Cocaine Addiction

In the past, cocaine has been associated with affluent groups, being a common drug of choice among white-collar workers for decades. But as time has passed, cocaine’s effect has permeated further, with its rapid spread across social demographics indicating a stark truth: addiction does not discriminate.

This has led to the assertion that we are living in an era coloured by a cocaine epidemic. But what is the actual extent of cocaine use in the UK? How has cocaine use evolved? What makes the substance so dangerous, and what cocaine addiction symptoms can we look out for?

Cocaine addiction: Key stats

Cocaine is perhaps more prevalent on the substance scene than we might first anticipate. More cocaine is taken in the UK than in any other country in Europe. It is the second most commonly used drug in the UK (following cannabis).

Cocaine importing is a key issue in the cocaine epidemic conversation, with anywhere between 25 and 40 tonnes of cocaine being smuggled into the country every year.

Since 2013, the number of adults using cocaine has increased by over a third (37%). Use has soared among young adults (those between the ages of 16 and 24), increasing by almost three-quarters (73%).

This high usage also maps onto treatment needs, with a total of 19,209 people beginning treatment for their cocaine addiction between 2020 and 2021. This suggests that approximately 15% of people seeking support for their use of substances were specifically struggling with cocaine.

In 2017, the deaths of 432 people in England and Wales were related to cocaine use (either in the context of overdose or other drug-related complication).

Cocaine: The chemistry

Cocaine is made from Erythroxylon coca, also known as the coca plant. This plant is native to certain areas in South America, including Bolivia, Peru and Columbia. While it is possible to achieve a high from eating the plant in its raw form, the plant matter (leaves and stems) can be treated in several ways to increase the stimulant’s power.

The active agent in the drug is cocaine hydrochloride. When this is extracted, cocaine as we know it can be produced. This is typically thought to take place in ‘jungle labs’, such as the kind in Columbia, where 90% of America’s cocaine supply is produced.

What does it do?

Cocaine is a stimulant, this means that it largely acts upon the body’s central nervous system (CNS). The CNS functions through a series of complex messages that are continually sent and received as a way of connecting the body and the brain.

These messages are relayed from the brain and through the spinal cord. Stimulant drugs speed up the transmission of these messages, therefore characterising the ‘high’ of cocaine as something that feels intense, fast, or even euphoric.

Cocaine: The law

In the UK, cocaine is a Class A drug. This means that penalties associated with using, supplying or producing cocaine have particularly hefty legal repercussions.
Under the Misuse of Drugs Act (1971), these penalties can lead to:

• an unlimited fine and up to 7 years in prison (for the possession of cocaine)
• an unlimited fine and up to life in prison (for the production, selling, dealing or sharing of cocaine)

Previous laws – particularly in America – have suggested that the legal consequences associated with crack cocaine are more severe than those associated with powder cocaine. However, in the UK today, both drugs are categorised as Class A.

But why is cocaine addictive?

As previously noted, cocaine acts on the central nervous system. More specifically, its effects are primarily upon the limbic system. The limbic system is ‘the part of the brain involved in our behavioural and emotional responses, especially behaviours we need for survival.’

This means that the limbic system is responsible for regulating the following:

• Hunger and thirst
• Mood
• Feelings of reward
• Habit formation
• Movement and coordination
• Learning and processing

As the psychoactive properties of cocaine impact the limbic system, using the drug can affect all of these areas in varying ways – for instance, the reward systems in the brain are stimulated through the use of cocaine. This is because cocaine use leads to an increase in dopamine activity in the brain. This then builds a connection between cocaine and the feeling of being rewarded, which can, therefore, become the foundation for the formation of addiction.

By impacting our limbic system’s regulation of appetite, we may find that we do not feel hungry or thirsty whilst using cocaine, and therefore may experience significant weight loss in tandem with heavy use.

All of these essential processes are then impacted by cocaine use. We can then begin to crave cocaine after a while, as it feels as though the body ‘needs’ it to maintain usual functioning.

How bad is cocaine addiction?

Drugs are categorised into different classes that work to rank them in terms of how dangerous they are. That means that cocaine, as a Class A drug, is considered to be particularly risky due to its various health effects.

This is concerning when we know that an estimated 1.3 million people used Class A substances in 2018/19. This equates to around 1 in 25 people.

Addiction and overdose risk

Another key facet to its danger, however, is the way that cocaine use leads to the development of addiction. Cocaine affects our neurocircuitry – the way our brains work – in a way that leads to strong cravings and powerful withdrawals.

This can lead to the sentiment that cocaine is a kind of ‘medicine,’ that it can help alleviate the difficult thoughts, feelings and physical sensations we are experiencing, when in fact, it is responsible for them. Self-medicating cocaine withdrawals and cravings for more cocaine lead to a vicious cycle that can only lead to dependency.

This often goes hand in hand with a developing tolerance; you may find that the amount of cocaine you needed at the start is no longer adequate. This then drives dependency but also increases the risk of accidental overdose.

Polydrug use

The danger of cocaine is exacerbated by the fact that a high number of chronic cocaine users also regularly use other substances. This is known as polydrug use.

One of the most common examples of polydrug use would be drinking alcohol alongside taking another substance, such as cocaine. Whilst this is typically associated with recreational drug use in a social setting, it can extend beyond that and is also a phenomenon found amongst solo users.

Polydrug use can happen in two ways:

• it can be simultaneous (substances are used together)
• or concurrent (substances are used in a kind of cycle, one after the other)

Polydrug use is particularly dangerous as ‘interactions between different substances, consumed close together in time, can increase drug toxicity.’
This means that there is an increased risk of accidental overdose when cocaine is used alongside other substances.

How cocaine affects the body

Chronic cocaine use can lead to an increased risk of organ failure (specifically of the kidney and liver) and complications with the cardiovascular system, including stroke and cardiac arrest. This indicates that cocaine has a very tangible impact on systems that are essential to basic functioning.

These conditions can ultimately decrease function and risk developing long-term conditions that need to be managed with appropriate medical care. If these conditions worsen, they can lead to death.

There are also specific risks associated with the method of cocaine use.

• Intranasal use (snorting) increases the risk of damage to the nose and sinuses
• Oral use (rubbing into the gums) increases the risk of sores and developing infection
• Intravenous use (injecting into the bloodstream) increases the risk of vein collapse and the development of infectious diseases such as HIV/AIDs and hepatitis
• Inhalation (smoking) increases the risk of respiratory complications

How cocaine affects the brain

Cocaine can also, however, have a severe impact on mental health. One study indicated that between 68 and 84% of users experience paranoia. Cocaine has also been linked to psychosis; with an approximated range of between 29% and 52% of users experiencing both hallucinations and delusions.

Hallucinations occur when an individual perceives something that others do not. Commonly, cocaine induced hallucinations are visual or auditory, but they can also be olfactory, gustatory and tactile.

Delusions, distinct from hallucinations, are persistent false beliefs not aligned with external reality, often referred to as ‘false beliefs’ in the professional field. Both hallucinations and delusions are integral to psychosis. Cocaine use or withdrawal can lead to cocaine-induced psychosis.

Individuals using cocaine regularly may also find it difficult to regulate their mood, having ‘swings’ between euphoria and intense periods of lowness, irritability and aggression.

How cocaine affects us socially

Addiction is a public health concern with broad repercussions, both direct and indirect. For instance, an individual’s job loss directly linked to cocaine use is a consequence of addiction. The broader unemployment stemming from addiction contributes indirectly to its socioeconomic implications.

Historically, cocaine has been linked to social unrest, surging in usage during periods of collective hardship like postwar or economic crises. An exception was observed during early COVID-19 lockdowns, where adult drug use decreased, attributed to limited substance access. Yet, adolescent drug use rose, underscoring varied substance usage patterns across demographics.

In terms of finances, the UK government reported that illicit drug misuse costs £10.7 billion every year. This covers the costs of hospital admissions, treatment, and associated health and social care provision. This ultimately leads to the rhetoric that alcohol and drug use have become a kind of ‘public health burden.’

Methods of treatment

Cocaine rehab can look slightly different from person to person. This is because rehab programmes are typically bespoke; they are tailored to the individual to enhance their efficacy.

Typically, however, cocaine addiction will be treated in four different stages:

1. Assessment and admission
2. Cocaine detox
3. Therapy
4. Aftercare

An assessment refers to the process of speaking with professionals about your situation. During this time, you may be asked to answer some questions about your current use of cocaine, as well as about any historical drug use. After getting to know you a little better, an assessment team will be able to advise you on your treatment options.

Following this, you may be offered a detox. A detox is a core component of most rehab experiences. This is because most drugs are physiologically addictive. Without spending the time to combat the cravings in the early stages of rehab, it can be difficult to continue through the process in a safe and focused manner.

After detoxing, you will experience a range of tried and tested therapies. These are aimed to help you tackle difficult feelings that may have come from using substances, as well as begin to unravel what may have led you to use cocaine. Such therapies include:

• Cognitive behavioural therapy (CBT)
• Dialectical Behavioural Therapy (DBT)
• Experiential Therapy
• Group Therapy
• Individual Therapy
• Psychodynamic Therapy
• Psychotherapy

These types of therapies are also helpful in supporting you to develop a range of coping strategies and tools for moving forward on your journey to staying clean.

The final stage is aftercare. Aftercare refers to any form of ongoing support – therapies, contact or treatment after you leave rehab. This aims to ensure that you are supported in making the transition into active recovery as much as possible.

Why Is Cocaine So Addictive?

The effects of its consumption can be very pleasurable, and can drive someone who has taken cocaine to want to repeat the experience, possibly very shortly afterwards. The after-effects of cocaine consumption can include a deficiency in dopamine, which itself can drive further engagement in cocaine use. Regularly repeating the consumption of cocaine can rapidly impact upon the brain’s reward centres, leading to the swift onset of psychological dependence.

Partly because of cocaine’s somewhat glamorous reputation, some people operating in certain circles, or active in some professional environments, may feel socially pressured to keep taking cocaine even if they are not particularly enthusiastic about its effects. Meanwhile, in some high-pressure working environments, cocaine use and abuse are rampant because of the drug’s stimulant properties. This allows for the extended wakefulness, productivity and purporting to produce increased focus. Cocaine’s appetite-suppressing qualities also make it a sought-after drug amongst individuals for whom weight loss, or maintaining a low weight, is a priority.

How long does it take to beat cocaine addiction?

It is not easy to give a straightforward answer, as every individual’s experience of cocaine addiction will be different. Some people may find that a short stay in rehab is enough to help them recover. Others may relapse and find returning to treatment is useful. Others may not stay for their full treatment, deciding that recovery is not right for them at that moment in time for various reasons. Every journey is personal.

Rehab duration depends on factors like the intensity and duration of use, overall health, metabolism, and biology. Withdrawal periods differ, ranging from days to weeks and sometimes months (protracted withdrawal).

While the average rehab duration is 28 days, it doesn’t imply a cure; instead, it establishes a solid recovery foundation tailored to individual journeys.

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