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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 cocaine 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 (October 2010). "Teen Cocaine Use". Archived from the original on 2018-02-13. Retrieved 2015-12-31. {{cite journal}}: Cite journal requires |journal= (help)
  2. ↑ Gawin, F.H. (1991). "Cocaine addiction: Psychology and neurophysiology". Science. 251 (5001): 1580–6. Bibcode:1991Sci...251.1580G. doi:10.1126/science.2011738. PMID 2011738.
  3. ↑ "Models of Intervention and Care for Psychostimulant Users, 2nd Edition – Monograph Series No. 51: The Cocaine Withdrawal Syndrome". The Department of Health. Government of Australia. April 2004. Archived from the original on 2016-12-24. Retrieved 2016-11-30.
  4. ↑ Brady KT, Lydiard RB, Malcolm R, Ballenger JC (1991). "Cocaine-induced psychosis". J Clin Psychiatry. 52 (12): 509–512. PMID 1752853.
  5. ↑ Thirthalli J.; Vivek B. (2006). "Psychosis Among Substance Users". Curr Opin Psychiatry. 19 (3): 239–245. doi:10.1097/01.yco.0000218593.08313.fd. PMID 16612208. S2CID 13350537.
  6. ↑ Elliott A.; Mahmood T.; Smalligan R.D. (2012). "Cocaine Bugs: A Case Report of Cocaine-Induced Delusions of Parasitosis". The American Journal on Addictions. 21 (2): 180–181. doi:10.1111/j.1521-0391.2011.00208.x. PMID 22332864.
  7. ↑ "Cocaine Withdrawal". Treatment4Addiction Online Recovery Resource Directory. AAC. Archived from the original on 2016-08-26. Retrieved 2016-11-30.
  8. ↑ Palinkas, L. A. (17 January 2008). "Cognitive behavioural therapy reduced cocaine abuse compared with 12 step facilitation". Evidence-Based Mental Health. ebmh.bmj.com. 2 (2): 51. doi:10.1136/ebmh.2.2.51. S2CID 146360156. Retrieved 25 August 2012.
  9. ↑ Koenig, X; Hilber, K (29 January 2015). "The anti-addiction drug ibogaine and the heart: A delicate relation". Molecules (Basel, Switzerland). 20 (2): 2208–28. doi:10.3390/molecules20022208. PMC 4382526. PMID 25642835.
  10. ↑ Brown, Thomas (March 2013). "Ibogaine in the treatment of substance dependence". Current Drug Abuse Reviews. 6 (1): 3–16. doi:10.2174/15672050113109990001. PMID 23627782.
  11. ↑ Hegarty, Stephanie (April 13, 2012). "Can a hallucinogen from Africa cure addiction?". BBC World Service. British Broadcasting Corporation.
  12. ↑ Margolin, Arthur (2 January 2002). "Acupuncture for the treatment of cocaine addiction: A randomized controlled trial". The Journal of the American Medical Association. 287 (1): 55–63. doi:10.1001/jama.287.1.55. PMID 11754709. S2CID 39099678.
  13. ↑ Otto, Katharine C.; Quinn, Colin; Sung, Yung-Fong (Spring 1998). "Auricular acupuncture as an adjunctive treatment for cocaine addiction: A pilot study". The American Journal on Addictions. 7 (2): 164–170. doi:10.1111/j.1521-0391.1998.tb00331.x. PMID 9598220.
  14. ↑ Page, R.A.; Handleya, G.W. (1993). "The use of hypnosis in cocaine addiction". American Journal of Clinical Hypnosis. 36 (2): 120–123. doi:10.1080/00029157.1993.10403054. PMID 8259763.
  15. ↑ Potter, Greg (2004). "Intensive therapy: Utilizing hypnosis in the treatment of substance abuse disorders". American Journal of Clinical Hypnosis. 47 (1): 21–28. doi:10.1080/00029157.2004.10401472. PMID 15376606. S2CID 42943267.
  16. ↑ Schaler, Jeffrey A. (September–October 1991). "Drugs and free will". Society. 28 (6): 42–49. doi:10.1007/BF02695758. S2CID 144015742.
  17. ↑ Barbara, John; Morrison, June (January 1975). "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): 28–33. doi:10.1177/001112877502100104. S2CID 144097494.
  18. ↑ Mardikian PN, LaRowe SD, Hedden S, Kalivas PW, Malcolm RJ; Larowe; Hedden; Kalivas; Malcolm (March 2007). "An open-label trial of N-acetylcysteine for the treatment of cocaine dependence: a pilot study". Prog. Neuropsychopharmacol. Biol. Psychiatry. 31 (2): 389–94. doi:10.1016/j.pnpbp.2006.10.001. PMID 17113207. S2CID 23859415.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  19. ↑ LaRowe SD; Myrick H; Hedden S (July 2007). "Is cocaine desire reduced by N-acetylcysteine?". Am J Psychiatry. 164 (7): 1115–7. doi:10.1176/appi.ajp.164.7.1115. PMID 17606664.
  20. ↑ Gass JT, Olive MF; Olive (January 2008). "Glutamatergic substrates of drug addiction and alcoholism". Biochem. Pharmacol. 75 (1): 218–65. doi:10.1016/j.bcp.2007.06.039. PMC 2239014. PMID 17706608.
  21. ↑ 21.0 21.1 Karila L; Gorelick D; Weinstein A (May 2008). "New treatments for cocaine dependence: a focused review". Int. J. Neuropsychopharmacol. 11 (3): 425–38. doi:10.1017/S1461145707008097. PMID 17927843. S2CID 36802680.
  22. ↑ Ling W, Shoptaw S, Majewska D; Shoptaw; Majewska (May 1998). "Baclofen as a cocaine anti-craving medication: a preliminary clinical study". Neuropsychopharmacology. 18 (5): 403–4. doi:10.1016/S0893-133X(97)00128-0. PMID 9536455. S2CID 20391648.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  23. ↑ Margolin A; Kosten TR; Avants SK (December 1995). "A multicenter trial of bupropion for cocaine dependence in methadone-maintained patients". Drug Alcohol Depend. 40 (2): 125–31. doi:10.1016/0376-8716(95)01198-6. PMID 8745134.
  24. ↑ Cherstniakova SA, Bi D, Fuller DR, Mojsiak JZ, Collins JM, Cantilena LR; Bi; Fuller; Mojsiak; Collins; Cantilena (September 2001). "Metabolism of vanoxerine, 1-[2-[bis(4-fluorophenyl)methoxy]ethyl]-4-(3-phenylpropyl)piperazine, by human cytochrome P450 enzymes". Drug Metab. Dispos. 29 (9): 1216–20. PMID 11502731. Archived from the original on 2021-08-28. Retrieved 2015-12-31.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  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; et al. (January 2, 2005). "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): 8–17. doi:10.1080/10550490590899817. PMID 15804873.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  27. ↑ Dursteler, Kenneth M.; Berger, Eva-Maria; et al. (June 17, 2015). "Clinical potential of methylphenidate in the treatment of cocaine addiction: A review of the current evidence". Substance Abuse and Rehabilitation. Dovepress. 6: 61–74. doi:10.2147/SAR.S50807. PMC 4476488. PMID 26124696. S2CID 7312588.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  28. ↑ Margolin, Arthur; Avants, S. Kelly; and Kosten, Thomas R. (1996). "Pemoline for the Treatment of Cocaine Dependence in Methadone-Maintained Patients". Journal of Psychoactive Drugs. 28 (3): 301–304. doi:10.1080/02791072.1996.10472491. PMID 8895115.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  29. ↑ Reisser, A. Lima; Lima, M.S.; et al. (April 22, 2002). Lima Reisser, Anelise (ed.). "Carbamazepine for cocaine dependence". The Cochrane Library. doi:10.1002/14651858.CD002023.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  30. ↑ Rosen, Hugo; Flemenbaum, Abraham; and Slater, Victor L. (November 1986). "Clinical trial of carbidopa-(l)-dopa combination for cocaine abuse". The American Journal of Psychiatry. 143 (11): 1493a–1493. doi:10.1176/ajp.143.11.1493a. PMID 3777260.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  31. ↑ 31.0 31.1 31.2 Chadwick, Michael J.; Gregory, David L.; and Wendling, Glenda (1990). "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): 275–286. doi:10.3109/00952999009001589. PMID 2288326.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  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 (February 13, 2011). "Reiz gegen Reiz ins Rennen schicken". der Standard (in Deutsch). Standard Verlagsgesellschaft m.b.H. 2016.
  34. ↑ Moore, Nich (February 15, 2011). "Swiss Docs Prove Blackjack Casino Gambling Best Cure for Cocaine Users". Blackjack Champ. Archived from the original on November 21, 2015. Retrieved December 31, 2015.
  35. ↑ Petry, Ph.D., Nancy M.; Alessi, Ph.D., Sheila M. (October 2010). "Prize-based contingency management is efficacious in cocaine-abusing patients with and without recent gambling participation". Journal of Substance Abuse Treatment. Elsevier. 39 (3): 282–288. doi:10.1016/j.jsat.2010.06.011. PMC 2937065. PMID 20667679.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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