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Cocaine Addiction Explained

Cocaine is one of the most infamous and damaging of all illegal drugs. Despite its associations with glamour and wealthy hedonism, cocaine abuse is still debilitating and can be deadly. This substance can lead to an addiction which can destroy even the most outwardly successful lives. Many thousands of people in the UK currently struggle with cocaine addictionat a huge cost to themselves, their loved ones, and society at large.

Understanding Cocaine Addiction

Addiction is fundamentally a disorder of the brain’s reward centres. The repeated exposure over time to rewarding stimuli and behaviour, can see parts and functions of the brain associated with the feeling of being rewarded to adjust to that exposure. For example, the trigger could be the consumption of cocaine and the experience of its effects. Thus, driving further engagement in this rewarding behaviour through mechanisms such as the release of dopamine (associated with feelings of pleasure and reward) and other neurochemicals.

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Taking cocaine repeatedly over a period of time creates rewarding sensations, including the physical and psychological pleasure of taking the drug. Someone who enjoys those sensations may yearn to repeat them, and be driven to take more cocaine in order to replicate that experience. As the reward centres continue to adapt to cocaine use, the person may become more and more reliant upon taking cocaine in order to experience the pleasurable sensations associated with it.  This would also drive off the negative sensations and emotions resulting from refraining from taking cocaine, often symptoms of withdrawal. The reward centres restrict the release of dopamine and other relevant chemicals in the absence of the addictive behaviour.

Although the effects that is has on the human brain, unlike some other substances of abuse, cocaine is not considered to be physically addictive. The dependence which cocaine use can result in is primarily a psychological phenomenon, and the symptoms of withdrawal associated with cocaine abuse are consequently mainly psychological in nature. However, this should not cause anyone to underestimate just how addictive cocaine can be: the psychological dependence resulting from protracted cocaine use can be extremely powerful and life-threatening.

Cocaine Explained

Cocaine is a strong stimulant derived from the coca plant, which is mostly used recreationally (though does have some medical uses, chiefly associated with its anaesthetic qualities).[1] Most commonly provided as a fine white powder, though also available in the smokable “rock” form known as crack cocaine, and occasionally in solution, cocaine can be found throughout the world despite its prohibited status, thanks to the huge profit margins associated with its supply. Although cocaine production remains centred upon its heartland of Central and South America, coca plants are now cultivated in various other parts of the world, while cocaine trafficking and consumption are a huge international challenge causing great instability in numerous regions.

The stimulant effects of the coca leaf have been known in Latin America for at least 1,000 years, but the cocaine alkaloid itself was not successfully isolated until 1855. Shortly afterwards, cocaine’s analgesic and psychoactive effects began to be explored, and the drug rapidly established itself across the Western world as both a medicine and a recreational substance. This was especially aided by its inclusion in products such as Mariani wine and the original recipe for Coca-Cola. By 1879, cocaine was being used as a treatment for morphine addiction, and a few years later was introduced as a local anaesthetic. Subsequently, cocaine was employed as a diet drug, as a stimulant for soldiers and explorers, and as a tool in psychiatry (with Sigmund Freud playing a key role in this regard).

Cocaine abuse was recognised as a vice by the late Victorian era (as can be seen by its appearance in the novels of Sherlock Holmes). Over the course of the 20th century, cocaine grew to prominence as a highly desirable recreational substance associated with high living. However, this glamorous reputation belied its impact upon the most vulnerable and deprived sections of society, especially following the emergence of the highly potent smokable form of cocaine, known as crack, in the 1980s.

In modern times, cocaine use has reached pandemic levels, with between 14 and 21 million individuals using the drug each year worldwide, creating a market worth anywhere between $100 billion and $500 billion. Up to 3% of the population of the developed world has taken cocaine at some point. The use of the drug results directly in well over 4,000 deaths annually, whilst fatalities indirectly related to cocaine, including murders and accidents, are easily several times that number.
Long-term cocaine usage can have a wide variety of very serious ramifications for the physical and mental health of the user, and can result in crippling addiction with permanently detrimental consequences for life prospects. Nevertheless, cocaine has managed to retain its place as the most glamorous and desirable of illegal substances, and its frequent appearance in film, television and other media ensures that it continues to be associated with a certain lifestyle to which many users still aspire.

Cocaine Formula, Brand and Street Names

Cocaine has the chemical formula C17H21NO4, and the chemical synonym benzoylmethylecgonine. Although the overwhelming majority of cocaine is of illicit origin, it is occasionally used medically in some jurisdictions, supplied under brand names including Neurocaine. [2]

Cocaine is supplied under a huge number and variety of street names, including but not limited to:

  • coke
  • C
  • Charlie
  • marching powder
  • nose candy
  • dust
  • devil dust
  • powder
  • snow
  • talc
  • blow
  • bump
  • bazooka
  • nose bag
  • nose powder
  • snuff
  • gak
  • posh
  • toot
  • sniff
  • schnozzle
  • happy powder
  • rush
  • Snow White
  • Mama C
  • white lady
  • witch
  • Devil’s dandruff
  • gear
  • yayo
  • beak
  • chop
  • flake
  • crack
  • rock
  • sugar
  • candy

Legal Status (UK)

In the UK, cocaine is considered one of the most serious and damaging illegal substances of abuse, and as a result is categorised as a class-A controlled substance under the Misuse of Drugs Act 1971.  The maximum sentence for possession of cocaine is seven years in prison and an unlimited fine, whilst those guilty of supply can face life imprisonment and an unlimited fine. [3]

Routes of Administration

Cocaine powder is most commonly insufflated (snorted), although it can be applied to the gums for absorption into the bloodstream, as well as turned into a solution for intravenous injection. Some users also apply cocaine rectally and/or vaginally.

Whilst powder cocaine can be smoked, the effects are typically less pronounced than if consumed by other means. However, cocaine can be transformed relatively easily into crack cocaine, which is usually smoked through a pipe.

Pharmacological Actions of Cocaine

The primary actions of cocaine in the brain relate to its impact upon neurotransmitters. Most prominently, cocaine blocks dopamine transporter proteins in the central nervous system, preventing the reuptake of dopamine and consequently causing an excess of dopamine in the synaptic cleft. Cocaine also affects certain receptors of serotonin, though how exactly it does this is not yet fully understood. The substance is also known to block sodium channels in the nervous system, thus preventing the transfer of information relating to pain and consequently acting as a local anaesthetic.

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Risk Factors for Cocaine Addiction

What exactly causes addiction in one individual, while another individual in very similar circumstances may not develop the condition, is not fully understood, although it is known that both environmental and genetic factors play a role.

However, various risk factors have been identified as contributing to the likelihood that cocaine addiction will develop, including:

  • a family history of substance abuse and addiction
  • a family history of mental health disorders
  • a personal history of mental health issues
  • previous experimentation with substances of abuse
  • a prior history of addiction to other substances
  • associating with a peer group within which substance abuse, especially cocaine abuse, is widespread
  • working in high-risk professions including medicine, financial services and the entertainment industry
  • a comparatively high level of disposable income
  • displaying narcissistic personality traits
  • a higher than average level of education
  • frequent travel to or family links with locations where cocaine is produced or trafficked
  • being aged between 16 and 30
  • being female
  • experiencing trauma and/or challenging life situations
  • experiencing childhood abuse
  • engaging in sex work
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How Dangerous Is Cocaine?

The dangers of cocaine are manifold. Most obviously, cocaine use can result in serious physical and psychological harm, potentially including death from overdose, and in dependence and addiction. Regular cocaine abuse, and in particular addiction, can have extremely serious financial, professional and reputational ramifications. It can lead to the breakup of important relationships and the permanent diminution of life circumstances, with further consequences for the well-being of the user. The lessening of inhibitions resulting from cocaine usage can lead to engagement in risky behaviour, including in unsafe sex potentially resulting in contraction of life-threatening diseases including HIV/AIDS (which can also result from intravenous drug use).

Cocaine’s criminal nature, and the huge profits which can be obtained from selling the drug, means that violence is frequently associated with cocaine use and supply. Meanwhile, the criminal penalties associated with cocaine can have permanently life-changing consequences for anyone caught in possession of or supplying the drug.

Dangers associated with cocaine overdose

Cocaine overdose can be fatal, with death resulting from any of numerous causes including heart attack, respiratory failure, stroke, and seizure. Organ failure can result from excessively high body temperature. Individuals suffering from cocaine overdose can sustain permanent physical damage and impairment even in non-fatal cases. [4]
Some prominent symptoms of cocaine overdose include:

  • irregular heartbeat
  • extremely high blood pressure
  • intense anxiety
  • confusion
  • nausea
  • tremors
  • muscle spasms
  • irregular breathing
  • psychosis
  • loss of motor control
  • loss of consciousness

If you observe these symptoms in anyone known to have taken cocaine, it is imperative that you contact the emergency services as soon as possible.

Signs and Symptoms of Cocaine Use

It may be very difficult to identify cocaine use, and abuse, even in someone very close to you, as the stigma associated with substance abuse and the illicit nature of cocaine mean that users often go to great lengths to conceal their cocaine consumption. However, some prominent symptoms of cocaine use may include:

  • excitable and exaggerated behaviour
  • egomania and excessive self-confidence
  • changes in pupil size
  • runny nose and sniffing
  • white powder around the nostrils
  • nosebleeds
  • mood swings
  • burns on the fingers or lips (from smoking crack cocaine) or scabs and bruises on veins (from injecting)
  • engagement in risky behaviour
  • a loss of interest in activities that were once important
  • altered sleeping and eating patterns
  • changes in sex drive and sexual interests
  • a lack of care in appearance and hygiene
  • financial difficulties
  • possessing paraphernalia related to cocaine abuse, including rolled-up notes, small spoons, small mirrors (especially marked with white residue), razor blades, plastic baggies and very sensitive scales
  • increasingly secretive, furtive or deceitful behaviour
  • changes in peer group and vocabulary
  • loss of weight
  • increased frequency of socialising and attending parties
  • fatigue
  • depression
  • decreased optimism regarding the future
  • apathy
  • aggression possibly including violence
  • paranoia
  • delusions
  • psychosis
  • the manifestation of withdrawal symptoms
  • anxiety when contemplating significant periods away from home, especially including travel abroad

Easiest Ways to Spot a Cocaine User

Cocaine use is typically a surreptitious activity, though in some circles and environments it may be relatively overt. It may be that you are unable to identify it in any given individual. Look for somewhat sudden and pronounced changes in habit and appearance, frequent disappearances (for example, to the bathroom) during social events, exaggerated behaviour and speech, flulike symptoms (especially sniffles, sneezes, a runny nose and red eyes), frequent mood swings, and new and perhaps suspicious peers. [5]

Be aware that not all signs suggesting cocaine use may actually have that cause. There may be other reasons for the behaviour-causing concern. Most importantly, if you suspect someone you know is using cocaine, do not confront them: contact an addiction specialist about your suspicions, and always prioritise your own safety and that of everyone around you.

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Trying Cocaine for the First Time

Every individual experience of substance abuse is unique, and there may be an infinite variety of settings and occasions on which someone may try cocaine for the first time. Typically, trying cocaine can be accompanied by significant excitement and apprehension.  There is a certain mystique associated with the drug. Its reputation is such that many people view it, at least initially, as being a “special” substance and one representing a significant treat or luxury. Individuals who have no previous experience of other stimulants, and/or already intoxicated on other substances, who take cocaine for the first time are significantly more likely to experience unpleasant and/or dangerous effects. Equally, they are more likely to suffer potentially a perilous loss of motor control and diminution of inhibitions.

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.

Teen Cocaine Addiction

Cocaine is not typically viewed as being a significant problem amongst teenagers in the UK. This is partly because of its comparatively high cost which often places it beyond the reach of the average teen’s disposable income. Nevertheless, cocaine’s seductive appeal is felt no less strongly by the younger people or peers, especially considering cocaine’s glamorisation in youth-facing music and other media. An unfortunate number of teens in the UK do succumb to cocaine addiction each year, typically requiring specialist treatment in dedicated facilities.

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Signs your teen is using cocaine

Many of the signs of teen cocaine use are the same or similar for people of all ages, including the presence of furtive and deceitful behaviour. Amongst the other signs are altered sleeping and eating patterns, associating with new and potentially problematic peers, exacerbated fatigue, problems at school including poor academic performance, isolation and social withdrawal, regularly asking for money, engagement in criminal activity, mood swings, a lack of care paid to appearance and hygiene, changes in vocabulary, changes in media taste and especially music, unexplained disappearances and frequent late nights, and more.

Some signs that your teen may be using cocaine specifically include irritated nostrils and/or nostrils covered in white residue, possessing paraphernalia associated with cocaine use including rolled-up notes, mirrors and razor blades, as well as unexplained financial shortages,. You may also notice frequent intoxication by looking for exaggerated behaviours, mood swings, excessive self-confidence and garrulousness, outbursts of aggression, possibly including acts of violence. If they express an inability to concentrate for more than short periods, it may be a sign of cocaine use among other things.

If you suspect your team may be abusing cocaine, while it is tempting to want to take action immediately, do not rush to confront them. Doing so may cause more harm than good. Instead, contact an addiction specialist with whom you can discuss your concerns and who can give you advice regarding your best course of action.

Cocaine Use and Psychosis

Cocaine users are known to be at an enhanced risk of developing psychosis. Over half of cocaine users have reported experiencing at least one of the symptoms of cocaine psychosis after taking the drug. The psychosis associated with cocaine is often significantly more persistent than that caused by other drugs. Itcan last weeks or even months after the last dose of cocaine. As a rule of thumb, the longer someone takes the drug, and the higher their dosages, the more likely they will be to develop some form psychosis, and the more severe and long-lasting that psychosis is likely to be.
Some of the symptoms of cocaine psychosis include:

  • a lack of emotional response
  • profound lethargy
  • incoherent thought and behaviour
  • disorganised speech
  • erratic, sometimes violent behaviour
  • visual and auditory hallucinations
  • delirium
  • delusions
  • paranoia
  • anxiety
  • suicidal or homicidal ideation

The treatment of cocaine-induced psychosis typically features supportive care during the phases: maintaining acceptable levels of body temperature, heart rate, blood pressure and hydration, and keeping the affected individual as calm as possible, possibly using sedatives. Antipsychotic drugs have been demonstrated to be beneficial during the early stages of treatment. However, an abstinence from medication and all substances of abuse during a subsequent therapy phase is the preferred approach.

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Co-Occurring Disorders with Cocaine Abuse

When a substance use disorder such as cocaine addiction co-occurs with another mental health disorder, the phenomenon is known as dual diagnosis. Dual diagnosis is comparatively common in cases of cocaine addiction, as the abuse of cocaine can both result from, and cause, mental health issues. People with poor mental health may turn to cocaine as a means of escapism or self-medication, while, in turn, the abuse of cocaine can lead to various mental health problems, both as a result of the impact of the drug on the brain and because of the deterioration of life circumstances which typically follows addiction.

Treating dual diagnosis is usually significantly more complex than the treatment of either condition independently, as patients with mental health disorders may struggle to engage with therapy or to remain in treatment altogether, and some medications which would otherwise be prescribed might interact dangerously with substances of abuse. As a result, addicts suffering from dual diagnosis typically require specialist care, often in dedicated facilities.

The Short-Term Side Effects of Cocaine Abuse

Alongside the desired euphoric high, various short-term side effects may result from cocaine abuse, including:

  • increased heart rate
  • increased blood pressure
  • increased body temperature
  • constricted blood vessels
  • nausea
  • loss of appetite
  • hyperstimulation
  • aggression
  • volatile and potentially violent behaviour
  • hallucinations
  • intense anxiety
  • paranoia
  • psychosis
  • overdose potentially resulting in death

The Long-Term Side Effects of Cocaine Abuse

Over the longer term, cocaine abuse can have a number of undesirable side effects, including:

  • addiction
  • permanent neurological damage
  • damage to blood vessels
  • damage to organs including liver, lungs and kidneys
  • hallucinations
  • damage to the nose from snorting
  • abscesses and disease from intravenous injection
  • respiratory failure
  • tooth decay and gum disease
  • psychosis
  • profound mood disorders including depression
  • confusion
  • sexual dysfunction
  • infertility

Cocaine Use and the Central Nervous System

Taking cocaine causes an increase in the quantity of dopamine (and other chemicals) released into synapses between neurons in the brain, creating pleasurable sensations which are transmitted throughout the body by the central nervous system (CNS). It also blocks the enzyme which reabsorbs dopamine, causing an accumulation of dopamine in very significant quantities, leading to the euphoric “rush” and persistent positive sensations associated with cocaine use.

Over the longer-term, cocaine can damage the receptors which it affects, making dopamine less effective and consequently impacting upon a user’s ability to feel pleasure. In turn, this leads to possibly depression and anhedonia which can have an extremely deleterious impact upon a cocaine user’s life even long after they stop taking the drug.

How Cocaine Affects People’s Lives

Cocaine abuse can have catastrophic effects upon the user’s life. Taking cocaine poses both short-term and long-term risks to physical and mental health, including the risk of death by overdose and permanent neurological damage due to protracted abuse. Because of cocaine’s illegal status, involvement with the drug can lead to a permanent criminal record and, potentially, imprisonment. Having traces of the drug in the body can result in job loss and disqualification from certain professions and activities, including professional sport, with permanent ramifications for the user’s career.

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The stigma associated with substance abuse means that being a known cocaine user can have significant reputational consequences. It can also lead to the collapse of relationships and problems with custody and/or visitation rights in cases of family breakdown.

Becoming addicted to cocaine can lead to huge debts and even financial destitution, with some users spending hundreds of pounds per day on the drug. Substance abuse is a major factor in homelessness across the UK. Addiction can also have lifelong ramifications for life circumstances and prospects, as well as for physical and mental health, self-esteem and outlook on the world.

Cocaine Addiction Withdrawal Symptoms

Individuals who have become addicted to cocaine typically go through withdrawal upon cessation of use. Some of the primary cocaine withdrawal symptoms include:

  • cravings
  • fatigue
  • weakness
  • restlessness
  • problems concentrating
  • increased appetite and weight gain
  • anxiety
  • anhedonia
  • exhaustion
  • insomnia
  • nightmares
  • mood swings
  • depression
  • suicidal ideation

CocaineTreatment Options

One corollary to the proliferation of substance abuse and addiction, including cocaine addiction, across the UK has been the emergence of numerous high-quality treatment facilities operating around the country. There are now various options, both public and private, for the treatment of cocaine addiction.

Medications That May Help Your Cocaine Addiction Recovery Efforts

At present, there is no pharmaceutical “cure” for cocaine addiction. However, some medications may be prescribed to assist with cocaine withdrawal and returning to a normal life after protracted cocaine abuse. For example, gabapentin can be used to increase levels of the neurotransmitter GABA, which has a calming effect and can reduce the impact of anxiety, while modafinil can assist with the stabilisation of dopamine levels and a return to normal sleep patterns. Meanwhile, various antipsychotics might be prescribed in case of psychosis, while antidepressants can address depression which emerges both during and after cocaine withdrawal.

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Medication Use in Treatment Facilities

Those who have chosen a reliable and CQC-regulated a cocaine treatment facilitywill be given a holistic treatment plan after being assessed, which may include the use of medication. This medication will be prescribed by experienced doctors at times and in dosages appropriate to each person’s particular case. Medical professionals will be on hand to provide supplementary medications if required.

It is considered extremely dangerous to self-medicate in any case of addiction, especially cocaine addiction, and at no time should you ever use any medication – in particular, medication procured online – which has not been prescribed by a doctor.

Cocaine Rehab Treatment Process

If you have taken the decision to enrol in rehab for your cocaine addiction, the first step will be a complete physical and psychological assessment, after which you will be provided with an addiction treatment plan, possibly followed by an immediate prescription of medication to address any incipient symptoms of withdrawal. The next phase will be detox, monitored and managed by trained professionals, during which withdrawal is likely to manifest. Some symptoms may be alleviated, at least in part, by medication.

Stays in residential rehab typically last for between 30 and 90 days. After detox, you will engage in a period of therapy to uncover and address the psychological causes of your addiction and to remediate the problematic behaviours which have led to your current condition. Throughout this period, you will adhere to your addiction treatment plan, which will also include bespoke fitness and dietary schedules and possibly a range of other elements varying by facility.
At the conclusion of the treatment programme, you will leave the facility equipped with various psychological defence mechanisms against relapse and new tools for coping with life after substance abuse. Quality rehabs will provide up to a year’s free aftercare to assist you with your readjustment into the wider world, and to optimise your chances of avoiding relapse and sustaining abstinence.

Cocaine Abuse Statistics

  • In 2017/18, around 875,000 people in England and Wales alone took powdered cocaine, according to Home Office statistics. [6]
  • Crack cocaine is used by between0.1% and 0.2% of the UK population.
  • Over 6% of 16-to-24-year-olds in the UK take cocaine each year.
  • Cocaine use is most common in households earning over £50,000 per year.
  • At least 4.2% of British students took cocaine in the last 12 months.

Ready to Get Help?

If you are struggling with a cocaine addiction, your condition could seriously damage your mental and physical health. Over the long term, cocaine abuse can have catastrophic consequences for your physical and mental health. If you are ready to reach out for help, however, that help is out there: speak with your GP and/or an addiction specialist about overcoming your condition.

Get help today

Every day that goes by, when you labour under the burden of addiction is another day wasted and another day full of risk. Don’t waste any more time: pick up the phone today to your GP and/or an addiction specialist and take the steps that could change and even save your life.

Take control of your life – get started on the road to recovery

It is understandable that you may feel your addiction has taken control of your life – but you can take back that control with professional help. Set out on the road to treatment today, and embark on the journey through recovery which will take you back to a healthy, happy and successful life.

Related FAQ’s

Is there a safe dose for cocaine use?
Even a small quantity of cocaine can cause potentially dangerous allergic reactions and other harmful health consequences. Possession of any quantity is illegal. Cocaine is not a safe drug and should not be considered as such.
Does addiction develop the same way in everyone?
No: everyone experiences substance abuse and addiction differently, although the psychological and neurological mechanisms driving it may be similar.
Are there health effects from exposure to second-hand cocaine smoke?
Although various experiments have failed to show any demonstrable health consequences of the exposure to second-hand cocaine smoke, some surveys have shown that it may lead to positive cocaine test results for individuals exposed to it. This could have very serious consequences for employment and life prospects generally. If you are in any way concerned that your life could be impacted by a positive drug test, it is imperative that you stay away from anyone smoking cocaine in any of its forms.
Why is it so hard to break a cocaine addiction?
Cocaine is extremely psychologically addictive and can produce very strong cravings, and a long-term desire to re-experience its effects. Many people are unable to resist the temptation to take cocaine that these cravings and desires represent. Moreover, in some professions and circles, cocaine use is extremely widespread and exposure to cocaine very difficult to avoid, which greatly increases the likelihood of relapse in individual users.
Are there different forms of cocaine?
Cocaine most commonly comes in the form of a white powder. However, on rare occasions it may also be found in solution form for injecting. Cocaine can also be turned into smokable crack cocaine, which is found in small white or off-white “rocks”.

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