Cocaine

Each time you use cocaine, the drug increases levels of the natural chemical dopamine in your brain. The high only lasts for a very short time and soon you need to use more to stay high.

Over time, this changes the brain’s reward system. When you are trying to quit it can cause severe depression and sometimes even thoughts of suicide. Withdrawal itself causes a mixture of intense feelings including anxiety, anger, paranoia, and mood swings.

Immediate Effects

Cocaine’s effects happen quickly after a single dose and last for a few minutes to an hour. Small amounts can make you feel happy, full of energy, talkative, and mentally alert. Large amounts can give you a more intense high - but can also cause feelings of panic, restlessness, anxiety and fear.

Physically, cocaine narrows your blood vessels and increases your blood pressure and heart rate. It can also cause severe reactions such as abnormal or irregular heartbeats, heart attacks, headaches, seizures, and stroke. Cocaine-related deaths are often a result of cardiac arrest or seizures.

Cocaine mixed with other substances is especially dangerous. When used with alcohol the two substances react to produce another substance in the liver called cocaethylene. This can make the harmful effects on the heart even worse.

Cocaine used with heroin is also very dangerous. When mixed with other drugs such as amphetamines and fentanyl it increases the risk of fatal overdoses.

Long Term Effects

Over time cocaine changes your brain chemistry, especially if you use stronger doses more often. Your body and mind start to rely on the drug and crave it - and the brain’s reward system becomes tied to cocaine use. At the same time, your level of stress increases, so you feel dissatisfied and unhappy when you are not taking the drug - signs of withdrawal.

All these effects make you more likely to focus on finding and using the drug, rather than enjoying your life in positive and meaningful ways.

Long term use can also cause other physical and mental changes such as headaches, seizures, depression or anxiety - and even stroke and sudden cardiac death. While at first cocaine may have protected you from anxiety or depression, over time it can cause it.

RISK OF COCAINE OVERDOSE

With regular use, “tolerance” may develop so you need to use more cocaine more often to get the same high and avoid the start of withdrawal symptoms. This is called “chasing the high.”

At the same time, you can also develop “sensitization”, where your body reacts more strongly even when you use lower doses of cocaine.  This is thought to underlie the craving for cocaine and may lead to relapse.

Both these processes can increase the risk of overdose if you are a regular user.

Risk Factors for Cocaine Abuse

Some factors may raise your chance of addiction.  These include:

• Family history – having a close relative with a substance use disorder
• Your community – growing up in a home or environment where cocaine is abused
• Your age – the younger you start the more likely you are to become addicted
• Your stress levels – feeling very stressed or pressured to excel in life
• Your emotional health – living with depression, constant worry or trouble focusing
• Childhood problems – living through trauma, poor nutrition, not enough sleep and an unhealthy environment as an infant and young child

Thinking about the major signs of cocaine addiction may help you look at your own cocaine use. These include:

• Spending a lot of time thinking about cocaine and trying to get it
• Having trouble cutting down or using less
• Feeling nervous, restless, irritable, or depressed
• Having intense cravings when you try to stop quickly or use less

You can use the screening tools below to help you see how cocaine is effecting your life. This can be done in the privacy of your home or wherever you feel comfortable.  The results are confidential.

There are many stages of the recovery process.  The first steps are admitting you are addicted to cocaine, you can’t manage it and it is harming your life.  When you are ready and willing to get treatment, it is time to plan your recovery.

Learning about different approaches to recovery can help you see a path ahead to getting sober and living cocaine-free. You may need different treatments and support at different stages of the process. There are many tools to help you.

Our TREATMENTS section describes many recovery options so you can find the help that best meets your needs.

Also see our PROGRAMS & SUPPORT section to learn about different ways to support your recovery.

Medical Detox

Medical Detox can help you withdraw from cocaine. This is done safely under a doctor’s care. Detox treats the immediate physical effects of stopping cocaine and removes toxins left in the body from chemicals found in the drug.

Withdrawal from chronic cocaine can cause anxiety, depression and intense cravings for the drug. Several types of medications help with these issues in different ways.

• Antidepressant and anti-anxiety medications can reduce cocaine withdrawal symptoms including anxiety and depression.
• Amantadine, a drug used to treat Parkinson's Disease, may reduce severe withdrawal symptoms and cocaine craving.
• Bromocriptine, a drug that works on the brain's pleasure system, can decrease craving for cocaine during detox and steady your mood.
• Propanolol, a drug used to treat high blood pressure, calms the body's "fight or flight" response. It can also treat anxiety and lessen symptoms like palpitations and sweating to help reduce cravings. But it does have a risk in people who use cocaine. It can decrease blood flow to the heart and put you at risk for irregular heart beats and stroke. Delayed toxic effects are also possible. Any use of beta-blockers for this purpose requires careful medical monitoring and caution.

Therapy or Counseling

There are many different types of therapy that can be helpful for cocaine addiction.

• Certified recovery coaches, addiction counselors and peer coaches provide one-on-one support to help you make changes and learn new skills – such as how to manage cravings, set new goals, stay motivated, and re-envision your life. 

• Individual, Group or Family therapy is more long-term, as you gain a deeper understanding of yourself and your relationships. Through this process you learn healthier ways to cope with life problems and can make good choices for yourself that replace substance use.

• Psychologist or Psychiatrist:  If you are dealing with longstanding depression and anxiety or psychological traumas such as physical, emotional or sexual abuse, the optimal recovery approach will include treatment by a psychologist or psychiatrist.

• Behavioral Therapies are  short-term therapies that are based on the idea that all behaviors are learned.  They help you become aware of your thoughts and how they feed your addiction.  By changing your thinking, you can change the choices you make in life.  Behavioral therapies have had success in treating cocaine addiction in residential and outpatient settings.

• Cognitive-Behavioral Therapy (CBT) is an effective form of short-term talk therapy used to treat addiction.  It helps you learn skills to stay drug-free  – such as recognizing when you are most likely to use cocaine, avoiding those situations, and coping better with problems related to drug use.

Group Support

Joining a 12-step recovery program like Cocaine Anonymous or other peer support group  is a good way to stay connected with others who share their experiences of getting sober and staying sober.   It is a very important part of the recovery process.

Inpatient and Outpatient Treatment

You may be helped by an outpatient treatment program or a stay at a residential treatment center or hospital for a period of time. These programs provide structured support for recovery. They are designed to help you see and change harmful patterns, learn healthier ways to be with others, handle stress without using drugs, and start on a new path that is committed to your sobriety.

ONLINE TREATMENT

Online programs and counseling are a private and convenient way to get treatment over the Internet. They offer many of the same features as in-person treatment, such as group sessions led by addiction counselors, family and individual therapy sessions, peer support and tools for recovery. Schedules are flexible, many offer 24/7 support, and you can often take refresher courses going forward.

Studies show that online treatment is effective in reducing drug use.

See our TREATMENTS section to learn more about these therapies.

Currently there are no medications approved by the FDA to specifically treat cocaine addiction. But researchers continue to study natural brain chemicals to help restore the imbalance caused by long-term cocaine use. 

Several medications developed to treat other disorders are used to reduce cocaine use. These include:

• Disulfiram, used to treat alcohol dependency
• Baclofen, a muscle relaxant
• NAC, an amino acid that curb cravings
• Modafinil, improves sleep after you are drug-free

What They Do

• Curb cravings
• Reduce withdrawal symptoms such as trouble sleeping and daytime sleepiness
• Ease anxiety
• Help prevent relapse

Do They Work?

There are a limited number of recent studies on medications for cocaine use disorder. The most effective ones so far work on the natural brain chemical dopamine (such as Modafinil) or GABA (such as Topiramate). Combination drugs are especially promising.

Scientific reviews do show that modafinil, bupropion, topiramate or disulfiram used with counseling and group support such as 12-step programs are better than either approach on its own.

NOTE: Even when taking medications it is vital to receive support from a peer group program like Cocaine Anonymous and treatments such as counseling or therapy. These help you see what role your thoughts, feelings and attitudes play in addiction – so you feel stronger and more able to handle your life.

BACLOFEN (Gablofen®; Lioresal®)

What it does:  This muscle relaxant curbs cocaine cravings, especially in long term and heavy users, and lessens withdrawal symptoms.

How it works:  Increases the amount of GABA in the brain, a natural chemical that has a calming and relaxing effect.

Side effects:  Drowsiness, dizziness, weakness, fatigue, nausea, headache, constipation.

** Using baclofen for more than a couple of months may cause dependence. Withdrawal can cause agitation, insomnia, and confusion. Do not stop using it suddenly – gradually lower the dose with the help of your doctor.

For a more complete list of side effects click here.

Availability:  Physician prescription

More information on Baclofen

DISULFIRAM (ANTABUSE)

What it does:  Makes drinking alcohol or using cocaine very unpleasant. It is used to reduce cocaine use and relapse, especially when caused by stress.

How it works:  Blunts cocaine cravings or changes the “high”. It may need to be used longer or at a higher dose to reduce the effects of cocaine that keep people using.

Side effects:  Nausea, vomiting (sometimes very severe, if any alcohol or cocaine is used), difficulty breathing, confusion and fainting. May also cause anxiety, paranoia and restlessness.

For a more complete list of side effects click here.

Availability:  Physician prescription

Gabapentin, Topiramate and Vigabatrin

What it does:  Eases anxiety and agitation during recovery.

How it works:  Reduces cravings and help you feel more relaxed by increasing the natural brain chemical GABA.

Side effects:  tiredness, dizziness, headache, nervousness, joint or muscle pain, memory problems.

For a complete list of side effects click here. Under Browse by generic or brand name click on the first letter of the drug you’re looking up, such as G to find Gabapentin, T to find Topiramate and V to find Vigabatrin.

Availability:  Physician prescription

MODAFINIL (PROVIGIL)

What it does:  Improves sleep during cocaine withdrawal and reduces cravings.

How it works:  Increases the natural brain chemicals dopamine and glutamate which is used up by cocaine use. This may work at the core of the craving for cocaine.

Side effects:  Anxiety, depression, diarrhea, dizziness, dry mouth, headache. DO NOT USE Modafinil if you have certain types of heart disease such as mitral valve prolapse.

For a more complete list of side effects click here.

Availability:  Physician prescription

N-ACETYLCYSTEINE (NAC)

What it does:  This amino acid curbs cocaine cravings and may repair damage in the brain caused by cocaine use.

How it works:  Restores the natural brain chemical glutamate to normal levels. Glutamate helps make GABA which calms anxiety, stress and fear.

Side effects:  diarrhea, nausea, vomiting, fatigue, skin rash

Availability:  Over the counter

For specific suggestions of other amino acids that can lessen cravings see our Nutrition page in the Holistic section

More information on N-Acetylcysteine

For Adults

For Families

For more resources see our For Family & Friends section.