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11- Bulkhead

Cocaine Abuse

AUTHORED BY Diedre O'Donnell, M.S., Neuropharmacology

Table of Contents

Overview of Cocaine Abuse

Signs and Symptoms

Cocaine Abuse Treatment

Statistics on Cocaine Abuse

Teen Cocaine Abuse

Resources, Articles and More Information

Overview of Cocaine Abuse

Cocaine is a type of drug that functions to increase the availability of the

neurotransmitter dopamine in the brain. Dopamine is associated with the

generation of 'euphoric' emotions, the regulation of movement, and the

 processing of reward cues. However, it is also associated with a considerable

potential for dependence and abuse. Cocaine abuse is related to an increased risk

of:

Psychiatric disorders.

Disease.

Death.

Cocaine is attractive as a recreational substance due to the perceived positive

effects on mood, motivation, and energy. Someone abusing cocaine may smoke,

snort, or take it intravenously (via injection).

Signs and Symptoms

Typical signs and symptoms of current cocaine use include:

Increased agitation.

Effusive enthusiasm.

Disinhibition.

Increased movement (i.e. hyperactivity).

Increased common cold-like symptoms and/or nosebleeds.

Signs of involuntary movements (i.e. muscle tics).

 Changes in concentration and focus.

Other Adverse Effects

One of the most serious effects of cocaine abuse is heart muscle

damage. Cocaine may cause damage by inducing cell death in the muscles of the

heart (cardiomyopathy). Intravenous cocaine use can lead to inflammation of the

inner tissues of the organ (endocarditis).

These cellular effects of cocaine cumulate into serious conditions such as heart

attacks and cardiac arrhythmias, which may be fatal. Other symptoms of

cocaine-induced cardiotoxicity include:

Inflammation of heart muscle.

Rupture of the aorta, the major artery leading from the heart.

Severe declines in health and life quality due to reductions in cardiac function

or severe blood loss.

Cocaine-induced heart failure or damage may also increase the risk of stroke,

or brain damage resulting from interruptions in the blood supply available to the

brain.

The abuse of this drug is also associated with kidney damage. The prolonged use

of cocaine is thought to be related to the inflammation of important microstructures

within this organ.

Cocaine Abuse Treatment

The nature of these treatments may be both behavioral and pharmacological.

Behavioral Therapies

Behavioral therapies are psychosocial treatments that address the reasons,

motivations and possible underlying psychological issues associated with a person's

substance abuse.

Current research indicates that behavioral therapy techniques are particularly

effective in patients affected by cocaine abuse and dependence.

An example of behavioral treatment associated with effective abstinence from

cocaine use is contingency management (CM). This treatment is based on

incentives (e.g. prizes or cash) for abstinence, or other positive parameters, such as

improved social interactions. This treatment has demonstrated promising in-

treatment results, but the long-term effects are less certain, as it appears to lose

efficacy over time.

Another form of behavioral treatment, cognitive behavioral therapy (CBT) may

be used. This type of treatment addresses the reasons behind the substance abuse,

and helps to alter maladaptive ways of thinking and acting that may be contributing

to the cocaine abuse issue.

 Pharmacological Therapies

Pharmacological (or drug-based) therapies refers to medications administered

to treat cocaine dependence by physiological means.

This type of treatment uses medications that may mimic the substance of abuse in

question, but to a reduced or different extent. The doses of these medications

are reduced (or 'tapered') over time, thus 'weaning' the patient off drug

dependence and allowing them to work on abstinence and recovery from addiction.

An emerging form of pharmacotherapy for cocaine dependence

is methylphenidate treatment. This medication is prescribed to treat ADHD, and

is similar to cocaine in terms of neurological effects. However, the stimulant effects

of methylphenidate act on the brain for a longer duration, but elicit less extreme

reactions, compared to cocaine. The hope is to alleviate the 'need' for cocaine, and

thus dependence, over time.

It is important to not that medically assisted treatment of any type is very program

specific, and not offered universally.

Statistics on Cocaine Abuse

According to the 2015 National Survey on Drug Use and Health:

Cocaine was the most common illicit substance involved in emergency

department visits in 2011, found in more than 40% of cases.

 Almost 5 million people reported using cocaine at some point in 2015, and

nearly million reported use at some point in their life.

Approximately 1.75 times more men than women abused cocaine in 2015.

Additionally, in 2011, the Drug Abuse Warning Network found that cocaine was the

most common illicit substance involved in emergency department visits in 2011,

found in more than 40% of cases.

Teen Cocaine Abuse

Cocaine abuse is relatively common among adolescents. Almost 2% of 8 th graders,

3% of 10th graders, and 4% of 12th graders reported use of cocaine at some point in

their life, per the National Institute on Drug Abuse's Monitoring the Future Study.

Initiating use at a younger age is one way to increase one's risk of cocaine

dependency. It is also thought to be related to increased risks of legal and

psychiatric problems in later life, and is associated with reduced responses to

treatment.

To prevent drug abuse in your teen, it's important to talk to him or her about

substance abuse at a young age and continue the conversation. Make sure

they understand the dangers of both illicit and prescription drugs, and

monitor their behavior, friends, and habits for sudden changes.

 Resources, Articles and More Information

For more information, see the following articles:

Effects of Cocaine Use

Concurrent Alcohol and Cocaine Abuse

Crack Cocaine's Effect on the Brain

You can also join the conversation on cocaine abuse and addiction by visiting

our Forum today.

Sources:

Drsteler KM, Berger E-M, Strasser J, et al. Clinical potential of

methylphenidate in the treatment of cocaine addiction: a review of the

current evidence. Substance Abuse and Rehabilitation. 2015;6:61-74.

Maraj S, Figueredo VM, Lynn Morris D. Cocaine and the heart. Clin Cardiol.

2010;33(5):264-269.

Qureshi AI, Chaudhry SA, Suri MFK. Cocaine use and the likelihood of

cardiovascular and all-cause mortality: data from the Third National

 Health and Nutrition Examination Survey Mortality Follow-up Study. Journal

of Vascular and Interventional Neurology. 2014;7(1):76-82.

Jaffe JA, Kimmel PL. Chronic nephropathies of cocaine and heroin

abuse: a critical review. Clin J Am Soc Nephrol. 2006;1(4):655-667.

Hellem T, Shi X, Latendresse G, Renshaw PF. The Utility of Magnetic

Resonance Spectroscopy for Understanding Substance Use Disorders: A Systematic

Review of the Literature. J Am Psychiatr Nurses Assoc. 2015;21(4):244-275.

Weiss LM, Petry NM. Substance abuse treatment patients with early

onset cocaine use respond as well to contingency management

interventions as those with later onset cocaine use. Journal of substance

abuse treatment. 2014;47(2):146-150.

Barrio G, Molist G, de la Fuente L, et al. Mortality in a cohort of young

primary cocaine users: controlling the effect of the riskiest drug-use

behaviors. Addict Behav. 2013;38(3):1601-1604.

Colzato LS, van den Wildenberg WP, Hommel B. Impaired inhibitory

control in recreational cocaine users. PLoS One. 2007;2(11):e1143.

Center for Behavioral Health Statistics and Quality. (2016). Results from the

2015 National Survey on Drug Use and Health: Detailed Tables. Substance

Abuse and Mental Health Services Administration, Rockville, MD.

Substance Abuse and Mental Health Services Administration, Drug Abuse

Warning Network, 2011: National Estimates of Drug-Related Emergency

 Department Visits. HHS Publication No. (SMA) 13-4760, DAWN Series D-39.

Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.

National Institute on Drug Abuse. Monitoring the Future Study: Trends in

Prevalence of Various Drugs.