Cocaine Use Disorder
(Cocaine Abuse; Cocaine Dependence)
Cocaine use disorder is when a person keeps using cocaine even when it leads to problems with thinking, behavior, and the body. A person may also become dependent on cocaine.
Powdered cocaine can be snorted or dissolved in water and injected. Crack is cocaine in a rock crystal form. It can be heated so its vapors can be smoked.
The cause of cocaine use disorder is not known. Things like genetics, the environment, and peer pressure may play a role.
Cocaine causes the brain to release large amounts of dopamine. Dopamine is a chemical that causes feelings of joy. Over time, more cocaine is needed to cause the same release of chemicals. This leads to misuse.
Cocaine helps release a chemical in the brain that causes joy.
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Things that may raise the risk of cocaine use disorder are:
Cocaine use disorder can lead to:
- Being unable to stop or limit use
- Craving cocaine
- Making a habit of using cocaine even though it causes problems
- Fast increase in the amount of cocaine needed
- Use that gets in the way of doing normal things
- Trying very hard to get more cocaine
With regular use, the body begins to need cocaine to get through the day. A person may get sick when they stop or use less cocaine. It may result in irritability, exhaustion, nausea, vomiting, shaking, and sweating. This can make it harder to stop using.
The doctor will ask about symptoms, past health, and cocaine use. A physical exam will be done. This is often enough to make the diagnosis.
Blood, urine, saliva, sweat, and hair may also be tested to look for signs of cocaine use.
The first step is to stop using cocaine. This is also known as detox. The second step is to change behaviors to stop from using the drug again.
It can take some time to recover. Treatment may be given in a rehabilitation program. Many people may need to be treated several times. It may include one or more of the following:
- Medicines, such as:
- Topiramate and gabapentin to lower the risk of seizures
- Methylphenidate—a stimulant
- Baclofen—a muscle relaxant
- Modafinil to improve alertness
- Disulfiram to reduce abuse, especially in those who also use alcohol
- Individual and family therapy to help a person learn:
- Coping and problem-solving skills
- How to replace cocaine use with healthier choices
- A support group, such as a 12-step program—to support recovery
The best way to prevent cocaine use disorder is to never use cocaine.
- Cocaine use disorder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cocaine-use-disorder.
- DrugFacts: Cocaine. National Institute on Drug Abuse website. Available at: https://nida.nih.gov/publications/drugfacts/cocaine.
- Kampman K, Jarvis M. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. J Addict Med. 2015 Sep-Oct;9(5):358-367.
- Ryan SA. Cocaine use in adolescents and young adults. Pediatr Clin North Am. 2019;66(6):1135-1147.
- Adrian Preda, MD
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