Disease: Cocaine and Crack Abuse

    Cocaine and crack abuse facts

    • Cocaine, also called coke, nose candy, snow, blow, or toot, is a substance that is derived from the coca plant. Crack cocaine, also called rock cocaine, refers to cocaine when it is in solid form.
    • Approximately 25 million people in the U.S. use cocaine at least once in their lifetime.
    • Cocaine intoxication tends to cause intense euphoria and pleasure, highly intensifying every pleasure. Then the person tends to become hyperactive and excessively alert.
    • Once the high associated with cocaine wears off, the individual often becomes agitated, irritable, and uncomfortable.
    • Cocaine intoxication tends to dramatically increase the release of the neurotransmitters dopamine, norepinephrine, and serotonin.
    • Cocaine abuse and addiction have no single cause but are rather the result of a combination of biological, psychological, and social factors.
    • Withdrawal symptoms and signs for cocaine include irritability, suppressed appetite, problems with sleep, and craving the substance.
    • Symptoms of cocaine abuse include recurrent use of the drug that results in legal problems, occurs in potentially dangerous situations, interferes with important obligations, or results in social or relationship problems.
    • Symptoms of cocaine dependence include tolerance, withdrawal, using a lot of the drug or for a long period of time, a persistent desire to use it, unsuccessful efforts to stop using cocaine, neglecting other aspects of life because of the drug use, and spending inordinate amounts of time or energy getting, using, or recovering from the effects of the substance.
    • Individuals who are addicted to cocaine are at increased risk for risky sexual behaviors and their consequences, as well as increased risk of suicide, homicide, domestic violence, other forms of violence.
    • Medical risks of cocaine abuse, particularly when in crack form, include tearing of the major artery in the body (aortic dissection) or stroke associated with extremely high blood pressure. It is also a risk factor for heart attack.
    • For children exposed to cocaine prenatally, the problems it can cause have been found as early as infancy.
    • Since there is no one test that definitively indicates that someone has cocaine abuse or addiction, health care professionals diagnose these disorders by gathering comprehensive medical, family, and mental health information, as well as securing a physical examination and lab tests to assess the sufferer's medical state.
    • Treatment services for cocaine abuse and addiction remain largely unutilized by most sufferers of these conditions.
    • The primary goals of recovery are abstinence, relapse prevention, and rehabilitation.
    • During the initial stage of abstinence, an individual who suffers from cocaine or other chemical dependency may need detoxification to help avoid or lessen the effects of withdrawal.
    • Often, much more challenging and time consuming than recovery from the physical aspects of cocaine addiction is psychological addiction.
    • The treatment of dual diagnosis seems to be more effective when treatment of the individual's mental illness is integrated with the treatment of the individual's chemical dependency.
    • Recovery from cocaine abuse is usually characterized by episodes of remission and relapse.

    Learn more about: dopamine

    What is cocaine? What is crack?

    Cocaine, also called coke, nose candy, snow, blow or toot, is a substance that comes from the coca plant. When mixed and heated with ether (cooked), a highly flammable substance (freebase), its gas is released in its pure form, which can be inhaled. Crack cocaine, also called rock cocaine, refers to cocaine when it is in solid form. It is made by mixing powder cocaine with baking soda and water, making it a highly concentrated and therefore highly addictive form of the drug. This form of cocaine is taken in by placing the cocaine rocks into a crack pipe and smoking them.

    How is cocaine abused?

    Cocaine is one of a number of street drugs that can be abused in a number of different ways, including injecting, smoking, or taken in through the nose by snorting.

    What are cocaine's effects on the body and the mind?

    The time it takes for a person to feel the effects of cocaine, as well as how long cocaine stays in the system, is determined by the way the drug is taken. For example, when cocaine is in solid form, the individual feels the effects of smoking crack cocaine within seconds, while the powder form of cocaine that is snorted (taken intranasally) takes up to 10 minutes to take effect. Regardless of the way this drug is taken, it tends to cause intense euphoria and pleasurable sensations, highly intensifying every pleasure. Then the person tends to become hyperactive and excessively alert. Once the high wears off (in less than 20 minutes for crack), the individual often becomes agitated, irritable, and uncomfortable.

    The physiological (biological) effects of cocaine on the brain involve the drug's effects on chemicals called neurotransmitters. Specifically, cocaine tends to dramatically increase the release of dopamine, norepinephrine and serotonin. Because these chemicals are responsible for pleasure and well-being, alertness, increase in blood pressure and pulse, as well as happiness, the effects of cocaine on the body and mind are consistent with these effects. Other physical signs and symptoms of cocaine use include decreased appetite, sleep, and male infertility.

    When a person withdraws from the effects of cocaine, the decrease in neurotransmitters results in a sudden drop in blood pressure or pulse, severe depression, and sometimes suicidal thoughts and behavior. In the event of cocaine overdose, the effect of excess dopamine can cause anger, aggressiveness, violence, psychosis, and sometimes homicidal thoughts and behavior. Cocaine abuse also tends to result in decreased inhibitions that can lead to risky sexual behaviors.

    What causes and prevents cocaine abuse and addiction?

    Like the majority of other mental health problems, cocaine abuse and addiction have no single cause. However, there are a number of biological, psychological, and social risk factors that can increase a person's likelihood of developing a chemical abuse or chemical dependency disorder. The frequency that substance-abuse disorders occur within some families seems to be higher than can be explained by the addictive environment of the family. Therefore, most substance-abuse professionals recognize a genetic aspect to the risk of drug addiction. This is particularly true for cocaine dependence.

    Mental-disorder symptoms that are caused by cocaine abuse or addiction include mood disorders like depression, anxiety, or bipolar disorder, as well as personality disorders like antisocial personality disorder. Social risk factors for drug abuse and addiction include male gender, ages 18 to 44 years old, Native American heritage, unmarried marital status, and lower socioeconomic status. According to statistics by state, people residing in the West tend to be at higher risk for chemical abuse or dependency. As with substance abuse in general, prevention of cocaine abuse and addiction is increased by circumstances like receiving appropriate supervision, as well as clear messages from family members that cocaine use is unacceptable.

    What are symptoms and signs of cocaine abuse and addiction?

    Cocaine abuse is a disorder that is characterized by a destructive pattern of using cocaine that leads to significant problems or distress. Cocaine addiction, also called cocaine dependence or cocaine dependency, is a disease that is characterized by a destructive pattern of cocaine abuse that leads to significant problems involving tolerance to or withdrawal from the substance, as well as other problems that the use of cocaine can cause for the sufferer, socially or in terms of the person's work or school performance.

    In order to be diagnosed with cocaine abuse, an individual must exhibit a destructive pattern of abusing this drug that leads to significant problems or stress but not enough to qualify as being addicted to it. This pattern is manifested by at least one of the following warning signs or symptoms of use or abuse in the same one-year period:

    • Recurrent cocaine use that results in a lack of meeting important obligations at work, school, or home
    • Recurrent cocaine use in situations that can be dangerous
    • Recurrent legal problems as a result of cocaine use
    • Continued cocaine use despite continued or repeated social or relationship problems as a result of the drug's effects

    In order to be diagnosed with cocaine addiction, an individual must exhibit a destructive pattern of abusing the substance that leads to significant problems as manifested by at least three of the following signs or symptoms in the same one-year period:

    • Tolerance, which is either markedly decreased effect of cocaine or a need to significantly increase the amount used in order to achieve the same high or other desired effects
    • Withdrawal, which is either physical or psychological signs or symptoms consistent with withdrawal from cocaine, or taking it or a substance that is chemically related in order to avoid developing symptoms of withdrawal
    • Larger amounts of cocaine are taken or for longer than intended.
    • The individual experiences persistent desire to take the drug or has unsuccessful attempts to decrease or control its use.
    • Significant amounts of time are spent either getting, using, or recovering from the effects of cocaine.
    • The individual significantly reduces or stops participating in important social, recreational, work, or school activities as a result of using cocaine.

    The individual continues to use cocaine despite being aware that he or she suffers from ongoing or recurring physical or psychological problems that are caused or worsened by the use of the drug.

    How is cocaine addiction diagnosed?

    There is no single test that indicates that someone is abusing or addicted to cocaine with complete certainty. Therefore, health care professionals diagnose these disorders by thoroughly gathering medical, family, and mental health information. The professional will also either perform a physical examination or request that the individual's primary care doctor do so. The medical examination usually includes lab tests to assess the person's general health and to explore whether or not the individual has a medical condition that includes mental health symptoms.

    In asking questions about mental health symptoms, mental health professionals are often trying to find out if the person suffers from depressive and/or manic symptoms, as well as whether the individual suffers from anxiety, hallucinations, delusions or some behavioral disorders. Health care professionals may provide the people they evaluate with a quiz or self-test to screen for substance abuse or dependence. Since some of the symptoms of cocaine misuse and dependence can also occur in other mental illnesses, the mental health screening helps determine if the individual suffers from bipolar disorder, an anxiety disorder, schizophrenia, schizoaffective disorder or other psychotic disorders, or a personality or behavior disorder like narcissistic personality disorder or attention deficit hyperactivity disorder (ADHD), respectively. Any disorder that is associated with sudden changes in behavior, mood, or thinking, like bipolar disorder, a psychotic disorder, borderline personality disorder, or dissociative identity disorder (DID), may be particularly challenging to distinguish from some symptoms of cocaine abuse or dependence. In order to assess the person's current emotional state, health care professionals perform a mental status exam as well.

    In addition to providing treatment that is appropriate to the diagnosis and to the person in need of it, determining the presence of mental illnesses that may co-occur (comorbid/dual diagnosis) with cocaine abuse or dependence is important in promoting the best possible outcome. Dual diagnosis of cocaine-abusing or addicted individuals indicates the need for treatment that addresses both issues in an integrated fashion by professionals with training and experience with helping this specific population.

    What is the treatment for cocaine and crack addiction?

    An unfortunate fact about the treatment of cocaine and other drug addiction is that it continues to be unutilized by most addicted individuals. For example, less than 10% of people with a substance abuse disorder and less than 40% of those with a substance dependence disorder receive treatment. Those statistics seem to be independent of socioeconomic or other demographic characteristics but do seem to be associated with the presence of other mental health problems (comorbidity).

    The primary goals for the treatment of addiction symptoms (also called recovery) are abstinence, relapse prevention, and rehabilitation. When the addicted person first abstains from using drugs, he or she may need help avoiding or lessening the effects of withdrawal. That process is called detoxification or detox. That part of treatment is usually performed in a hospital or other inpatient setting (often called detox centers), where medications used to decrease withdrawal symptoms and frequent medical assessments can be provided. The medications used as part of detox depend on the substance the individual is dependent upon. As with many other drugs of abuse, the detox process from cocaine is the most difficult aspect of coping with the physical symptoms of addiction and tends to last days. Medications that are sometimes used to help cocaine addicts abstain from drugs use include propranolol (Inderal, Inderal LA, InnoPran XL), which decreases some of the physical symptoms associated with cocaine withdrawal, as well as vigabatrin (Sabril), a medication that treats seizures.

    Learn more about: Inderal | Inderal LA | InnoPran XL | Sabril

    Usually much more challenging and time consuming than recovery from the physical aspects of cocaine addiction is psychological addiction. People who may have less severe psychological symptoms of cocaine dependency may be able to be maintained in an outpatient treatment program. Those who have a more severe addiction, have relapsed after engaging in outpatient programs, or whom also suffer from a severe mental illness might need the higher level of structure, guidance, and monitoring provided in an inpatient drug treatment center, often referred to as "rehab." After inpatient treatment, many cocaine addicts may need to reside in a sober-living community, that is, a group-home setting where counselors provide continued sobriety support and structure on a daily basis.

    Another important aspect of treating cocaine addiction is helping family members and friends of the addicted person refrain from supporting addictive behaviors (codependency). Whether codependent loved ones provide financial support, excuses, or fail to acknowledge the addictive behaviors of the addict, discouraging such codependency of friends and family is a key part of the recovery of the affected individual. Focusing on the cocaine-addicted person's role in the family likely becomes even more urgent when that person is a child or teenager, given that underaged people almost always come within the context of a family. Cocaine dependency treatment for children and adolescents differs further from that in adults by the younger addict's tendency to need help finishing their education and achieving higher education or job training compared to addicts who may have completed those parts of their lives before developing the addiction.

    What is cocaine? What is crack?

    Cocaine, also called coke, nose candy, snow, blow or toot, is a substance that comes from the coca plant. When mixed and heated with ether (cooked), a highly flammable substance (freebase), its gas is released in its pure form, which can be inhaled. Crack cocaine, also called rock cocaine, refers to cocaine when it is in solid form. It is made by mixing powder cocaine with baking soda and water, making it a highly concentrated and therefore highly addictive form of the drug. This form of cocaine is taken in by placing the cocaine rocks into a crack pipe and smoking them.

    How is cocaine abused?

    Cocaine is one of a number of street drugs that can be abused in a number of different ways, including injecting, smoking, or taken in through the nose by snorting.

    What are cocaine's effects on the body and the mind?

    The time it takes for a person to feel the effects of cocaine, as well as how long cocaine stays in the system, is determined by the way the drug is taken. For example, when cocaine is in solid form, the individual feels the effects of smoking crack cocaine within seconds, while the powder form of cocaine that is snorted (taken intranasally) takes up to 10 minutes to take effect. Regardless of the way this drug is taken, it tends to cause intense euphoria and pleasurable sensations, highly intensifying every pleasure. Then the person tends to become hyperactive and excessively alert. Once the high wears off (in less than 20 minutes for crack), the individual often becomes agitated, irritable, and uncomfortable.

    The physiological (biological) effects of cocaine on the brain involve the drug's effects on chemicals called neurotransmitters. Specifically, cocaine tends to dramatically increase the release of dopamine, norepinephrine and serotonin. Because these chemicals are responsible for pleasure and well-being, alertness, increase in blood pressure and pulse, as well as happiness, the effects of cocaine on the body and mind are consistent with these effects. Other physical signs and symptoms of cocaine use include decreased appetite, sleep, and male infertility.

    When a person withdraws from the effects of cocaine, the decrease in neurotransmitters results in a sudden drop in blood pressure or pulse, severe depression, and sometimes suicidal thoughts and behavior. In the event of cocaine overdose, the effect of excess dopamine can cause anger, aggressiveness, violence, psychosis, and sometimes homicidal thoughts and behavior. Cocaine abuse also tends to result in decreased inhibitions that can lead to risky sexual behaviors.

    What causes and prevents cocaine abuse and addiction?

    Like the majority of other mental health problems, cocaine abuse and addiction have no single cause. However, there are a number of biological, psychological, and social risk factors that can increase a person's likelihood of developing a chemical abuse or chemical dependency disorder. The frequency that substance-abuse disorders occur within some families seems to be higher than can be explained by the addictive environment of the family. Therefore, most substance-abuse professionals recognize a genetic aspect to the risk of drug addiction. This is particularly true for cocaine dependence.

    Mental-disorder symptoms that are caused by cocaine abuse or addiction include mood disorders like depression, anxiety, or bipolar disorder, as well as personality disorders like antisocial personality disorder. Social risk factors for drug abuse and addiction include male gender, ages 18 to 44 years old, Native American heritage, unmarried marital status, and lower socioeconomic status. According to statistics by state, people residing in the West tend to be at higher risk for chemical abuse or dependency. As with substance abuse in general, prevention of cocaine abuse and addiction is increased by circumstances like receiving appropriate supervision, as well as clear messages from family members that cocaine use is unacceptable.

    What are symptoms and signs of cocaine abuse and addiction?

    Cocaine abuse is a disorder that is characterized by a destructive pattern of using cocaine that leads to significant problems or distress. Cocaine addiction, also called cocaine dependence or cocaine dependency, is a disease that is characterized by a destructive pattern of cocaine abuse that leads to significant problems involving tolerance to or withdrawal from the substance, as well as other problems that the use of cocaine can cause for the sufferer, socially or in terms of the person's work or school performance.

    In order to be diagnosed with cocaine abuse, an individual must exhibit a destructive pattern of abusing this drug that leads to significant problems or stress but not enough to qualify as being addicted to it. This pattern is manifested by at least one of the following warning signs or symptoms of use or abuse in the same one-year period:

    • Recurrent cocaine use that results in a lack of meeting important obligations at work, school, or home
    • Recurrent cocaine use in situations that can be dangerous
    • Recurrent legal problems as a result of cocaine use
    • Continued cocaine use despite continued or repeated social or relationship problems as a result of the drug's effects

    In order to be diagnosed with cocaine addiction, an individual must exhibit a destructive pattern of abusing the substance that leads to significant problems as manifested by at least three of the following signs or symptoms in the same one-year period:

    • Tolerance, which is either markedly decreased effect of cocaine or a need to significantly increase the amount used in order to achieve the same high or other desired effects
    • Withdrawal, which is either physical or psychological signs or symptoms consistent with withdrawal from cocaine, or taking it or a substance that is chemically related in order to avoid developing symptoms of withdrawal
    • Larger amounts of cocaine are taken or for longer than intended.
    • The individual experiences persistent desire to take the drug or has unsuccessful attempts to decrease or control its use.
    • Significant amounts of time are spent either getting, using, or recovering from the effects of cocaine.
    • The individual significantly reduces or stops participating in important social, recreational, work, or school activities as a result of using cocaine.

    The individual continues to use cocaine despite being aware that he or she suffers from ongoing or recurring physical or psychological problems that are caused or worsened by the use of the drug.

    How is cocaine addiction diagnosed?

    There is no single test that indicates that someone is abusing or addicted to cocaine with complete certainty. Therefore, health care professionals diagnose these disorders by thoroughly gathering medical, family, and mental health information. The professional will also either perform a physical examination or request that the individual's primary care doctor do so. The medical examination usually includes lab tests to assess the person's general health and to explore whether or not the individual has a medical condition that includes mental health symptoms.

    In asking questions about mental health symptoms, mental health professionals are often trying to find out if the person suffers from depressive and/or manic symptoms, as well as whether the individual suffers from anxiety, hallucinations, delusions or some behavioral disorders. Health care professionals may provide the people they evaluate with a quiz or self-test to screen for substance abuse or dependence. Since some of the symptoms of cocaine misuse and dependence can also occur in other mental illnesses, the mental health screening helps determine if the individual suffers from bipolar disorder, an anxiety disorder, schizophrenia, schizoaffective disorder or other psychotic disorders, or a personality or behavior disorder like narcissistic personality disorder or attention deficit hyperactivity disorder (ADHD), respectively. Any disorder that is associated with sudden changes in behavior, mood, or thinking, like bipolar disorder, a psychotic disorder, borderline personality disorder, or dissociative identity disorder (DID), may be particularly challenging to distinguish from some symptoms of cocaine abuse or dependence. In order to assess the person's current emotional state, health care professionals perform a mental status exam as well.

    In addition to providing treatment that is appropriate to the diagnosis and to the person in need of it, determining the presence of mental illnesses that may co-occur (comorbid/dual diagnosis) with cocaine abuse or dependence is important in promoting the best possible outcome. Dual diagnosis of cocaine-abusing or addicted individuals indicates the need for treatment that addresses both issues in an integrated fashion by professionals with training and experience with helping this specific population.

    What is the treatment for cocaine and crack addiction?

    An unfortunate fact about the treatment of cocaine and other drug addiction is that it continues to be unutilized by most addicted individuals. For example, less than 10% of people with a substance abuse disorder and less than 40% of those with a substance dependence disorder receive treatment. Those statistics seem to be independent of socioeconomic or other demographic characteristics but do seem to be associated with the presence of other mental health problems (comorbidity).

    The primary goals for the treatment of addiction symptoms (also called recovery) are abstinence, relapse prevention, and rehabilitation. When the addicted person first abstains from using drugs, he or she may need help avoiding or lessening the effects of withdrawal. That process is called detoxification or detox. That part of treatment is usually performed in a hospital or other inpatient setting (often called detox centers), where medications used to decrease withdrawal symptoms and frequent medical assessments can be provided. The medications used as part of detox depend on the substance the individual is dependent upon. As with many other drugs of abuse, the detox process from cocaine is the most difficult aspect of coping with the physical symptoms of addiction and tends to last days. Medications that are sometimes used to help cocaine addicts abstain from drugs use include propranolol (Inderal, Inderal LA, InnoPran XL), which decreases some of the physical symptoms associated with cocaine withdrawal, as well as vigabatrin (Sabril), a medication that treats seizures.

    Learn more about: Inderal | Inderal LA | InnoPran XL | Sabril

    Usually much more challenging and time consuming than recovery from the physical aspects of cocaine addiction is psychological addiction. People who may have less severe psychological symptoms of cocaine dependency may be able to be maintained in an outpatient treatment program. Those who have a more severe addiction, have relapsed after engaging in outpatient programs, or whom also suffer from a severe mental illness might need the higher level of structure, guidance, and monitoring provided in an inpatient drug treatment center, often referred to as "rehab." After inpatient treatment, many cocaine addicts may need to reside in a sober-living community, that is, a group-home setting where counselors provide continued sobriety support and structure on a daily basis.

    Another important aspect of treating cocaine addiction is helping family members and friends of the addicted person refrain from supporting addictive behaviors (codependency). Whether codependent loved ones provide financial support, excuses, or fail to acknowledge the addictive behaviors of the addict, discouraging such codependency of friends and family is a key part of the recovery of the affected individual. Focusing on the cocaine-addicted person's role in the family likely becomes even more urgent when that person is a child or teenager, given that underaged people almost always come within the context of a family. Cocaine dependency treatment for children and adolescents differs further from that in adults by the younger addict's tendency to need help finishing their education and achieving higher education or job training compared to addicts who may have completed those parts of their lives before developing the addiction.

    Source: http://www.rxlist.com

    An unfortunate fact about the treatment of cocaine and other drug addiction is that it continues to be unutilized by most addicted individuals. For example, less than 10% of people with a substance abuse disorder and less than 40% of those with a substance dependence disorder receive treatment. Those statistics seem to be independent of socioeconomic or other demographic characteristics but do seem to be associated with the presence of other mental health problems (comorbidity).

    The primary goals for the treatment of addiction symptoms (also called recovery) are abstinence, relapse prevention, and rehabilitation. When the addicted person first abstains from using drugs, he or she may need help avoiding or lessening the effects of withdrawal. That process is called detoxification or detox. That part of treatment is usually performed in a hospital or other inpatient setting (often called detox centers), where medications used to decrease withdrawal symptoms and frequent medical assessments can be provided. The medications used as part of detox depend on the substance the individual is dependent upon. As with many other drugs of abuse, the detox process from cocaine is the most difficult aspect of coping with the physical symptoms of addiction and tends to last days. Medications that are sometimes used to help cocaine addicts abstain from drugs use include propranolol (Inderal, Inderal LA, InnoPran XL), which decreases some of the physical symptoms associated with cocaine withdrawal, as well as vigabatrin (Sabril), a medication that treats seizures.

    Learn more about: Inderal | Inderal LA | InnoPran XL | Sabril

    Usually much more challenging and time consuming than recovery from the physical aspects of cocaine addiction is psychological addiction. People who may have less severe psychological symptoms of cocaine dependency may be able to be maintained in an outpatient treatment program. Those who have a more severe addiction, have relapsed after engaging in outpatient programs, or whom also suffer from a severe mental illness might need the higher level of structure, guidance, and monitoring provided in an inpatient drug treatment center, often referred to as "rehab." After inpatient treatment, many cocaine addicts may need to reside in a sober-living community, that is, a group-home setting where counselors provide continued sobriety support and structure on a daily basis.

    Another important aspect of treating cocaine addiction is helping family members and friends of the addicted person refrain from supporting addictive behaviors (codependency). Whether codependent loved ones provide financial support, excuses, or fail to acknowledge the addictive behaviors of the addict, discouraging such codependency of friends and family is a key part of the recovery of the affected individual. Focusing on the cocaine-addicted person's role in the family likely becomes even more urgent when that person is a child or teenager, given that underaged people almost always come within the context of a family. Cocaine dependency treatment for children and adolescents differs further from that in adults by the younger addict's tendency to need help finishing their education and achieving higher education or job training compared to addicts who may have completed those parts of their lives before developing the addiction.

    Source: http://www.rxlist.com

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