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Cocaine produces abuse, dependence, and withdrawal patterns almost identical to those produced by "speed" (amphetamines). These include heightened activity, sleeplessness, euphoria, high energy, feelings of power, and sometimes paranoia or, in extreme cases, convulsions, loss of contact with reality, or even death through respiratory arrest or ventricular fibrillation. Abuse of and dependence on cocaine can produce terrible effects, from runny and bleeding noses through loss of jobs, money, and social contacts; nevertheless, abuse is common. Increasing amounts of cocaine are usually necessary to maintain its effects, so obtaining enough is a tremendous financial burden, and often leads to illegal behaviors, including prostitution that can lead, in turn, to HIV and other sexually transmitted diseases. As with amphetamines, cocaine intoxication can lead users to become aggressive and get into fights. Cocaine overdose, or doses adulterated with poisons like strychnine, are particularly prone to kill users. Cocaine intoxication produces effects so similar to those of amphetamine intoxication that they can be distinguished only because in one case the person took amphetamine and in the other the person took cocaine! Cocaine acts a little faster and wears off a little quicker than amphetamine, and accordingly may be more addictive. Withdrawal from cocaine, just as from amphetamine, produces some effects that are opposite to those of use; that is, instead of having more energy and going for long periods without sleep, a person undergoing withdrawal is generally fatigued and unhappy, and may need to rest and sleep for a long time. About 12% of the population of the United States
has used cocaine at least once; the usual route of administration is
through sniffing lines of the powder, although smoking of crack
cocaine is also common. Almost as many inject it as smoke it, and it
may also be taken in combination with heroin in the form of a
"speedball." The treatment for cocaine abuse or
dependence begins with removal of the drug under careful
supervision. The patient will need rest and nutritious food, and
medical supervision is advisable if the abuse or dependence is at
all serious. People in recovery may be paranoid, anxious, and
agitated; they will almost certainly be unhappy and have a disrupted
sleep pattern. Medications may be helpful in dealing with these
withdrawal symptoms. Most people with cocaine dependence drop out of
treatment programs and relapse at least once. Last updated 12/19/03 |
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