Why is cocaine addictive? What Is The Best Cocaine Addiction Treatment?

Why is cocaine addictive? What Is The Best Cocaine Addiction Treatment?

What is coke and where does it come from?


Cocaine comes from the coca plant. These plants require a moist, warm climate. They grow best on equatorial, wet mountain sides at high elevations. The plant grows in the South American countries of Peru, Bolivia, Colombia, and other nearby countries.


The coca plant is illegal to grow, import, or possess in the United States. In regions where it grows naturally, local people have been known to chew on the leaves for energy. This is an old practice, going back centuries. The leaves of the coca plant are not as addicting as powder cocaine.


The process of making cocaine from the coca plant involves a difficult process of adding gasoline repeatedly. The extraction of cocaine from coca is dangerous to the health of the farmers and workers and it is bad for the environment.


Was cocaine ever socially acceptable and legal?


The soft drink Coca Cola was originally made with cocaine when it first went on the market in 1886. At the time, the drug was legal.


From 1884 to 1896, the great psychiatrist and father of psychoanalysis, Sigmund Freud, experimented with cocaine and used it to treat his patients. Freud was a leading advocate for the therapeutic usefulness of the drug.


Unfortunately, Freud’s well known cases in which he treated patients with cocaine did not end well. When the Harrison Narcotics Tax Act was passed in 1914, cocaine became illegal. Medical use of the drug was put to an end, except for use as a local anesthetic.


How addicting is cocaine?


Cocaine’s addictive potential makes it one of the most harmful drugs on the planet. Some experts consider cocaine to be the second most addictive drug, after methamphetamine.


However, nicotine is known to be the most addictive drug of all, placing cocaine at number three on the list. While nicotine may be the most addictive drug of all, it is a legal drug, still somewhat socially accepted and it does not alter the brain’s pathways as severely as cocaine and meth.


Cocaine also has the potential to cause immediate, serious health conditions, including respiratory failure, heart failure, seizures, stroke, cerebral hemorrhage, and sudden death. There is no safe amount of cocaine.


Why do people use cocaine if it is so dangerous? Why is cocaine so addictive?


Cocaine is a stimulant that causes euphoria. By increasing levels of dopamine in the brain, it reinforces the reward circuit of the brain.


Because of the highly-addictive nature of cocaine, users tend to binge-use the drug. They often deplete their finances, using cocaine until they have no more drug and no money to buy more of it.


How can you tell when a person is using cocaine?


Here are some signs to look for with cocaine use. If someone you know has dilated pupils and has a high level of excitability and talkativeness, they may be on cocaine. Also, look for weight loss, moodiness, social isolation and a need for privacy, increased confidence, a decline in personal hygiene, as well as risky and impulsive behaviors.


A person on cocaine may have serious financial or legal difficulties. They may have altered sleeping and eating habits, usually with a lack of sleep and a lack of appetite.


How do people use cocaine?


The most common way cocaine is used is by snorting it. If you suspect that someone close to you is using cocaine and you see white powder residue on their face, they are probably snorting it.


Another way that people use cocaine is by smoking it. In the old days, they called it “freebase.” It was made using ether, which is highly flammable.


The famous comedian, Richard Pryor, caught on fire while using freebase cocaine. He almost died during the incident.


What is freebase cocaine?


Cocaine in powder form is technically a salt. That is because it is a stable compound, made from an acid and a base combined. The proper name for cocaine in powder form is cocaine hydrochloride, or cocaine HCL.


Cocaine hydrochloride is also used in the medical field as a local anesthetic. Otolaryngologists, or ear, nose, and throat doctors, sometimes use this form of cocaine, which is stored in a bottle as a paste, to numb regions in the nose, mouth, or throat. Dentists may rarely use it also.


Cocaine as a stable salt cannot be effectively smoked. There may be some additional effect when users sprinkle cocaine powder on marijuana, known as a bazooka. When the HCL (an acid) part of the compound is removed, only the cocaine base remains.


This is why they call it free base. Free base, or rock crystal cocaine, can be smoked at relatively low temperatures.


What is crack cocaine?


In the 80s, drug users discovered a safer and easier way to turn powder coke into a rock cocaine which could be smoked. They called it crack, probably because of the crackling noise made when they cooked the powder cocaine with baking soda. Or, it could have been because of the popping and crackling sounds made when smoking it.

When dealers learned how to make crack cocaine, they discovered they could make more money with it on the streets by getting new users hooked. A single dose of crack can be sold for as little as $5 or even $2.


Crack cocaine use became rampant in the 80s and 90s, leading to a drug epidemic. The drug was everywhere on the streets. It was cheaper and it was far more addicting than powder cocaine.


What makes crack cocaine so much more addicting is the speed with which it reaches the brain. When a user smokes crack, it goes to the lungs and then quickly gets to the brain in seconds.


When a crack smoker inhales the smoke of the heated crack rocks, they may start to feel the strong rush of the cocaine high before they are even through inhaling. They call pieces of crack rocks because they are often small, uneven pieces of white material that resemble off-white rocks.


Crack vs. coke: How long does cocaine last compared to crack?


While the effects of crack are intense, they also wear off very quickly.

The effects of powder cocaine usually last about 30 minutes. The effects of crack may only last a few minutes. Because of this, crack users often smoke continuously, using as much crack as the user can afford or obtain.


People on crack often deplete their finances, sell their belongings, and eventually turn to crime to feed their habit. Otherwise, they spend much of their days suffering from the psychological effects of crack withdrawal, characterized by depression, anxiety, and intense drug cravings.


What is fake crack cocaine?


Crack probably more resembles cut up pieces of white bar soap. In fact, some street dealers trick crack users by selling them pieces of soap instead of real crack. They might even coat the fake crack with Orajel, or another OTC anesthetic so it numbs the tongue or causes it to tingle. This might fool some buyers who test the crack by touching it to their tongue.


What does it mean to inject cocaine or speedball it into a vein? How addictive is IV cocaine use?


Another way that people use cocaine is by injecting it into a vein. Intravenous cocaine use is far less common than snorting or smoking it. Injecting cocaine is also more addicting than snorting it, because the high comes in a fast rush, similar to smoking crack.


Not only is the risk of overdose and serious health consequences much higher with shooting up cocaine, there are other risks as well. These include infectious diseases, such as HIV, Hepatitis, and endocarditis. Endocarditis is a dangerous heart valve infection that can lead to the need for open-heart surgery. It also often leads to death from heart failure.


To add to the danger, some users combine heroin and cocaine in their syringe and shoot up the combination of the two together. This is known as speedballing.


As you can imagine, speedballing is a highly dangerous activity. On top of all the usual serious risks of infections or getting cotton fever, which happens when bits of cotton used to absorb the drug for the syringe and needle get pulled into the syringe by accident, the user now has many additional risks.


The risk of overdose from either heroin or cocaine, or both is possible. And, the overdose risks are higher due to the synergistic combination of the two drugs. Additionally, there is more of a danger of getting sick from the adulterants added to either drug. For example, the heroin might contain fentanyl, carfentanil, or one or more of many exotic synthetic opioid analogs.


Why do cocaine overdose victims often have Xanax in their system?


Cocaine dealers often distribute Xanax 2 mg tablets with cocaine. The 2 mg pill is shaped like a rectangle or a bar. In fact, they are called bars on the street, or xanibars, zannies, or planks.


The reason they give these out is to help the cocaine user come down from their high at some point when the effects of cocaine become unbearable, or they start crashing. When a person uses cocaine for a while, they start to get very paranoid.


They may even have vivid hallucinations of being chased or followed. Cocaine users have been known to get a cheap motel room to enjoy a coke binge, only to end up cowering in the bathroom, terrified that the police are going to barge into the room at any moment.


After days, weeks, and months of excessive cocaine use, the user becomes fully obsessed with cocaine and how to get more of it. Their thoughts become singularly focused on getting money to buy more cocaine and avoiding getting caught.


You can imagine that at some point, the sickness caused by cocaine dependence and overuse becomes unbearable, so the cocaine user will appreciate having the potent tranquilizer Xanax, given to them by their dealer. Unfortunately, Xanax and other drugs can be a deadly combination. Xanax is the most common secondary drug found in an overdose victim’s system. Cocaine and Valium is another combination often found on autopsy in cocaine overdoses.


Using other drugs with cocaine increases the risk of overdose.


A two-drug habit adds significant danger to the cocaine user’s drug use. The mixture of narcotics or tranquilizers with cocaine makes the possibility of overdose and death more likely.


The deadly combination of drugs is a serious issue. Even when the cocaine user has no intention of using other drugs with their cocaine, they may not have a choice. Cocaine on the streets has been analyzed and found to contain other drugs, including fentanyl.


Why would a clandestine drug lab put fentanyl into powdered cocaine? Cutting coke with cornstarch, talcum powder, or sugar is common. Yet, when a dealer can cut it with an inexpensive second drug, it saves them money, and it gives the user a more intense high. However, the problem is that fentanyl is highly potent, measured in micrograms, and it is easy to accidentally add in a deadly dose to the cocaine.


Also, consider that a cocaine user may be opioid-naive and have no tolerance for fentanyl. So, now, on top of all the other concerns of using cocaine, accidental opioid overdose is another possibility.


What makes cocaine so addictive to people with attention deficit hyperactivity disorder (ADHD)?


It is not unusual to discover that a cocaine user has underlying mental health issues. While we think of ADHD as a childhood condition, where a child is unable to focus on a task long enough to complete it, adults can also suffer from ADHD. In fact, it is most often continued from childhood and is frequently a missed diagnosis.


When a person with ADHD who never received proper medical treatment uses a stimulant like cocaine, they may feel that they are able to focus their thoughts and concentrate normally for the first time in their lives. Because of this, they may continue cocaine use to self-medicate their ADHD.


One serious problem with this form of self-medication is that the user with ADHD may overuse and become addicted to cocaine. When they finally quit the drug and enter recovery, there are less medical options available to treat their ADHD, because drugs such as Ritalin, Adderall, and Vyvanse may trigger cravings and a relapse.


What does cocaine feel like?


It is difficult for people who have not used a drug to imagine how it feels to use that drug. While we might imagine that using cocaine is similar to drinking too much coffee, the extremely heightened euphoria goes far beyond the effects of caffeine.


For many users, the effects of cocaine on the pleasure centers of the brain are similar to sexual stimulation. In fact, cocaine users often use the drug to enhance sexual activity when they first start using it. The effects of cocaine on the reward circuit of the brain crosses over with the pathways for sexual pleasure.


This creates a unique problem for many cocaine users. Because of the shame and taboo associated with discussing sexual issues, the recovering cocaine addict may feel uncomfortable discussing the struggle they have with cravings and thoughts of drug use that might be triggered by sexual stimulation or thoughts.


Returning to full normal functioning in life can be complicated by how cocaine rewires the architecture of brain chemistry. Over time, the former cocaine user must learn to separate normal, healthy sexual functioning from thoughts of going back to cocaine use. For this reason, therapy is a critical part of recovering from cocaine addiction.


As you can imagine, the unique and detrimental effects of prolonged cocaine use create issues that are best addressed by a professional psychologist. While group support meetings are helpful as well, intense therapy is important, where the patient is able to freely open up about issues relating to past cocaine use without fear of being shamed or criticized.


Do you know how to stop doing cocaine?


This is a good question. While rehabs brag about the many forms of therapy they offer for cocaine addiction, there is currently no highly effective medical treatment available. Possibly, one of the great benefits of going to rehab for cocaine addiction is that it gives a person time for the addicted brain to heal while being physically kept away from sources for obtaining more cocaine.


Cognitive behavioral therapy has shown promise in treating cocaine addiction. CBT can be administered by a licensed therapist or psychologist. It is also available as a feature of prescription digital therapeutics software, including Reset by Pear Therapeutics.


Are support groups helpful?


Another place to go for CBT is Smart Recovery. Smart Recovery is a group meeting program that is based on the use of therapeutic tools, such as CBT, to help members to overcome addictions. There is also LifeRing, another group meeting organization for addiction recovery support.


When it comes to group meetings, there are also the traditional 12-step groups, such as Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous. Any of these three groups would be acceptable for someone who wants to quit using cocaine. When someone shows up to a meeting high on drugs, they are still allowed to attend the meeting, but they are asked not to speak during the meeting. Group support is a good way to meet new friends and develop a support network of trusted people to call to talk to or ask for help.


Can family therapy help?


There are experts who say that addiction is a family disease or a family condition. Family counseling and family therapy are therapeutic modalities that can be very helpful in healing the family.


While addiction is a mental health condition that requires treatment and must be taken seriously, families can be torn apart by it and family members may harbor resentments. The best rehab programs have family involvement at the center of their programs.


Is there medication that can help a cocaine user to stop?


While there is no medication currently approved for cocaine addiction treatment, there are some medications that have shown promise in studies. Naltrexone, an opioid blocker, may be helpful in suppressing cocaine cravings. Ondansetron, the generic version of the anti-nausea drug, Zofran, also shows promise for patients with specific genetic markers.


Is there any sign that cocaine use is going down?


The war on drugs continues on all fronts. Federal agents are seizing huge cocaine shipments on a regular basis. Considering that it takes 1000 Kg of coca leaves to make 1 Kg of powder cocaine, you can imagine the size of cocaine operations in South American countries and the logistics involved in trying to get the drug into the US.


Unfortunately, it appears that there is always a market for potent stimulant drugs. Cocaine has been somewhat displaced in certain regions of the US by methamphetamine. Meth is a synthetic drug that can be manufactured easier and cheaper than cocaine. It is also far longer lasting for the user, lasting for many hours per dose.


In the midst of the current opioid epidemic, addiction experts warn us that there is an impending stimulant addiction crisis on the horizon. While they are mostly worried about methamphetamine, cocaine is still a huge concern.


What is the first step to take in overcoming cocaine addiction?


Like any medical health issue, the best place to start is with an appointment with your family doctor. You will likely also be referred to an addiction specialist. While traditionally, addiction doctors preferred to see patients in-person, in light of the COVID-19 pandemic due to the novel coronavirus, telemedicine visits may be a viable alternative. Even support meetings may be held over Zoom meetings. Therapists are conducting telehealth visits as well.


In the case of cocaine addiction, because there is no currently accepted medication-assisted treatment, group meetings should be part of your program early on. Abstinence-based programs, such as AA, NA, and CA, are excellent to help reinforce the importance of complete abstinence from cocaine and other drugs.


Rehab can also be an excellent resource to allow for time away from the lifestyle that can put you at risk for relapsing. In some cases, long-term rehab, lasting as long as five or six months, may be the best solution.


Cocaine addiction will improve with time away from the drug. The brain will heal over time, forming new pathways to adjust to a life without cocaine. Cravings will diminish in intensity and will occur less often. The most important concept to continue healing is to not use cocaine or any similar drug, no matter what.