Cocaine Addiction: Definition, Causes, Symptoms, Effects, and Treatment Methods

Cocaine addiction is a chronic and relapsing disorder that involves an uncontrollable craving for cocaine, a powerful drug derived from coca plant leaves. Cocaine gives a powerful release of dopamine, which creates a quick but short tip of euphoria, which makes the drug highly addictive.

The main causes or risk factors of cocaine addiction are a combination of psychological, social, and genetic factors. Some symptoms of cocaine addiction include dilated pupils, decreased appetite, mood swings, anxiety, hyperactivity, and neglect of responsibilities.

Cocaine addiction leads to several negative effects, including weight loss, cardiovascular issues, respiratory problems, hallucinations, and risk of overdose. The main treatment methods considered for cocaine addiction are medical detoxification, medications, CBT (cognitive behavioral therapy), rehabilitation programs, and support groups.

What is Cocaine Addiction?

Cocaine addiction is a chronic substance disorder where individuals develop a compulsive need to use cocaine, a powerful stimulant that affects the central nervous system (CNS). V. Milivojevic in their research titled “The Neuroscience of Cocaine” (2017) states that cocaine addiction is defined as a substance use disorder characterized by repeated, uncontrollable urges to consume cocaine, despite knowing its harmful consequences.

Cocaine rapidly increases levels of dopamine, a brain chemical tied to pleasure and reward, and produces feelings of euphoria, heightened energy, and confidence. These effects are short-term and lead users to take more doses to maintain the high. The street names for cocaine are coke, snow, and blow. The drug is initially used for fun but carries a strong risk of dependency.

How is Cocaine Consumed?

Cocaine is consumed by snorting, smoking, injections, and rubbing. Snorting is inhaling powdered cocaine through the nose. The snorting method allows cocaine to be absorbed through nasal tissues. Another method is smoking cocaine in its freebase form, known as crack, which produces an intense, quick, but short high. People inject cocaine directly into the bloodstream, too, which provides an instant effect and the most intense high but poses serious health risks, including increased chances of overdose and infections from needle use. Some people rub cocaine on their gums, though this method is less common and gives a milder high.

How is Cocaine Made?

Cocaine is made from the coca plant leaves found in South American countries. The process begins by harvesting coca leaves, which are then dried and chopped. The chopped leaves are soaked in a mixture of chemicals, including gasoline, to extract the cocaine alkaloid. After several rounds of filtering and chemical processing, the mixture produces a thick paste known as coca paste.

This paste is further refined by adding acid and other chemicals, which eventually yield a crystalline powder called cocaine hydrochloride. The final product is purified, dried, and packaged before being distributed illegally. The process of cocaine production involves dangerous solvents and chemicals, which is why the drug is considered toxic and illegal.

What are the Types of Cocaine?

The different types of cocaine are listed below.

• White Powder Cocaine: White powder cocaine is the most common form that is snorted or injected. It’s a refined, white powder derived from coca leaves and is highly addictive.

• Crack Cocaine: Crack cocaine is processed with baking soda to create small and rocky crystals. People usually smoke crack to get a very intense high.

• Cocaine Hydrochloride: Cocaine hydrochloride is the purest form of powdered cocaine. It is used medically as a local anesthetic and commonly consumed for fun too.

• Synthetic Cocaine: Synthetic cocaine is a laboratory-made stimulant designed to mimic the effects of natural cocaine. Synthetic cocaine contains different unpredictable and toxic chemicals.

• Pink Cocaine: Pink cocaine, known as “tusi,” is a synthetic blend mixed with different stimulants and psychedelics with a pink color. Pink cocaine has unpredictable effects and high toxicity.

• Black Cocaine: Black cocaine, commonly known as “black coke,” is a chemical version made to avoid detection during transport. It requires further processing to be consumed.

• Basuco (Trash Cocaine): Basuco is a low-quality cocaine paste with dangerous unknown ingredients. Busaco is usually smoked and is highly addictive, especially in South America.

• Fish Scale Cocaine: Fish scale cocaine is a high-purity form of cocaine that is shiny and resembles fish scales. Fish scale cocaine gives a more intense and long-lasting high.

• Yellow Cocaine: Yellow cocaine has a yellowish color because of the impurities and additives. Yellow cocaine is usually less potent but contains unknown and harmful byproducts.

• Brown Cocaine: Brown cocaine is similar to yellow cocaine and contains impurities or additives that give it a brown color.

How Common is Cocaine Addiction?

Cocaine addiction is very common in the United States and affects millions every year. As of 2022, cocaine was the second most used illicit drug in the United States, following marijuana. Around 42.2 million people in the U.S. have used cocaine at least once in their lifetime, according to the research titled “Percentage of U.S. adults that used cocaine within the past year in 2021 and 2022.”

From 2002 to 2006, the overdose rate rose from 1.6 to 2.5 deaths per 100,000 in the standard population, then dipped to 1.3 in 2010. By 2022, it had surged to 8.2 deaths per 100,000, marking a 12.3% rise from the previous year’s rate of 7.3, according to the “Drug Overdose Deaths in the United States, 2002–2022” by CDC.

What are the Causes of Cocaine Addiction?

The causes of cocaine addiction include effects on the brain’s reward system and psychological, social, and genetic factors.

These causes are explained below.

• Effects on the Brain’s Reward System: Cocaine affects the brain’s reward system by releasing large amounts of dopamine, the neurotransmitter that gives feelings of pleasure and motivation, according to the study titled, “Cocaine dependence: a disease of the brain’s reward centers” by Charles A. Dackis, M.D (2001). This creates a cycle of craving and repeated use as the brain adjusts to require more cocaine to feel the same pleasure.

• Psychological Factors: Individuals with psychological and mental health disorders, such as depression, anxiety, or PTSD, have a high risk of turning to cocaine as a way to cope with their emotions.

• Social Factors: Social factors and environmental influences, such as peer pressure, acceptance of drug use in society, and stressful life events increase the chances of being prone to cocaine addiction, according to the study “The Effects of Social Contact on Cocaine Intake Under Extended-Access Conditions In Male Rats” by Andrea M Robinson, Ryan T Lacy.

• Genetic Factors: Genetic factors significantly impact the likelihood of cocaine addiction, with research estimating heritability between 65% and 79%, according to Judit Cabana-Domínguez and Anu Shivalikanjli in their research “Genome-wide association meta-analysis of cocaine dependence: Shared genetics with comorbid conditions.” Some individuals are biologically more prone to developing dependence and have an increased risk compared to others.

What are the Symptoms of Cocaine Addiction?

The symptoms of cocaine addiction include a combination of physical, behavioral, and psychological signs.

The signs and symptoms of cocaine addiction are listed below.

Physical Symptoms of Cocaine Addiction

The physical symptoms of cocaine addiction include dilated pupils, nosebleeds, weight loss, and tremors and twitches.

These symptoms are explained below.

• Dilated Pupils: Cocaine stimulates the nervous system and causes the pupils to enlarge, often noticeable even in low light, according to the Research Report Series “Cocaine: Abuse and Addiction” published by the National Institute on Drug Abuse.

• Nosebleeds: Frequent snorting of cocaine irritates and damages nasal passages and leads to chronic nosebleeds.

• Decreased Appetite: Decreased appetite refers to no desire to eat food. Cocaine suppresses appetite and individuals thinking of food makes people feel sick or nauseous when high.

• Tremors and Twitches: Tremors and twitches refer to involuntary shaking, muscle twitches, and physical restlessness, which are signs of cocaine addiction.

Behavioral Symptoms of Cocaine Addiction

The behavioral symptoms of cocaine addiction include euphoria, hyperactivity, neglect of responsibilities, and impulsiveness.

These symptoms are explained below.

• Euphoria: Euphoria refers to feelings of pleasure and relaxation. Cocaine users experience intense but short-lived euphoria, which leads to repeated use.

• Hyperactivity: Hyperactivity means being extra attentive and active. Cocaine stimulates the nervous system and leads to hyperactivity, increased energy, and restlessness.

• Neglect of Responsibilities: The obsession with cocaine causes people to neglect responsibilities, such as work, school, and family obligations.

• Impulsiveness: Cocaine users, specifically addicts, act recklessly or make quick decisions, sometimes involving financial or legal risk.

Psychological Symptoms of Cocaine Addiction

The psychological symptoms of cocaine addiction include paranoia, anxiety or depression, mood swings, and delusions.

These symptoms are explained below.

• Paranoia: Chronic cocaine use and addiction leads to feelings of fear or suspicion of others, often without basis in reality.

• Anxiety or Depression: Cocaine’s stimulating effects heighten anxiety levels and even lead to panic attacks in some cases.

• Mood Swings: Mood swings refer to sudden shifts in mood. Cocaine users frequently shift from euphoria to irritability or anger as the effects of the drug wear off.

• Depression: Cocaine users experience depression signs, such as sadness or hopelessness after the high or trip goes away.

• Delusions: Delusions refer to experiencing false beliefs or perceptions. Delusions start after prolonged abuse of cocaine.

What are the Effects of Cocaine Addiction?

The effects of cocaine addiction are short-term, long-term physical, and long-term psychological issues.

The effects of cocaine addiction are explained in detail below.

Short-Term Effects

The short-term effects of cocaine addiction are listed below.

• Weight Loss: Cocaine suppresses appetite and reduces the body’s ability to store fat, according to the study “The skinny on cocaine” published by the University of Cambridge. The scenario ultimately leads to unhealthy weight loss.

• Increased Heart Rate: Cocaine raises heart rate being a stimulant, which leads to heart strain and increased risk of cardiovascular issues, according to the research “The Effects of Cocaine on Heart Rate and Electrocardiogram in Zebrafish (Danio rerio)” by Erik J Mersereau, Shelby L Poitra.

• Elevated Blood Pressure: Cocaine usually causes a spike in blood pressure, putting additional stress on the cardiovascular system and heightening the risk of complications.

Long-Term Physical Effects

The long-term physical effects of cocaine addiction are listed below.

• Cardiovascular Issues: Long-term use of cocaine damages the heart and blood vessels and increases the risk of heart attacks and strokes, according to the study “Cardiovascular effects of cocaine in humans: laboratory studies” by Richard W. Foltin and Marian W. Fischman.

• Respiratory Problems: Smoking or snorting cocaine damages the lungs and nasal passages, leading to chronic respiratory issues, as stated in the study “Cocaine-Induced Lung Damage and Uncommon Involvement of the Basal Ganglia” by Hamid Ziani, Siham Nasri, Imane Kamaoui, and Imane Skiker.

• Seizures: Cocaine’s impact on the brain lowers the seizure threshold and leads to sudden and unprovoked seizures.

• Overdose and Death: High doses or prolonged use significantly raise the risk of overdose, which is fatal due to respiratory failure or heart complications. Manuel Cano and Sehun Oh highlight the increased rate of cocaine-involved overdose mortality rates in the US in their research titled “Cocaine use and overdose mortality in the United States: Evidence from two national data sources, 2002–2018.”

Long-Term Psychological Effects

The long-term psychological effects of cocaine addiction are listed below.

• Neurological Disorders: Prolonged cocaine use alters brain function and leads to neurobiological disorders, such as tremors, difficulty walking, and coordination problems.

• Memory Deficits: Long-term cocaine use impacts cognitive functions and makes it difficult to remember important information and recall memories, according to the study “Cognitive Impairment in Cocaine Users is Drug-Induced but Partially Reversible: Evidence from a Longitudinal Study” by Matthias Vonmoos and Lea M Hulka.

• Auditory Hallucinations: Individuals with cocaine addiction experience auditory hallucinations and delusions, such as hearing things that aren’t there, due to the brain changes caused by cocaine, according to the study “Delusions and hallucinations of cocaine abusers and paranoid schizophrenics: a comparative study” by J Mitchell and A D Vierkant.

• Paranoia: Chronic cocaine use leads to intense paranoia, including unwarranted distrust and fear of others, as stated in the research titled “Cocaine and Psychiatric Symptoms” by W Alexander Morton.

• Delusional Parasitosis: Long-term cocaine users believe they have parasites under their skin, causing them to scratch excessively and create skin lesions, according to the study “Cocaine Bugs: A Case Report of Cocaine-Induced Delusions of Parasitosis” by Amber Elliott and Roger Smalligan.

What are the Treatment Methods for Cocaine Addiction?

The treatment methods for cocaine addiction include medical detoxification, medications, CBT (cognitive behavioral therapy), rehabilitation programs, and support groups.

These treatment methods are listed below.

• Medical Detoxification: Medical detoxification is the first step of addiction treatment that helps the body rid itself of cocaine while managing withdrawal symptoms under medical supervision. The detox process usually takes around 5 to 7 days. Medical detoxification is effective in stabilizing physical health quickly, but without follow-up support, relapse risk remains high.

• Medications: Medications like antidepressants or antiepileptics support cocaine addiction recovery by managing mood or seizure risks. Medications provide added stability in the early months, but they typically require longer use. Some approved medications for cocaine dependence include tiagabine, topiramate, and modafinil, according to the study titled “New Medications for the Treatment of Cocaine Dependence” by Kyle M Kampman in NCBI.

• Cognitive Behavioral Therapy (CBT): CBT addresses the thought patterns driving cocaine use and is effective in helping individuals develop healthier coping mechanisms, according to the study titled “Modified Cognitive Behavioral Therapy (M-CBT) for Cocaine Dependence” by Efrat Aharonovich and Deborah S Hasin. CBT programs and sessions usually last for 12 to 16 weeks and provide tools for long-term recovery.

• Rehabilitation Programs: Inpatient or outpatient rehab programs offer structured environments with therapy, medical support, and interaction with other people with SUDs. Rehabilitation programs range from 30 days to several months. Rehab provides a strong foundation but requires significant time commitment and is costly.

• Support Groups: Support groups like Cocaine Anonymous (CA) offer individuals long-term social support and an opportunity to share experiences with people going through the same struggles. Support group meetings happen weekly or more often. People find support groups to be an essential part of recovery.

What are the Withdrawal Symptoms of Cocaine Addiction?

Cocaine withdrawal occurs when a person who is dependent on cocaine stops or reduces use. Unlike withdrawal from other substances, cocaine withdrawal is often more psychological than physical but still produces intense symptoms.

Some cocaine withdrawal symptoms are listed below.

• Restlessness and Agitation: Many individuals feel highly irritable and restless, with an increased sense of frustration and discomfort as the brain adjusts without the high of cocaine.

• Lethargy: Lethargy is a common symptom after the stimulating effects of cocaine wear off. People commonly experience extreme fatigue and low energy.

• Change in Sleep Patterns: Cocaine withdrawal disturbs sleep and causes insomnia, weird dreams, or extended periods of sleep as the body tries to recover.

• Poor Concentration: Many people struggle to focus on tasks and may feel mentally “foggy” or distracted during cocaine withdrawal.

• Increased Appetite: Cocaine suppresses appetite, so during withdrawal, people experience intense hunger that leads to overeating as the body tries to restore energy.

• Strong Cravings: Strong cravings for cocaine are withdrawal symptoms driven by both physical and psychological dependence. Strong cravings increase the risk of relapse during early recovery.

How to Prevent Cocaine Addiction Relapse?

To prevent cocaine addiction relapse, it’s essential to maintain sobriety and manage stressors. Ongoing therapy and counseling, such as cognitive behavioral therapy (CBT), help individuals identify and change behaviors associated with cocaine use. Developing healthy habits, such as engaging in physical activities, mindfulness practices, or creative hobbies, helps manage stress and emotions. It’s important to build a strong support network of friends and family for ongoing recovery.

How Cocaine Addiction Relate to Other Substance Addictions?

Cocaine addiction relates to other substance addictions by co-occurring, particularly with drugs like marijuana, fentanyl, and heroin. Many individuals struggling with cocaine addiction use other substances to manage withdrawal effects or to enhance the drug’s high. For example, marijuana is used with cocaine, as its calming effects balance cocaine’s intensity. Opioids like fentanyl and heroin are used to balance cocaine’s stimulant effects and create a dangerous pattern of polydrug use.

Do Cocaine and Marijuana Addiction Co-Occur?

Yes, cocaine and marijuana addiction often co-occur. Many individuals use marijuana with cocaine to help reduce the anxiety and restlessness that cocaine causes. Marijuana’s relaxing effects help to “come down” from a cocaine high and create a cycle of dependency on both substances.

What is the Difference Between Treatment Options for Cocaine and Fentanyl Addiction?

The difference between treatment options for cocaine and fentanyl addiction is that treatment for cocaine addiction focuses on behavioral therapies, such as cognitive-behavioral therapy (CBT), and support groups. Fentanyl addiction treatment includes medication-assisted treatment (MAT) with drugs like methadone or buprenorphine to manage withdrawal symptoms and reduce cravings. Both treatments involve therapy, but fentanyl addiction specifically requires medical intervention due to the opioid's intense physical dependence.

Does Cocaine Addiction Resemble Heroin Addiction?

No, cocaine addiction does not resemble heroin addiction. Cocaine and heroin addiction share some behavioral patterns, such as intense cravings and the potential for life disruption, but they differ in their effects. Cocaine is a stimulant that gives feelings of euphoria, energy, and alertness, while heroin is a depressant that provides relaxation and sedation.