Cocaine Addiction

Searidge Foundation is a beautiful drug rehab located in Annapolis Valley, Nova Scotia. Here, patients can receive evidence-based treatment plans and be part of the process in finding the best care for them. We value the voice of our patients and work with them in moving closer to living a cocaine free life. At Searidge Foundation, we offer:

Cocaine detox
Residential treatment for Cocaine
Cocaine intervention
Cocaine rehabilitation
SMART Recovery Meetings

WHAT IS COCAINE?

Often referred to as coke, cocaine is a substance that was first extracted from the leaves of a South American plant called coca. In the nineteenth century, it was thought to be a miracle drug and was often prescribed as treatment for depression or physical exhaustion, and it was used as a local anesthetic for surgeries and dental work.

Cocaine gained popularity among civilians and its usage peaked in the 80’s. In fact, it was the invention of “crack” cocaine which introduced the drug to low income inner-city areas. However, despite its lackluster reputation as “crack” cocaine, coke in powder-form developed a glamorous image associated with being wealthy or powerful which gave it an illustrious reputation. This instigated its use among upper-class citizens. Although, coke use is concentrated among certain demographics in Canada such as homeless or street-involved adults, and youth living in urban areas.

Coke is easily identified as a white powder usually mixed with other similar looking substances such as corn starch. Similarly, “crack” cocaine is a white, crystalized version of coke, often mixed with baking soda to achieve form. Unlike the powered-form which is insufflated (snorted), crack is smoked. This allows for a more rapid onset of effects.

WHAT IS COCAINE ADDICTION?

Cocaine is a highly addictive central nervous system stimulant. In 2015, self-reported data indicated that the prevalence of cocaine use in Canada in adults over 25 was 0.8%. Usage among youth (ages 15-24) was 3.5%, and it ranked as number 3 in the top five substances used in the past year by Canadians. As previously mentioned, coke use is concentrated among certain demographics in Canada. In Halifax, the prevalence of coke use among recreational drug users was roughly 50%. In addition, use among street-entrenched adult users was 40%, and roughly 60% of street-involved youth reported using cocaine in the past year.

It is believed that the stimulant and addictive properties of coke are a consequence of inhibition of dopamine reabsorption by neurons. First-time coke users can become hooked after their first experience, especially with crack. Animal studies with rats and monkeys have shown that once they have learned how to self-administer the drug, they will do nothing else. In fact, they stop all other functions of surviving (i.e. eating, sleeping) to continuously consume the drug as long as they are physically able to.

The uncontrollable nature of coke self-administration demonstrates its addictive properties. When the supply of the drug is depleted, animals become excited just at the sight of the mechanism involved in drug administration (e.g. pushable lever that delivers drug reward). Researchers coined this as “addiction cue” and it is often observed in humans with cocaine addiction. When individuals who are addicted to coke encounter a cue associated with the drug such as associated paraphernalia (e.g. crack pipe) or familiar places of past use, they will experience an immediate onset of increased heartrate accompanied by intense feelings of craving. This initiates the drive to seek out the drug and relive previous pleasurable experiences associated with the drug. The effects of cocaine addiction cues are powerful reinforcers and compel users to actively seek out the drug. In addition, coke users may also develop a tolerance to drug through long-term use which can lead to subsequent consumption of higher doses of the drug. Generally speaking, cocaine addiction begins as a psychological dependence and develops into a physical addiction or dependence through continued use.

SHORT-TERM EFFECTS AND RISKS

Users typically experience an increase in energy and alertness accompanied by euphoria and increased body temperatures. Oftentimes, users report an increase in heart rate and blood pressure. Conversely, some users may experience agitation or paranoia. Some individuals have experienced a reduction in appetite and muscle spasms. More serious short-term effects of cocaine can include a stroke, fainting or a possible overdose.

LONG-TERM EFFECTS AND RISKS

Oftentimes, chronic users of coke report sleep disturbances such as insomnia. This is usually accompanied by weight-loss. In addition, some users have experienced coke tolerance, depression, cardiovascular problems, nasal damage, kidney failure, throat and lung damage (through “crack” cocaine), headaches, hallucinations, seizures, and attention and memory deficits. Maternal use of cocaine during pregnancy is serious and can result in a significantly decreased birth weight accompanied by long-term health complications.

INTOXICATION AND OVERDOSE

The most common presentation of cocaine intoxication is acute agitation. Other users have reported seizures, ischemic strokes and hyperthermia (overheating). Hyperthermia is often accompanied by severe agitation, psychosis, blood clots, or rhabdomyolysis, followed by failure of multiple organs. Other coke users have suffered heart attacks and myocardial ischemia. This often occurs within the first few hours of administration when the concentration of the drug within the body is highest. However, users have reported these incidences several weeks after use.

Although less common than heart and nervous system complications, users may experience respiratory compromise such as barotrauma and pneumothorax. These are typically associated with the inhalation of coke via crack. Other potential complications may include worsening of pre-existing asthma and crack lung. Crack lung often leads to acute respiratory distress syndrome caused by alveolar hemorrhaging.

Finally, other coke-related toxicities may include damage to the gastrointestinal tract (e.g. colitis) or the liver.

PHARMACOLOGY – HOW DOES IT WORK?

Cocaine is broken down by enzymes in the blood and liver into roughly 12 different inactive substances. Of them, norcocaine is the only known active metabolite and produces similar effects to cocaine. Coke’s primary mode of action is to inhibit proteins in the brain that regulate neurotransmitter concentrations within and outside the cell. Specifically, coke targets transporters that return serotonin (5-HT), dopamine, and noradrenaline to neurons.

Indeed, dopamine is the neurotransmitter responsible for making humans feel pleasure. During uncompromised activity, it is released by neurons into brain and recycled back into the neuron by transporters for later-use. In the presence of cocaine, transporters are not able to under-go this recycling (reuptake) process leading to a prolonged increase of dopamine in the brain. Although the increased amounts of dopamine produce feelings of euphoria, the prevention of reuptake leads to depleted stocks of the neurotransmitter which can lead to subsequent depression when cocaine is metabolized out of the system.

Studies have shown that the same mechanisms by which coke produces feelings of euphoria are all involved in pleasurable stimuli such as food, water, sex and other drugs of abuse. This is a result of increased dopamine levels in the nucleus accumbens of the brain – a major player in the brain’s reward and limbic system. When someone experiences something pleasurable, there is a surge of dopamine into the nucleus accumbens. The same thing occurs when someone consumes a high dose of coke. This produces vivid memories of euphoria associated with the drug and because of cocaine’s ability to imitate pleasurable stimuli, it signals to the brain to remember the experience as worthwhile. This motivates further pursuing of the substance and it is taken continuously. This uncontrollable urge is what creates coke addiction. Indeed, users will build a tolerance overtime, requiring higher doses of the drug to achieve the euphoric feelings associated with first-use.