Cocaine Addiction and How to Overcome It

In 2020, 4.8 million people aged 12 or older used cocaine, according to the National Survey on Drug Use and Health [1]. Cocaine is a challenging but treatable chronic addiction that affects the brain’s reward system. 

Overcoming cocaine addiction typically requires professional help and support due to the long-term brain changes caused by chronic use. Read on to learn more about this and how Cocaine Use Disorder (CUD) can be treated.

Understanding Cocaine Addiction. What Happens to the Brain?

Cocaine may be snorted, smoked as “crack”, or injected, but by whatever means, it rapidly enters the bloodstream and penetrates the brain. It achieves its main psychological effect—the high—by causing a buildup of the neurochemical dopamine. Cocaine binds to the dopamine transporters which are blocked from their normal function of retrieving excess dopamine.

Cocaine causes euphoria in the short term and addiction in the long term via its effects on the limbic system in the brain. This consists of numerous regions, including centers for feelings of pleasure and reward, centers for memory, and the center for weighing options and restraint.

Over time, repeated cocaine use can result in:

• Desensitization to natural rewards
• Sensitization of stress circuits
• Intense cravings, even after long periods of abstinence

Some researchers have found that cocaine causes certain proteins to alter gene activity in such a way as may explain the long-lasting neurobiological effects of cocaine [2]. And reduced functioning in addicts of the frontal lobe, where decision-making is located in the brain, may explain important clinical phenomena such as denial by the addict and loss of control over the impulses in the reward systems [3]. 

Signs of Cocaine Addiction

Profound loss of control is the main characteristic of cocaine addiction and a core issue in its treatment. Denial, another essential element of cocaine addiction, prevents cocaine-addicted individuals from realizing their loss of control and shields them from their progressive impairment even when it is obvious to everyone else in their life. 

Those addicted to cocaine readily risk death, medical complications, incarceration, job loss, financial ruin, and family turmoil in the course of using cocaine. Cocaine craving, an unpleasant state that can be immediately (although briefly) ameliorated with cocaine, acts as a negative reinforcer of the addiction cycle.

Through conditioning, stimuli in the drug environment associated with the use of cocaine can produce intense cravings in addicted individuals. The inability of patients to control cocaine use illustrates the power of reward centers over behavior, and partially explains the relapsing nature of cocaine dependence. Reduced dopamine-mediated reward could explain the high rates of depression, irritability, anxiety, and suicide that have been reported in cocaine-addicted individuals [3].

Key signs of cocaine addiction include:

• Inability to cut down or stop cocaine use despite attempts
• Damage to relationships, work, finances, or health
• Continued use despite negative consequences

Diagnostic Criteria of Cocaine Use Disorder (CUD)

The Diagnostic and Statistical Manual DSM-5, used by psychiatrists to diagnose mental health conditions, diagnoses CUD as caused by at least 2 of 11 criteria (in 4 groups) in the preceding 12 months [4]:

1. Physiologic, including craving, tolerance, and withdrawal
2. Loss of control of cocaine use
3. Cocaine use taking precedence over other activities (including responsibilities at home, work, or school)
4. Other negative consequences from cocaine use. 

Side Effects of Cocaine Abuse

Short-term effects include [1]:

• Loss of appetite and weight loss
• Constant runny nose or nosebleeds
• Frequent upper respiratory infections
• Changes in personal hygiene
• Sleep pattern changes, particularly sleeping less than usual
• Loss of interest in friends, family, and social activities
• Loss of interest in food, sex, or other pleasures
• Emotional changes like being angry or impatient for no obvious reason
• Mental health issues like severe depression, paranoia, or experiencing hallucinations
• Showing signs of withdrawal when you can’t get cocaine

Long-term effects include:

• Heart attack
• Stroke
• HIV/AIDs
• Hepatitis 
• Pneumonia
• Increased seizures related to epilepsy

Co-occurring Disorders

Many people with cocaine abuse disorder also experience other mental health conditions, as well as polysubstance use of more than one drug together with cocaine, further increasing the health risks. One study reported the following [4]:

• 45% of cocaine users reported a lifetime mood disorder
• 31% reported a lifetime anxiety disorder

Compared to those who have never used cocaine, current cocaine use is associated with:

• An almost tripled risk for depression (16% vs 6%)
• A more than doubled risk for anxiety disorders (11% vs 5%)
• 11 to 28% lifetime prevalence of bipolar disorder among individuals with CUD, compared to 1 to 3% for those in the general population.

Treatment Options

Because researchers have yet to identify effective medication treatments, therapists must rely entirely on psychosocial approaches for treatment. Since the cycle of cocaine addiction is pleasure-reinforced, those addicted often have mixed feelings about recovery, making treatment challenging. Effective treatments for cocaine addiction include:

Behavioral Therapies

• Cognitive Behavioral Therapy (CBT)
• Individual and group counseling
• Couples therapy

Psychosocial Treatments

• Support groups (e.g.Narcotics Anonymous, Cocaine Anonymous)
• SMART Recovery programs

Incentive-based Interventions

• Contingency Management (CM)
• Offers rewards for maintaining sobriety and treatment adherence

Medically Supervised Detox

• While not always necessary for cocaine-only use, it may be recommended when other substances are involved

Inpatient or Outpatient Rehabilitation

• Inpatient care provides 24/7 support and allows full focus on recovery
• Outpatient programs offer various levels of care while allowing patients to live at home

Aftercare and Ongoing Support

• Continued care after formal treatment to support sobriety and prevent relapse

Steps to Overcome Cocaine Addiction

1. Seek professional help from a healthcare provider or local drug treatment service.
2. Undergo a comprehensive assessment to develop a tailored treatment plan.
3. Safely detox under medical supervision to manage withdrawal symptoms.
4. Engage in behavioral therapies and counseling to address underlying issues.
5. Participate in support groups or mutual-help programs.
6. Develop a relapse prevention plan and coping strategies.
7. Consider ongoing aftercare to maintain long-term sobriety.

While quitting cocaine without professional help is possible, studies show that the success rate is significantly lower compared to structured treatment programs. 

Only 10-30% of people who attempt to quit cocaine without support remain drug-free for six months or more, whereas rehab programs have success rates of 50-60%.

Remember, recovery is a journey, and seeking help is a sign of strength. With proper treatment and support, people can and do overcome cocaine addiction

Trauma-Informed Therapies at Maple Mountain Mental Health and Wellness

Addiction and trauma can feel isolating and overwhelming, but healing is possible with the right support.  Whether through therapy, medication, or holistic practices, recovery is within reach. Seeking help is a sign of strength and you don’t have to navigate this journey alone.

Maple Mountain Mental Health & Wellness Center has a compassionate team of trauma-informed therapists who are here to provide comprehensive support. 

We understand the complex nature of trauma and offer individualized treatment options. Healing starts with taking the first step.  Reach out to our Admissions team today.

Sources

[1] Cocaine (Crack). 2023. ClevelandClinic.org.

[2] Nestler EJ. The neurobiology of cocaine addiction. Sci Pract Perspect. 2005 Dec;3(1):4-10.

[3] Dackis, Charles A. et al. 2001. Cocaine dependence: a disease of the brain’s reward centers. Journal of Substance Abuse Treatment, Volume 21, Issue 3, 111 – 117

[4] Schwartz EKC, et al. 2022. Cocaine Use Disorder (CUD): Current Clinical Perspectives. Subst Abuse Rehabil. 2022 Sep 3;13:25-46.