Cocaine or coke – is an ‘organic’ stimulant derived from the cocoa plant that can either be snorted, inhaled (as crack cocaine) or dissolved and injected and is the 2nd most frequently used recreational drug after cannabis, although cocaine may still be used for medical purposes. It works by increasing the amount of brain chemicals – also called neurotransmitter – such as dopamine – causing euphoria or heightened pleasure.
Cocaine produces its euphoric effect in two ways:
- Artificially increasing the release of dopamine
- Preventing the normal re-absorption of dopamine back into the brain’s nerve cells
- In all cases of regular cocaine misuse and addiction the body builds a tolerance to the increased levels of dopamine, and progressively larger amounts of cocaine are required to achieve the ‘same’ high.
Cocaine addiction tends to happen when there is a loss of control of use. There will often be uncontrollable urges to use and incredible difficulty stopping.
Cocaine is extremely physically and mentally addictive, meaning that initial physical detox will then require longer therapeutic input.
About cocaine usage
How does it make you feel?
Cocaine can make you feel great in the short term, otherwise why would anyone take it in the first place! It can make you feel:
- Full of energy
- Confident and outgoing
- Able to do more and achieve more
However, cocaine can also have physical and psychological effects such as:
- Feel hot and sweaty
- Make your pulse faster and make your heart pound
- Feel sick and reduce appetite
- Feel very anxious and worried
- Feel paranoid
How does it change your behaviour?
You may be:
- More chatty and sociable
- Look more excited and animated
- Look more confident and assertive
- Look like you are having more fun
But cocaine can also make people:
- Overconfident and take risks (spend much more, do dangerous things)
- Angry and irritable
- Restless and unable to sit still
The feelings of euphoria that cocaine provides are often very short-lived. Individuals who are addicted to cocaine frequently experience various negative physical and psychological effects. High levels of paranoia are common among cocaine misusers. They tend to lose touch with reality; these people may see something or hear sounds that do not exist. Individuals suffering from cocaine addiction may also be diagnosed with serious health problems. These medical problems range from heart problems, respiratory failure, and nervous system complications that cause strokes.
Short term health risks
Common signs of snorting cocaine, the most popular method of ingestion, include:
- Loss of the sense of smell
- Nose bleeds
- Difficulty swallowing
- Chronically runny nose
Longer-term Health risks
There are certain signs that will help you identify cocaine addiction in an individual.
Below are two sections of signs that may point to if you or someone you know have an addiction to cocaine.
If you are concerned about your own situation, consider the following symptoms of cocaine addiction:
- Thoughts of cocaine consume a good portion of your day
- You find yourself looking for new ways of accessing cocaine
- You frequently worry you won’t have access to cocaine during your day
- Cocaine is affecting your job, finances or relationship
- You get upset when others question you about your cocaine use
- You are willing to go to great lengths to get cocaine
- You must regularly increase your cocaine intake to achieve the same feeling
- You find yourself concealing cocaine or your use
If you are concerned about a loved one rather than yourself, signs to look for include:
- Unreasonable sensitivity whenever the topic of cocaine is discussed
- White powder on items in the house
- Bags of cocaine lying around the house for their next hit
- Unexplained withdrawal from family relationships or positive friendships
- Increased isolation and episodes of social withdrawal
- Lack of concern for employment
- Unexplained financial problems
- Unexplained mood swings
- Unexplained weight loss or gain
Any combination of these signs or symptoms may suggest a potential cocaine addiction and should not be ignored. There may be a reasonable explanation but it is worth exploring the possibility of addiction.
Cocaine gives the brain a big shot of “happy chemicals” from the brain, or “neurotransmitters”, but once that big boost is gone, the brain is left like a dry desert with the neurotransmitters all used up. This causes the down and lots of withdrawals like:
- Tremors, aches and pains
- Sleep problems
- Sexual problems
- Loss of enjoyment
- Difficulty concentrating
- No desire to do anything
- Low sex drive
- Feeling suicidal
We try hard to control the withdrawal symptoms from cocaine during a detox and we are proud of the feedback that our patients give us on the Bonds protocol detox process. We specialise in detox usually over 1-2 weeks using non-addictive medication to make it as comfortable as possible. Published evidence shows that even an early version of the Bonds protocol was very well tolerated in opioid detox, for example, and opioid detox is notoriously unpleasant, often worse than a detox for amphetamines or cocaine. Although we don’t have data for cocaine or amphetamine detox, you may find it useful to know that 97% of opioid patients* did not report pain during a Bonds protocol detox from opioids. (ref Beaini AY et al (2000, October). A compressed opiate detoxification regime with naltrexone maintenance: patient tolerance, risk assessment and abstinence rates. Addiction Biology, 1;5(4):451-62 ).+
Once the drugs are out of your system, you can then have naltrexone which can reduce cravings for cocaine and a wide range of other substances, thus supporting long term abstinence.
*Outcome measures recorded at a time in previous years when Dr Amal Beaini was previously providing the BONDS protocols from the Detox5 service, not The BONDS clinic at Broughton. These BONDS protocols are now part of The BONDS Clinic at Broughton and Detox5 has closed a few years ago. Abstinence data at 12 months did not include those patients who could not be contacted or lost to follow up.
Our programme model is tailored to the individual’s needs. Our detox varies depending on whether the substance is a lone problem or is accompanied by misuse of other substances, the amount the patient is using, and if there any underlying mental health issues. The internal audits of the BONDS treatment protocols of many years have shown that approximately 70% of patients with alcohol or substance misuse also have an underlying mental health disorder. This combination of addiction and a mental health disorder is called Dual Diagnosis.