Cocaine Addiction & Treatment

What is Cocaine Addiction & dependence?
Dependence on cocaine means that you have a strong emotional, psychological, and physical need to take the drug. You might take more of the drug over longer periods than you intended. Using cocaine may interfere with the rest of your life.

 Cocaine is a drug made from the leaves of the coca plant, which grows in South America. It is a stimulant, which means it causes talkativeness, increased breathing and heart rate, increased energy, and sleeplessness. In very high doses, it can cause heart attacks and seizures.

 Crack, a less expensive form of cocaine that is smoked rather than snorted, has helped make cocaine abuse a widespread problem.

 Some people are more sensitive than others to cocaine. A small amount of the drug can kill people sensitive to it.

 Pregnant women using cocaine are at high risk of miscarriage. Babies born to cocaine-dependent mothers are addicted at birth. The infants are jittery and don’t respond well to people. Moreover, they have to go through the painful process of withdrawal.

 

Cocaine dependence can be treated, although it is a long-term process. The most important part of treatment is for you to be in a drug-free environment.

 How does Cocaine Addiction occur?
Cocaine powerfully affects some of the chemicals of the brain that change mood and emotions. At first you feel pleasure, increased energy, and enhanced self-esteem. You also experience decreased anxiety and social inhibitions.

 Cocaine also affects sexual behavior. In small doses cocaine increases sexual arousal and makes orgasms and erections easier. In large doses cocaine makes you feel increased sexual desire but you are less able to achieve orgasm. Men may have problems with impotence.

 Over time, cocaine keeps your brain from storing and using chemical messengers that create these good feelings. Because you lack a way to use these natural chemical messengers, you may feel depressed. As a result, you develop a craving for more cocaine and the good feelings it produces.

 As the addiction progresses, you tend to withdraw from friends and spend more time using cocaine. Later, you may lose your job and become isolated from everyone. Family problems and crises occur, such as divorce and financial problems.

 What are the symptoms of Cocaine Addiction?
If you use cocaine over a long period you feel wired, irritable, and depressed. You can’t sleep. You lose your appetite and are not content with life. You may also:

•  lose your sex drive
• develop disturbed thinking, such as paranoid delusions (ideas that others are out to get you when they are not)
• become depressed
• in some circumstances, have hallucinations (for example, seeing things that are not there or feeling things, such as bugs under your skin, that are not there)
• feel disoriented.

Other symptoms of cocaine dependence include:

•  use of the drug throughout the day
• episodes of overdose
• problems in social activities and work, such as missing work, fighting, losing friends
• inability to reduce or stop the use of cocaine.

When you stop taking the drug and the level of it in your blood drops, you are said to “crash.” Possible effects of crashing include:

 

• depression
• fatigue
• suicidal feelings
• sleepiness
• decreased level of activity
• increased craving for cocaine.

How is Cocaine Addiction diagnosed?
To diagnose cocaine dependence, your healthcare provider will review your symptoms, examine you, and take a history of drug use. He or she may order an analysis of your urine. Cocaine can remain in urine for many hours after you have used the drug.

 How is Cocaine Addiction treated?
Usually, the first thing your healthcare provider treats are your physical complications. Complications of cocaine dependence may include:

 

• effects on the heart, including heart attack, disturbances in the rhythm of the heart, and high blood pressure
• effects on the nervous system, including paranoia, hallucinations, lethal high fever, stroke, and seizures.

For any treatment to be successful, you must want to give up cocaine. The most important part of treatment is for you to be in a drug-free environment. Treatment for cocaine dependence is long-term and ongoing. You can join a self-help group (for example, Cocaine Anonymous), a support group, a therapy group, or be part of a supervised treatment program. The healthcare providers and counselors in any treatment program will work with you regularly to help you adapt to a life free from cocaine.

 

While you are withdrawing from cocaine, you may be tempted to use more alcohol and other drugs to reduce your restlessness and anxiety. Seek professional help so that you don’t switch to other harmful drugs. Antidepressants and mood stabilizers prescribed by your healthcare provider can help treat both mania and depression that may occur with cocaine withdrawal.

 You need to regain general physical health by eating nutritious meals, getting enough sleep, and exercising regularly.

 If this therapy does not work, you may need to be hospitalized for treatment.

 How can I take care of myself?
The best way to help yourself is to see your healthcare provider and make plans to stop taking cocaine. If you are already seeing a healthcare provider, it is important to take the full course of treatment he or she prescribes.

 You may want to call the National Clearinghouse for Alcohol and Drug Information (NCADI) at 1-800-729-6686.

 Changing your lifestyle can help you to stop using cocaine. Make the following a regular part of your life:

 

• Exercise 30 minutes three times a week.
• Participate in relaxing recreation activities at least once or twice a week.
• Do progressive relaxation exercises daily.
• Imagine, or call to mind, your positive life experiences often.
• Eat balanced, nutritious meals.
• Get 7 to 9 hours of rest per night.
• Practice deep breathing exercises during times of high stress.
• Talk with friends and develop other support systems.
• Drink little or no alcohol or caffeine.
• Listen to music to help you relax.
• Develop and maintain an attitude that things will work out.
• Ask for assistance at home and work when the load is too great to handle.
• Seek professional help to talk through anxiety-producing life events. Ask for help in developing positive coping methods.

Understanding Sexual Addiction

What is sexual addiction?
Sexual addiction is a pattern of sexual behaviors acted out even though it is harmful to self or others.

 How does sexual addiction occur?
The exact cause of sexual addiction is not known. Experts think it may be caused by physical differences in the brain or nervous system. It might also be related to things such as child abuse or a family history of mental illness.

 What are the symptoms of sexual addiction?
Symptoms of sex addiction include: 

• being unable to stop thinking about sex
• needing to have sex more and more often
• trying and failing to control, cut back, or stop having sex
• feeling restless or in a bad mood when trying to control sexual urges
• having school, job, or relationship problems because of sex.

Some out of control repetitive behaviors, which may reflect sexual addiction include: 

• masturbation
• extramarital affairs
• pornography
• cyber sex or phone sex
• multiple anonymous partners
• unsafe sexual activity
• thinking of sex partners as just objects to be used
• going to strip clubs and adult bookstores
• prostitution.

How is sexual addiction diagnosed?
Your healthcare provider or therapist will ask about your symptoms and will make sure you do not have a medical problem. Your therapist will also check for other problems, such as substance abuse, mood disorders, and personality disorders.

 How is sexual addiction treated?
Treatment for sexual addiction is long-term and ongoing. Good options include self-help groups, support groups, or supervised treatment programs. Cognitive behavior therapy may also help.

 Female hormones or testosterone-lowering medicines may be used to reduce sex drive in men. SSRI antidepressants may reduce sex drive and lessen obsessive thoughts and compulsive behaviors. Mood stabilizers or antipsychotic medicines may also be helpful.

 When should I seek help?
Thinking about sex all the time may cause loss of friendships and family relationships. Fear of being caught may cause stress. Sexual addiction also increases the risks for HIV/AIDS and other sexually transmitted diseases. Sex addiction may cause job loss or high levels of debt from paying for prostitutes, cyber-sex, or phone sex. People who are addicted to sex may have legal problems due to sexual harassment, obscene phone calls, prostitution, rape, or child molesting.

HOW IS ALCOHOLISM DIAGNOSED

Barriers to a Diagnosis: Even when people with alcoholism experience withdrawal symptoms, they nearly always deny the problem, leaving it up to coworkers, friends, or relatives to recognize the symptoms and to take the first steps toward encouraging treatment. Denial, in fact, may be an important warning signal for alcoholism.

 

Family members cannot always rely on a physician to make an initial diagnosis. Although 15% to 30% of people who are hospitalized suffer from alcoholism or alcohol dependence, physicians often fail to screen for the problem. In addition, doctors themselves often cannot recognize the symptoms. In one study, alcohol problems were detected by the physician in less than half of patients who had them. Even when physicians identify an alcohol problem, however, they are frequently reluctant to confront the patient with a diagnosis that might lead to treatment for addiction.

 

Screening Tests for Alcoholism: A physician who suspects alcohol abuse should ask the patient questions about current and past drinking habits to distinguish moderate from heavy, or hazardous, drinking. [See Box Definition of Alcohol Use and Abuse.]

 

A physician who suspects alcohol abuse or dependency have a number of short screening tests available, which a person can even take on his or her own. Because people with alcoholism often deny their problem or otherwise attempt to hide it, the tests are designed to elicit answers related to problems associated with drinking rather than the amount of liquor consumed or other specific drinking habits.

 

CAGE Test. The CAGE test is an acronym for the following questions and is the quickest test:

 

• Attempts to CUT (C) down on drinking.

 

• ANNOYANCE (A) with criticisms about drinking.

 

• GUILT (G) about drinking.

 

• Use of alcohol as an EYE-OPENER (E) in the morning.

 

This test and another called the Self-Administered Alcoholism Screening Test (SAAST), appear to be most useful in detecting possible alcoholism in white middle-aged males. They are not very accurate for identifying alcohol abuse in older people, white women, and African-and Mexican-Americans.

 

T-ACE Test. The T-ACE test is a four-question test that appears to be quite accurate in identifying alcoholism in both men and women. It asks the following questions:

 

• Does it TAKE (T) more than three drinks to make you feel high?

 

• Have you ever been ANNOYED (A) by people’s criticism of your drinking?

 

• Are you trying to CUT DOWN (C) on drinking?

 

• Have you ever used alcohol as an EYE OPENER (E) in the morning?

 

A positive response to two of these four questions is considered to indicate possible alcohol abuse or dependence.

 

AUDIT Test. A more effective and important test for most people may be the Alcohol Use Disorders Identification Test (AUDIT), which is the only test specifically designed to identify hazardous or harmful drinking. It asks three questions about amount and frequency of drinking, three questions about alcohol dependence, and four questions about problems related to alcohol consumption.

 

A Single-Question. One simple question may be as sensitive as the CAGE or Audit test: “When was the last time you had more than five drinks (for men) or four drinks (for women) in one day?” An answer of “within three months” accurately identified about half of people who were problem drinkers. Problem drinking is defined as hazardous drinking within the last month or some alcohol-use disorder during the past year. [See Box Definition of Alcohol Use and Abuse.]

 

Other Screening Tests. Other short screening tests are the Michigan Alcoholism Screening Test (MAST) and The Alcohol Dependence Scale (ADS).

 

Ruling Out Other Problems: Some symptoms of alcoholism may be attributed to other disorders, particularly in the elderly, where symptoms of confusion, memory loss, or falling may be attributed to the aging process alone. Heavy drinkers may be more likely to complain to their doctors about so-called somatization symptoms, which are vague ailments such as joint pain, intestinal problems, or general weakness, that have no identifiable physical cause. Such complaints should signal the physician to follow-up with screening tests for alcoholism.

 

Alcoholism is particularly less likely to be recognized in elderly women. In fact, only 1% of older women who need treatment for alcoholism are diagnosed accurately and treated appropriately. Instead, they are often diagnosed with depression and may even be prescribed anti-anxiety drugs or antidepressants that can have dangerous interactions with alcohol.

 

Tests for Related Medical Problems A physical examination and other tests should be performed to uncover any related medical problems.

 

Tests for alcohol levels in the blood are not useful for diagnosing alcoholism because they reflect consumption at only one point in time and not long-term usage. Certain blood tests, however may provide biologic markers that suggest medical problems associated with alcoholism or indications of alcohol abuse:

 

• A test for a factor known as carbohydrate-deficient transferrin (CDT) has been approved as a marker for heavy drinking. It can be helpful in monitoring patients for progress towards abstinence and may also be an indicator for a higher risk for suicide in people with alcoholism.

 

• Gamma-glutamyltransferase (GGT). This liver enzyme is very sensitive to alcohol and can be elevated after moderate alcohol intake and in chronic alcoholism.

 

• Aspartate and alanine aminotransaminases (AST,ALT) are tests for enzymes and factors that can help identify liver damage.

 

• Tests of testosterone levels in men with alcoholism may be low. (This result sometimes persuades men with alcoholism to seek help.)

 

• A mean corpuscular volume (MCV) blood test is sometimes used to measure the size of red blood cells, which increase with alcohol use over time.