The powder form of cocaine can be inhaled through the nose or dissolved in liquid and injected. Crystalized cocaine is heated to produce vapors that are then inhaled. NIDAreports that injecting or smoking the drug causes the substance to be delivered very rapidly into the bloodstream and then to the brain, which contributes to its highly addictive nature. The effects from inhaling the powder form last 15-30 minutes; the effects of smoking last 5-10 minutes. Many people who use this drug will binge on the substance, using it repeatedly within a limited timeframe to sustain the high they feel. This can increase the risks associated with drug use and lead to addiction.
According to NIDA, cocaine is a central nervous system stimulant. It increases levels of the neurotransmitter dopamine within the brain, which regulates pleasure and movement. Dopamine is normally released by neurons within the brain and then absorbed back into the neuron. Cocaine prevents dopamine from being reabsorbed, so the brain continues to feel the effects of dopamine. This causes the high associated with the drug.
Short-term Effects of Cocaine
Cocaine can have many effects on both the mind and body. Short-term effects of cocaine use may include the following:
- Increased energy
- Feeling talkative
- Mental alertness
- Gastrointestinal distress
- Decreased need for food and sleep
- Constricted blood vessels
- Dilated pupils
- Increased sensitivity to sights, sounds, and touch
- Increased body temperature
- Increased heart rate
- Increased blood pressure
- Decreased appetite
Large doses of cocaine intensify the short-term effects of the drug, but also cause erratic and violent behavior.
Long-term Effects of Cocaine
NIDA lists many risks associated with use of cocaine. Chronic use of cocaine can lead to malnourishment, heart attack, and stroke. Deaths caused by cocaine are often the result of cardiac arrest and cessation of breathing.
Bingeing on cocaine carries high risks. This pattern of drug use can lead to irritability, restlessness, anxiety, paranoia, and psychosis. The drug becomes even more dangerous when combined with other substances. Cocaine and heroin, when combined, carry a very high risk of overdose.
People who abuse cocaine are also at a heightened risk for contracting HIV and other infectious diseases. Individuals who use the drug intravenously can contract diseases by sharing needles or other equipment. Drug use can also lead to risky behaviors like unsafe sex, which can lead to disease exposure.
Long-term effects of cocaine may include damage to various vital organs and body systems. Snorting cocaine causes significant damage to the respiratory system. This method of drug use can lead to the loss of sense of smell, nosebleeds, trouble swallowing, hoarseness, and runny nose. Ingesting cocaine orally can restrict blood flow to the stomach, causing gangrene, or death of tissue. Some people have an allergic reaction to cocaine when injected intravenously.
Repeated use of cocaine can cause long-term or permanent changes to the central nervous system, which can lead to addiction and other problems. Frequent use can also lead to tolerance, meaning an increasingly larger dose of the drug must be used to achieve the same effects previously felt after smaller doses. This increases the risk of overdose, as well as the risk of permanent damage to the brain and body.
People who regularly use cocaine often become physically dependent on the drug. Once dependence occurs, the individual will experience withdrawal symptoms when decreasing or stopping use.
The cause of addiction is believed to be partially genetic; NIDA reports that certain genes can increase the likelihood of an individual becoming addicted to drugs and alcohol. However, environment also plays a role. Certain environmental factors may cause genes linked to addiction to become active. Most experts believe it is this interaction between genetics and environment that leads to addiction.
According to NIDA, about 13 percent of all admissions to drug abuse treatment programs in 2007 were a result of cocaine use. Of those who seek treatment for cocaine addiction, 72 percent smoke the drug and are also likely addicted to other substances.
There are currently no medications approved by the FDA for the treatment of cocaine addiction. Consequently, the primary treatment for cocaine abuse comes in the form of behavioral interventions. Many treatment options are available in both residential and outpatient settings.
Inpatient rehabilitation programs are also called residential treatment. These programs take place at a specialized treatment facility, where people receiving inpatient care live fulltime for a set number of weeks or months. Outpatient treatment differs in that the individuals enrolled in the program continue to live in their own homes, but spend a certain amount of time per day in treatment at the rehab facility. The most intensive form of outpatient treatment is called partial inpatient treatment or intensive outpatient treatment. This involves spending a majority of each day at the rehab facility or in therapy. Other less intensive programs require fewer hours of treatment.
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Detox is often the first step in recovery from addiction. The detox process often involves physical and psychological withdrawal. This can involve many unpleasant symptoms, which can be managed by the treatment team. While cocaine does not come with an intense physical withdrawal process, psychological withdrawal symptoms will usually be present when a person attempts to stop using the drug after long-term use.
Detox can take place in either an inpatient or outpatient setting. According to Alcohol Health and Research World, most people experience milder, less dangerous symptoms of withdrawal and can safely detox in an outpatient setting. Mild withdrawal symptoms include sweating, tremors, and nausea. Outpatient programs are often less expensive and time-consuming than inpatient treatment. People with a strong outside support system of friends and family may benefit from an outpatient detox program, since outpatient treatment allows the individual to stay in closer contact with loved ones. Outpatient programs do, however, carry a higher risk of relapse, due to the easier access to cocaine.
While detox is often the starting place for treatment, it is not treatment in and of itself. It must be followed by comprehensive therapy to address the causes of the addiction.
Inpatient, or residential programs offer constant supervision and care, and usually last several weeks or even months. This treatment modal offers the most intensive rehabilitation services. While in treatment, individuals in an inpatient program live at the treatment facility fulltime. This model views addiction within the contexts of environment, relationships, and other contributing factors. Individuals in treatment are encouraged to accept personal responsibility for choices, and to analyze patterns of negative thoughts or behaviors that contribute to their addiction. Some inpatient facilities also offer additional services, including employment services, social skills training, and other life skills.
Some individuals may find inpatient programs offer certain advantages over outpatient treatment. The U.S. National Library of Medicine published a study finding that people who participated in an inpatient treatment program were four times less likely to relapse during the course of treatment than those enrolled in outpatient programs. This may be due to inpatient treatment offering less access to addictive substances.
Many different types of inpatient programs are available for people addicted to cocaine. Programs are offered in varying lengths, with long-term programs sometimes lasting several months, while short-term treatment may be completed within a few weeks. While both long- and short-term programs can be effective, the Journal of the American Medical Associationreports that long-term programs may lead to higher rates of success in some areas of recovery. Most programs, regardless of length, begin with an intense period of treatment, and then gradually reduce the number of hours spent receiving treatment each day.
Often, individuals will transition from an inpatient program to an outpatient program as they progress through recovery.
NIDA recommends that treatment be tapered gradually, rather than ended abruptly, with individuals continuing outpatient therapy and participating in support groups after the completion of a residential program.
Outpatient treatment is offered in many different forms, each varying in length and intensity. Outpatient programs typically incorporate individual therapy, group therapy, and treatment for co-occurring disorders or health concerns into the treatment process. Outpatient programs may be beneficial for some individuals, particularly those with life commitments that do not allow them to participate in residential treatment.
Both inpatient and outpatient rehabilitation programs typically incorporate individual counseling into the treatment plan. Also called talk therapy or psychotherapy, counseling usually addresses the underlying issues and contributing factors that may have caused the disorder, including relationship and social issues, employment difficulties, and other stressful life circumstances. Individual counseling can be helpful in the development of healthy coping skills and patterns of thought or behavior. Common methods of therapy used in treating addiction, according to SAMHSA, include Contingency Management, Cognitive Behavioral Therapy, and Motivational Enhancement Therapy.
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