing withdrawal symptoms and cocaine cravings.
Behavioral Therapies
Cognitive-Behavioral Therapy (CBT): CBT enables the patient to identify and modify the thinking and behaviors that predispose him or her to use cocaine. It educates on how to manage stress and avoid places that cause cravings [4].
Contingency Management: This approach offers incentives that are physical to encourage good behavior in the community such as abstaining from the use of drugs. For instance, patients may be given vouchers for services or goods as a reward for negative drug tests.
Self-Help Groups And Rehabilitation Centre
Support Groups: Cocaine Anonymous is the fellowship of men and women who share their experience, strength, and hope to solve their common problem and help other cocaine addicts recover. Group discussions and fellowship can be helpful when it comes to preventing relapse and staying clean.
Rehabilitation Programs: Hospital or clinic-based rehab programs provide a more formal setting where a person can begin the process of rehabilitation. Many of these programs use therapy, medical treatment, and support groups in a single program.
Why a Holistic Approach Is Essential
Cocaine addiction treatment involves the physical, psychological, and social treatment of the patient. This includes:
Mental Health Support: The presence of other mental illnesses like depression or anxiety also needs to be treated to avoid relapse.
Physical Health: Nutrition, exercise, and proper medical care are the key to physical and mental health recovery.
Social Support: Establishing new relationships and creating a positive social environment can help to receive the necessary emotional support for further treatment.
1. WebMD. What to Know About Cocaine. https://www.webmd.com/mental-health/addiction/cocaine-use-and-its-effects
2. National Institute On Drug Abuse. Cocaine. https://nida.nih.gov/research-topics/cocaine
3. PubMed Central. The Neurobiology of Cocaine Addiction. https://pmc.ncbi.nlm.nih.gov/articles/PMC2851032/
4. Wikipedia. Cocaine Addiction. https://en.wikipedia.org/wiki/Cocaine_dependence
Yes, it is possible to have psychological dependence on cocaine even if one has used it only once. The stimulation of dopamine in the brain by cocaine makes the user have the urge to use the substance again. Though physical dependence might take a long time to develop, the intense feeling of happiness, that comes with the first use of the substance, leads to cravings and the desire to use the substance again, which increases the likelihood of substance dependence over time.
Pregnant women who take cocaine are likely to suffer from severe complications as well as their unborn babies. It also raises the chances of having a miscarriage, premature delivery, a low birth weight of the baby, and developmental issues. Newborn babies of mothers who use cocaine have some withdrawal signs at birth and are more likely to develop learning and developmental problems. Cocaine also constricts blood vessels and can cause the fetus to potentially have brain damage or birth defects.
Cocaine taken in combination with other drugs, like alcohol, further raises the dangers of both substances. Alcohol and cocaine are metabolized with the liver yielding cocaethylene which enhances the toxicity of the two substances and the likelihood of a sudden fatality. Cocaethylene also stays in the body longer than cocaine, which means that the cardiovascular system is under more stress. Cocaine is often taken with other depressants such as opioids which hide some of the effects leading to overdose.
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