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Cocaine withdrawal

Cocaine withdrawal happens when a person who uses a lot of cocaine stops using cocaine. It can also happen when a person who uses a lot of cocaine starts using less than they did before.

Cocaine (also called coke) is a powerful stimulant. It is an illegal drug outside of hospital usage. It makes people feel very happy, talkative, energetic, and not want to eat as much food.

Side effects of cocaine

Cocaine's most dangerous side effects include:[1][2]

Withdrawal effects of cocaine

After using cocaine regularly, some users will become addicted. When a person who is used to using cocaine stops right away, they will go through what is called a "crash" along with many of other cocaine withdrawal symptoms, like:[3]

Some cocaine users also report having similar symptoms to schizophrenia patients and feel that their mind is lost. Some users also report formication: feeling like things are crawling on the skin (also called, "coke bugs" or "spiders"). These symptoms can last for weeks or, in some cases, months.[4][5][6]

Even after many withdrawal symptoms go away, most users feel like they need to keep using cocaine. This feeling can last for years and may get worse during times of stress. About 30-40% of cocaine addicts start using other kinds of drugs or alcohol after they stop using cocaine.[7][better source needed]

Treatment

Therapy

Twelve-step programs like Cocaine Anonymous (modeled on Alcoholics Anonymous and Narcotics Anonymous) have been widely used to help people addicted to cocaine. Cognitive Behavioral Therapy (CBT) and Motivational Therapy (MT) have proven to be more helpful than 12-step programs in treating cocaine dependency.[8] However, both of these approaches have a fairly low success rate.

Ibogaine has been researched a treatment for cocaine dependency.[9][10] It is used in clinics in Mexico, the Netherlands, and Canada, but it cannot be used legally in the United States.[11]

Non-drug treatments like acupuncture[12][13] and hypnosis[14][15] have been studied. However, these studies have not clearly shown that acupuncture or hypnosis helps with cocaine withdrawal.

Cocaine addiction continues to be the second-most difficult addiction to manage, behind heroin addiction.[16][17]

Medications

Medications that have been studied to treat cocaine withdrawal include acetylcysteine,[18][19][20] baclofen,[21][22] bupropion,[23] vanoxerine,[24] and vigabatrin.[21]

Kim Janda has been working for years on a vaccination that would treat cocaine use disorders.[25]

The anti-depressant desipramine,[26] and the stimulants methylphenidate[27] and pemoline,[28] have been used to treat cocaine dependence in people who also have a mental illness.

Several drugs have been used to treat cocaine withdrawal and cravings:

Finally, drugs have been used to cause an "aversion reaction" (a very bad reaction) when given with cocaine. The most common of these drugs is phenelzine.[a]

Reward-based treatments

On February 14, 2011, two Swiss psychologists published two years' research on cocaine addiction. They found that addicts who gambled were less likely to use cocaine or to relapse on cocaine. They think gambling may refocus the brain's "reward center" from cocaine to gambling. They said that psychotherapy should be used along with gambling. More research is being done on long-term relapse rates (the number of people who eventually start using cocaine again).[33][34][better source needed]

However, a more recent study looked at prize-based contingency management: a treatment method that offers addicts chances to win prizes if they do not use cocaine. This study found that prize-based contingency management helped cocaine addicts stay off cocaine, whether or not they had gambled recently. This suggests that it is the chance of a reward, not the gambling itself, that helps cocaine addicts stay off of cocaine.[35]

Cocaine Withdrawal Media

  • US yearly overdose deaths involving cocaine.

  • US. Opioid involvement in cocaine overdose deaths. Green line is cocaine and any opioid. Gray line is cocaine without any opioids. Yellow line is cocaine and other synthetic opioids.

  • A "cocaine alert" sign posted by GGD Amsterdam: the sign reminds people to "Call 112 for an ambulance."

References

  1. ↑ [32] ←Page #928 (4th page of article) ¶4. §(1), (2) & (3); Lines 10—12 & 15—18 of aforementioned 4th ¶.
  1. ↑ Walsh, Karen. Teen Cocaine Use (October 2010). Retrieved 2015-12-31.
  2. ↑ Gawin, F.H.. Cocaine addiction: Psychology and neurophysiology. Science 251 (5001) (1991). p. 1580–6. doi:10.1126/science.2011738.
  3. ↑ Models of Intervention and Care for Psychostimulant Users, 2nd Edition – Monograph Series No. 51: The Cocaine Withdrawal Syndrome. The Department of Health (April 2004)Government of Australia. Retrieved 2016-11-30.
  4. ↑ Cocaine-induced psychosis. J Clin Psychiatry 52 (12) (1991). p. 509–512.
  5. ↑ Thirthalli J.. Psychosis Among Substance Users. Curr Opin Psychiatry 19 (3) (2006). p. 239–245. doi:10.1097/01.yco.0000218593.08313.fd.
  6. ↑ Elliott A.. Cocaine Bugs: A Case Report of Cocaine-Induced Delusions of Parasitosis. The American Journal on Addictions 21 (2) (2012). p. 180–181. doi:10.1111/j.1521-0391.2011.00208.x.
  7. ↑ Cocaine Withdrawal. Treatment4Addiction Online Recovery Resource DirectoryAAC. Retrieved 2016-11-30.
  8. ↑ Palinkas, L. A.. Cognitive behavioural therapy reduced cocaine abuse compared with 12 step facilitation. Evidence-Based Mental Health 2 (2) (17 January 2008)ebmh.bmj.com. p. 51. doi:10.1136/ebmh.2.2.51. Retrieved 25 August 2012.
  9. ↑ Koenig, X. The anti-addiction drug ibogaine and the heart: A delicate relation.. Molecules (Basel, Switzerland) 20 (2) (29 January 2015). p. 2208–28. doi:10.3390/molecules20022208.
  10. ↑ Brown, Thomas. Ibogaine in the treatment of substance dependence. Current Drug Abuse Reviews 6 (1) (March 2013). p. 3–16. doi:10.2174/15672050113109990001.
  11. ↑ Hegarty, Stephanie. Can a hallucinogen from Africa cure addiction?. BBC World Service (April 13, 2012)British Broadcasting Corporation.
  12. ↑ Margolin, Arthur. Acupuncture for the treatment of cocaine addiction: A randomized controlled trial. The Journal of the American Medical Association 287 (1) (2 January 2002). p. 55–63. doi:10.1001/jama.287.1.55.
  13. ↑ Otto, Katharine C.. Auricular acupuncture as an adjunctive treatment for cocaine addiction: A pilot study. The American Journal on Addictions 7 (2) (Spring 1998). p. 164–170. doi:10.1111/j.1521-0391.1998.tb00331.x.
  14. ↑ Page, R.A.. The use of hypnosis in cocaine addiction. American Journal of Clinical Hypnosis 36 (2) (1993). p. 120–123. doi:10.1080/00029157.1993.10403054.
  15. ↑ Potter, Greg. Intensive therapy: Utilizing hypnosis in the treatment of substance abuse disorders. American Journal of Clinical Hypnosis 47 (1) (2004). p. 21–28. doi:10.1080/00029157.2004.10401472.
  16. ↑ Schaler, Jeffrey A.. Drugs and free will. Society 28 (6) (September–October 1991). p. 42–49. doi:10.1007/BF02695758.
  17. ↑ Barbara, John. If addiction is incurable, why do we try to cure it?: A comparison of control methods in the U.K. and the U.S. Crime & Delinquency 21 (1) (January 1975). p. 28–33. doi:10.1177/001112877502100104.
  18. ↑ Mardikian PN, LaRowe SD, Hedden S, Kalivas PW, Malcolm RJ. An open-label trial of N-acetylcysteine for the treatment of cocaine dependence: a pilot study. Prog. Neuropsychopharmacol. Biol. Psychiatry 31 (2) (March 2007). p. 389–94. doi:10.1016/j.pnpbp.2006.10.001.
  19. ↑ LaRowe SD. Is cocaine desire reduced by N-acetylcysteine?. Am J Psychiatry 164 (7) (July 2007). p. 1115–7. doi:10.1176/appi.ajp.164.7.1115.
  20. ↑ Gass JT, Olive MF. Glutamatergic substrates of drug addiction and alcoholism. Biochem. Pharmacol. 75 (1) (January 2008). p. 218–65. doi:10.1016/j.bcp.2007.06.039.
  21. ↑ 21.0 21.1 Karila L. New treatments for cocaine dependence: a focused review. Int. J. Neuropsychopharmacol. 11 (3) (May 2008). p. 425–38. doi:10.1017/S1461145707008097.
  22. ↑ Ling W, Shoptaw S, Majewska D. Baclofen as a cocaine anti-craving medication: a preliminary clinical study. Neuropsychopharmacology 18 (5) (May 1998). p. 403–4. doi:10.1016/S0893-133X(97)00128-0.
  23. ↑ Margolin A. A multicenter trial of bupropion for cocaine dependence in methadone-maintained patients. Drug Alcohol Depend 40 (2) (December 1995). p. 125–31. doi:10.1016/0376-8716(95)01198-6.
  24. ↑ Cherstniakova SA, Bi D, Fuller DR, Mojsiak JZ, Collins JM, Cantilena LR. Metabolism of vanoxerine, 1-[2-[bis(4-fluorophenyl)methoxyethyl]-4-(3-phenylpropyl)piperazine, by human cytochrome P450 enzymes]. Drug Metab. Dispos. 29 (9) (September 2001). p. 1216–20. Retrieved 2015-12-31.
  25. ↑ Douglas Quenqua (3 October 2011). An Addiction Vaccine, Tantalizingly Close. https://www.nytimes.com/2011/10/04/health/04vaccine.html. 
  26. ↑ Kosten, M.D., Thomas; Sofuoglu, M.D., Ph.D., Mehmet. Desipramine Treatment for Cocaine Dependence in Buprenorphine- or Methadone-Treated Patients: Baseline Urine Results as a Predictor of Response. The American Journal on Addictions 14 (1) (January 2, 2005). p. 8–17. doi:10.1080/10550490590899817.
  27. ↑ Dursteler, Kenneth M.; Berger, Eva-Maria. Clinical potential of methylphenidate in the treatment of cocaine addiction: A review of the current evidence. Substance Abuse and Rehabilitation 6 (June 17, 2015)Dovepress. p. 61–74. doi:10.2147/SAR.S50807.
  28. ↑ Margolin, Arthur; Avants, S. Kelly; and Kosten, Thomas R.. Pemoline for the Treatment of Cocaine Dependence in Methadone-Maintained Patients. Journal of Psychoactive Drugs 28 (3) (1996). p. 301–304. doi:10.1080/02791072.1996.10472491.
  29. ↑ Reisser, A. Lima; Lima, M.S.. Carbamazepine for cocaine dependence. The Cochrane Library (April 22, 2002). doi:10.1002/14651858.CD002023.
  30. ↑ Rosen, Hugo; Flemenbaum, Abraham; and Slater, Victor L.. Clinical trial of carbidopa-(l)-dopa combination for cocaine abuse. The American Journal of Psychiatry 143 (11) (November 1986). p. 1493a–1493. doi:10.1176/ajp.143.11.1493a.
  31. ↑ 31.0 31.1 31.2 Chadwick, Michael J.; Gregory, David L.; and Wendling, Glenda. A Double-Blind Amino Acids, L-Tryptophan and L-Tyrosine, and Placebo Study with Cocaine-Dependent Subjects in an Inpatient Chemical Dependency Treatment Center. The American Journal of Drug and Alcohol Abuse 16 (3–4) (1990). p. 275–286. doi:10.3109/00952999009001589.
  32. ↑ Chemistry, Design, and Structure-Activity Relationship of Cocaine Antagonists. Satendra Singh | display-authors = etal Chem. Rev. 2000, 100. 925-1024. PubMed; Chemical Reviews (Impact Factor: 45.66). 04/2000; 100(3):925-1024 American Chemical Society; 2000, ChemInform; May, 16th 2000, Volume 31, Issue 20, DOI: 10.1002/chin.200020238.ISSN 0009-2665. Mirror hotlink.
  33. ↑ Thema, Zum. Reiz gegen Reiz ins Rennen schicken (in de). der Standard (February 13, 2011)Standard Verlagsgesellschaft m.b.H. 2016.
  34. ↑ Moore, Nich. Swiss Docs Prove Blackjack Casino Gambling Best Cure for Cocaine Users. Blackjack Champ (February 15, 2011). Retrieved December 31, 2015.
  35. ↑ Petry, Ph.D., Nancy M.. Prize-based contingency management is efficacious in cocaine-abusing patients with and without recent gambling participation. Journal of Substance Abuse Treatment 39 (3) (October 2010)Elsevier. p. 282–288. doi:10.1016/j.jsat.2010.06.011.
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