Cocaine is a highly addictive stimulant drug. Although it’s illegal, cocaine is still relatively easy to obtain, providing its users with a short-lasting but potent high. According to the most recent “National Survey on Drug Use and Health” (NSDUH), an estimated 1.9 million people aged 12 and older used cocaine during the past month in 2018. The report also stated that an estimated 977,000 people that year had cocaine use disorder (cocaine addiction).
What Is “Substance Addiction”?
Like other addictive substances such as alcohol, illegal or prescription drugs, cocaine can become a “substance addiction.” Substance addiction is the repeated or escalating use of a drug despite its negative health and other effects. When someone is addicted to cocaine (or another drug of abuse), according to the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) they:
- Take the drug in larger amounts or longer than necessary
- Want to stop or cut down on taking the drug but can’t of their own power
- Spend increasing amounts of time seeking, using, and recovering from drug use
- Experience drug cravings and urges to use
- Shirk responsibilities at work, school, or home because of drug use
- Continue using despite the problems drug use causes in relationships
- Discontinue meaningful or important activities (recreational, social, occupational) due to drug use
- Use the drug repeatedly, even if it puts them in danger
- Keep using the drug even though they may have a psychological or physical problem that it could have caused or made worse
- Develop tolerance (need more of the drug to achieve the desired effect)
- Develop symptoms of withdrawal, which they can relieve by taking more of the drug
Why Is Cocaine Addictive?
Cocaine use was popular in many parts of the world, including North America, for many years before it was classified as an illegal substance under the 1970 “Controlled Substances Act.” Prior to cocaine’s classification by the Drug Enforcement Administration (DEA) as a Schedule II drug, few people bothered to ask is cocaine addictive. Even after its Schedule II classification, cocaine saw a meteoric rise in popularity, particularly as a club drug. In the United States today, cocaine is the second most popular recreational drug after marijuana.
In 2016 research with animals, which was supported by grants from the National Institutes of Health, Wake Forest Baptist Medical Center scientists said they were a little closer to understanding the answer to the question, “Why is cocaine addictive?” They found that the drug “leaves a long-lasting imprint on the dopamine system that is activated by re-exposure to cocaine.” Furthermore, they said that it’s this “priming effect,” thought to be potentially permanent, that could be a contributing factor in relapse episodes in those with an addiction to cocaine.
Significantly, even after the rat subjects in the research had been abstinent for 60 days, it only took a single cocaine dose for the animals to revert to their previous dopamine and tolerance levels, increasing the likelihood of bingeing again, in a “terrible cycle of addiction.” (In human years, that period of 60 days is equivalent to about four years.)
Mechanism of Action
The National Institutes of Health, National Library of Medicine states that cocaine, a tropane alkaloid with stimulating and analgesic effects, binds to the transport proteins of serotonin, norepinephrine, and dopamine and then inhibits the re-uptake of these proteins into presynaptic neurons. Cocaine’s mechanism of action is through “binding and blocking voltage-gated sodium channels in the neuronal cell membrane.” Thus, cocaine inhibits both nerve impulse initiation and conduction, producing a loss of sensation that is reversible.
When Does Cocaine Use Become Addiction?
Addiction can occur when drug use is repeated over time. The pattern of going from casual and occasional use to regular and then heavy use is common in the development of addiction to a substance. Besides the user becoming dependent on the substance and getting so used to it that the effects diminish, requiring the individual to take more of the drug, addiction is a progressive and relapsing brain disease that won’t go away on its own and requires professional treatment.
However, it is important to note that someone can develop a dependence and tolerance to a substance, such as cocaine, without developing an addiction to cocaine. What differentiates cocaine addiction from dependence, though, is the inability of the cocaine user to stop using the drug despite increasingly negative and mounting consequences associated with drug use.
Cocaine addiction symptoms include the following:
- Neglecting attendance at important events (school, work, family)
- Avoiding responsibilities at home, work, school
- Experiencing strained personal relationships
- Continuing to use despite negative consequences
- Getting into legal difficulties caused by drug use
- Denying any drug use or problems associated with one’s use
- Decreased appetite
Other signs of cocaine addiction that habitual cocaine users typically experience include negative health-related side effects, such as changes in the brain’s functionality, which can lead to mental health problems, impaired mobility, and impaired cognition.
As defined by the National Institute on Drug Abuse (NIDA), “tolerance is the need to take higher doses of the drug to get the same effect.” Tolerance is often found accompanying dependence, and the NIDA says that it can be difficult to distinguish one from the other. Tolerance is the reason substance users need to take more of a drug and more often in order to recapture the euphoria or high they seek.
What are Substance/Cocaine Addicts Chasing?
Why do people addicted to a substance like cocaine keep using the drug? What is it that they are chasing? A simple answer is euphoria, an escape from reality, and the intense feelings of pleasure that the drug elicits for body and mind. The desire to feel that thrill again is what drives continued or repeated use.
Furthermore, the longer a person uses cocaine, the more likely they are to become addicted to cocaine, yet their compulsion to chase that high never subsides. Their brains are rewired to seek that reward that is so inextricably linked to cocaine use. As such, they will keep coming back to the drug despite increasingly negative consequences to mental and physical health, career, home, relationships, finances, entanglements with the law, and other mounting, perilous results of being addicted to cocaine.
Long-Term Health Effects of Substance Addiction
Continuing to use addictive substances, despite increasing negative consequences, can result in a cascade of health effects, many of which are potentially serious, perhaps fatal. Some of the health effects of addiction to cocaine, in particular, depend on the method of use. These methods used by those with cocaine addiction include snorting, inhaling, smoking, taking the drug by mouth, and injecting the drug.
Long-Term Effects of Snorting Cocaine
After an extended period of snorting cocaine, a person may begin to suffer frequent nosebleeds, loss of smell, constantly runny nose, and difficulty swallowing.
Long-Term Effects of Inhaling Cocaine
Heating cocaine to a point of volatility and inhaling the fumes is another method of using cocaine (crack cocaine). Long-term health effects may include acute pulmonary syndrome accompanied by fever, hypoxia, and hemoptysis, which may lead to respiratory failure.
Long-Term Effects of Smoking Cocaine
Cocaine addicts who smoke the drug are known to have a higher risk of contracting pneumonia and other infections, such as a cough, asthma, and developing respiratory distress. Cardiac arrhythmia, myocardial ischemia, and other cardiac events may occur, and cardiac arrest is possible in some instances.
Long-Term Effects of Ingesting Cocaine by Mouth
For those who take cocaine by mouth, there’s an increased risk of bowel decay resulting from reduced flow of blood in the body.
Long-Term Effects of Cocaine Injection
Injecting cocaine subjects the cocaine addict to a higher risk of contracting blood-borne diseases, including Hepatitis C and HIV. Other health effects of needle injection of cocaine during cocaine addiction include scarred or collapsed veins (injection sites), and infections of the skin or soft tissue.
Other Long-Term Health Effects of Cocaine Addiction
In addition to the effects of long-term cocaine use, cocaine addicts are frequently malnourished and may develop movement disorders, such as Parkinson’s disease. Restlessness, severe paranoia, irritability, and auditory hallucinations are other health effects of addiction to cocaine in the longer term. Heavy cocaine users are often prone to chronic cognitive impairment, including deficits in memory and working memory, attention, planning, decisionmaking, and impulse control.
What Happens When It Is Stopped Cold Turkey
Stopping the use of any addictive drug cold turkey is never a good idea. For someone addicted to cocaine, simply discontinuing cocaine use is a foolhardy choice, one that’s bound to fail. Cocaine’s effects wear off quickly, depending on how it’s used, but as soon as the withdrawal symptoms set in, the urge to use again to quell those unpleasant feelings is often impossible to ignore. Besides, cocaine addiction is a pattern of binge use and repeat. Without medical monitoring and professional detox and treatment, a cocaine addict is not likely to be able to overcome cocaine addiction on their own.
Why Cocaine Addiction Needs Treatment
In order to overcome cocaine addiction, it isn’t enough to just decide to do so. In fact, willpower alone cannot defeat an addiction to cocaine, as repetitive drug use has rewired the brain and resulted in significant and serious brain changes. Someone who’s addicted to cocaine may well intend to quit using the drug, but addiction to cocaine is too powerful for the addict to successfully quit without professional treatment. As soon as the unpleasant, upsetting, and painful withdrawal symptoms set in, the addict experiences an overwhelming compulsion to use the substance again and relapses. This overrides all thought of quitting and overcoming cocaine addiction.
Yet all is not lost in the goal to beat addiction to cocaine. Medically monitored cocaine detox and treatment can prove to be a life-saver and get you back to living a normal, healthy life.