Cocaine Abuse & Treatment
Cocaine is a crystalline tropane alkaloid that is procured from coca plant leaves. The drug acts as both reuptake inhibitor for neurotransmitters serotonin, norepinephrine, epinephrine and dopamine by blocking their transporters. It is occasionally prescribed for genuine medical uses, particularly as local anesthesia for eye, ear and throat surgeries.
Cocaine stimulates the nervous system and increases alertness, feelings of well-being and euphoria, energy and motor activity, the perception of competence and sexuality and possible enhanced athletic performance. It can also generate anxiety, paranoia and restlessness.
Cocaine is listed at a Schedule II drug according to the Controlled Substances Act of 1970, which means that it has a high potential for abuse and dependence.
With excessive dosage, the onset of tremors, convulsions and increased body temperature are noticeable. Because of the way it affects the mesolimbic pathway, which modulates behavioral responses to stimuli that activate feelings of reward and reinforcement through the neurotransmitter dopamine, cocaine is addictive.
In the late 19th century, cocaine began to be used to treat morphine addition. It was also introduced in Germany around that time for clinical use as a local anesthetic and has historically been used in eye and nasal surgery. Cocaine wasn't officially considered a controlled substance until 1970 when it was listed as such in the Controlled Substances Act.
A problem with illegal cocaine use by long-time users is the risk of ill effects or damage caused by the compounds used in adulteration.
Cutting or "stamping on" the drug is common, using compounds which simulate ingestion effects, such as Novocain which produces temporary anesthaesia as many users believe a strong numbing effect is the result of strong and/or pure cocaine, ephedrine or similar stimulants that produce an increased heart rate.
Other symptoms of repeated use include insatiable hunger, aches, insomnia/oversleeping, lethargy, and persistent runny nose. Depression with suicidal thoughts may develop in very heavy users. Frequent usage also leads to a rise in tolerance thus requiring a larger dosage to achieve the same effect.
Treatment for cocaine abuse and addiction focuses on behavioral interventions.
Cognitive Behavioral Therapy and other interventions have been shown to be effective for decreasing cocaine use and preventing relapse. Treatment must be tailored to the individual patient’s needs in order to optimize outcomes—this often involves a combination of treatment, social supports, and other services.
Currently, there are no FDA-approved medications for treating cocaine addiction. Researchers are trying to develop medications that help alleviate the severe craving associated with cocaine addiction, as well as medications that counteract cocaine-related relapse triggers, such as stress. Several compounds are currently being investigated for their safety and efficacy, including a vaccine that would sequester cocaine in the bloodstream and prevent it from reaching the brain.
Current research suggests that while medications are effective in treating addiction, combining them with a comprehensive behavioral therapy program is the most effective method to reduce drug use in the long term.
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