Detoxification from Cocaine
Cocaine dependence results in a period of physical and mental instability upon discontinuation of use. The usual pattern of cocaine use involves “binges” or “runs” lasting from 12 to 36 hours during which the person consumes all the cocaine available. Following this are periods usually lasting several days during which no cocaine is used and detoxification occurs. The following will explain “Does cocaine need a detox?”.
Although not usually medically dangerous, withdrawal from cocaine ranges from a feeling of tiredness to major irritability and agitation. Does someone “need” a detox program to withdraw? Generally no.
More often than not, the only reasons that someone “needs” a detox center for cocaine withdrawal is for one of the following reasons:
- Feel they can’t stop using without a detox
- Have become psychotic as a result of the use and need medical supervision
- Feel they are a danger to themselves, suicidal.
- Have nowhere else to go
The effects of withdrawal include:
- hypersomnia (an excessive feeling of sleepiness, fatigue).
- loss of concentration.
- diminished capacity to experience pleasure.
- increased appetite.
- paranoid ideation.
In addition, the cocaine-dependent person will experience cravings for the chemical, leading to another episode of bingeing (Alterman, O’Brien & McLellan, 1991; Institute of Medicine, 1990).
Detoxification efforts have focused on ways of managing withdrawal symptoms and cravings long enough to disrupt the cycle of binging and craving.
Drugs that have been used to counteract cocaine withdrawal problems include:
- desipramine hydrochloride.
- flupenthixol decanoate.
Treatment Applications for Cocaine
- Treatment is especially difficult with stimulant abuse because of the intense reinforcing qualities of the chemicals.
- It is recommended that cocaine and crack users get into specific 12-Step groups (either Narcotics Anonymous or Cocaine Anonymous) because of the difference in the effects of the chemical from alcohol.
- In treatment, cocaine users are often eager to leave the program because of the intensity of the crash and the highly reinforcing qualities which make them want to run from treatment to obtain the chemical.
- The use of other stimulants, such as caffeine, diet pills, and nicotine while in treatment, produces the same or similar kinds of effects as cocaine and can trigger craving and relapse. Another difficulty with treatment is that there are so many other kinds of stimulants.
- In therapy, things which need to be dealt with are: changing a person’s language, changing their habits of preparing the drug or preparing to get the drug, finding different activities and places to go once they are out of treatment, and stimulation through exercise and activity rather than looking for cocaine.
- Nutritional counseling is indicated (with some people, teaching them to eat again) because of their lack of appetite. This can be complicated due to the loss of tissue in the olfactory system which can lead to lack of sense of smell or taste which means that food or eating will have really very little reinforcing quality.
Cocaine and stimulant abuse are major problems for which effective pharmacotherapies have yet to be developed. Several studies have demonstrated that antidepressant medications and some medications used for treating Parkinson’s disease may be helpful in reducing cocaine dependence. These medications are neither substitution agents such as methadone nor blocking agents such as naltrexone, but reducing craving for cocaine thereby reduces a patient’s cocaine abuse. Current research is developing a blocking agent for cocaine similar to naltrexone in order to reduce cocaine’s reinforcing properties. However, the mainstay of treatment for cocaine abuse remains psychotherapeutic treatments in conjunction with regular urine monitoring for cocaine.
Intervention Services can guide, educate or be a resource to you, the one who is reaching out. Essentially, Intervention Services is on hand 24 hours a day to help you to help your loved one who may be abusing drugs or alcohol. If you have questions or need to speak with someone, understand that most of our employees are recovering professionals who can speak with you as someone who once abused drugs themselves.
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