Patient education: Cocaine use disorder (The Basics)

What is cocaine? — Cocaine is a drug that comes from the leaves of the coca plant. It is used in some prescription medicines to treat pain. It is also used illegally, usually in these 2 forms:

●A white powder that is snorted through the nose or mixed in water and injected into a vein

●Rock crystals (called "crack") that are smoked

Cocaine has many different common (or "street") names and is sometimes used with other illegal drugs (table 1).

What does illegal cocaine use do to the brain and body? — Cocaine can make you feel alert, full of energy, and very happy. It can also make you feel less sleepy and less hungry than normal.

Cocaine can also make you:

●Feel anxious, irritable, or restless

●Have panic attacks

●Feel suspicious or paranoid

●More likely to make bad or unsafe decisions

●Have delusions – This means believing things that are not true.

●Have hallucinations – This means seeing, hearing, tasting, or smelling things that are not really there.

●Tremble or shake

●Have trouble controlling your body

●Pick at your skin

●Have a fast heartbeat

●Sweat

●Feel sick to your stomach (nausea)

People who use large amounts of cocaine over a long period of time can have problems with thinking, memory, attention, and making decisions. They also have a higher chance of suicide than people who do not use cocaine.

Who uses illegal cocaine? — About 2 percent of Americans older than 14 use illegal cocaine. Most people who use cocaine are males ages 15 to 35 who live in cities. Some people use cocaine only once in a while. But others take large amounts over short periods of time. This is called a "binge."

What is cocaine use disorder? — Cocaine use disorder is basically the medical term for cocaine addiction. It can be mild to severe. People with cocaine use disorder have 2 or more of the following problems. The more problems they have, the more severe their disorder.

●They end up using more cocaine than they planned to, or they use it for longer than they planned to.

●They wish they could use less cocaine, but they can't.

●They spend a lot of time trying to get cocaine, getting high, or recovering from being high.

●They crave or have a strong desire or urge to use cocaine.

●Because of their cocaine use, they often don't do things that they need to do or that are expected of them, such as go to work or school, remember family events, and clean their home.

●They keep using cocaine even if it causes or worsens problems in their relationships or interactions with other people.

●They stop or cut back on important social, work, or fun activities they used to do.

●They keep using cocaine even in situations where it is dangerous to do so (such as driving).

●They keep using cocaine even when they know they have a physical or mental problem that was probably caused or made worse by their drug use.

●They need to use more and more cocaine to get the same effects they used to get with less. Or they get less effect from using the amount that used to get them high. This is called "tolerance."

●They have "withdrawal symptoms" if they stop using cocaine after using it for a long time. Withdrawal symptoms can include:

•Feeling sad or depressed

•Feeling tired

•Having dreams that are unpleasant and seem very real

•Sleeping too little or too much

•Hunger

•Being restless or moving little or slowly

How is cocaine addiction treated? — In general, treatment involves addiction counseling and being in a support group.

●Addiction counseling – People with addiction work with a counselor to better understand their addiction. They learn new ways to live their life without using drugs.

●Support groups – In support groups, people with addiction share their experiences with each other. The most common of these groups is Cocaine Anonymous (www.ca.org), but some people dislike that it involves God or a "higher power." There are other groups that do not focus on that.

Some people cannot stop using cocaine even with counseling and support groups. They might benefit from a more structured treatment program that includes specific types of therapy, behavioral exercises, and routine drug testing.

There are no medicines that are proven to work to treat cocaine use disorder.

For specific situations, there are other treatments. An example is family therapy, which can be especially helpful for children or teens with addiction who have families willing to participate in treatment.

Get help right away if you are thinking of hurting or killing yourself! — Sometimes, people with depression think of hurting or killing themselves. If you ever feel like you might hurt yourself, help is available:

●In the US, contact the 988 Suicide & Crisis Lifeline:

•To speak to someone, call or text 988.

•To talk to someone online, go to www.988lifeline.org/chat.

●Call your doctor or nurse and tell them that it is an emergency.

●Call for an ambulance (in the US and Canada, call 9-1-1).

●Go to the emergency department at your local hospital.

If you think your partner might have depression, or if you are worried that they might hurt themselves, get them help right away.

More on this topic

Patient education: Cannabis use disorder (The Basics)
Patient education: Alcohol use — when is drinking a problem? (The Basics)
Patient education: Alcohol poisoning (The Basics)

Patient education: Alcohol use — when is drinking a problem? (Beyond the Basics)
Patient education: Risks and benefits of alcohol (Beyond the Basics)