Cocaine is a powerfully addictive substance that directly affects the brain. Because of its very potent euphoric effects, dependence can develop after a relatively short period of use. Cocaine can make a person hyperactive, extroverted, restless, talkative, and more alert. It also results impaired judgment, repetitive behavior and feelings of grandiosity. Cocaine dependence frequently leads to mental or physical complications such as paranoid ideation, aggressive behavior, anxiety, depression, and weight loss.
Cocaine use ranges from occasional use to repeated or compulsive use, with a variety of patterns in between. There is no safe way to use cocaine. Repeated use of cocaine by any route of administration – oral, intranasal, intravenous, inhalation – can produce addiction and other adverse health consequences.
The most frequent medical complications of cocaine use include disturbances of the rhythm of the heart, chest pain, heart attack, respiratory failure, seizures, stroke, abdominal pain and nausea. Different routes of cocaine administration produce different medical problems. Chronic snorting of cocaine can lead to a chronically inflamed runny nose, nosebleeds, and loss of the sense of smell. Persons who inject cocaine can develop severe allergic reactions and are at increased risk for developing human immunodeficiency virus (HIV/AIDS) and hepatitis. Those ingesting the drug can suffer from gangrene of the bowel.
The treatment of cocaine addiction is complex since it must address a variety of psychobiological, social and pharmacological aspects of the patient’s drug abuse. Both outpatient and residential behavioral therapies (such as cognitive behavior therapy and contingency management) have been found to be effective for cocaine addiction. The National Institute on Drug Abuse (NIDA) is also testing several new cocaine treatment medications that may prove helpful in reducing cravings and preventing relapse. Ultimately, the most effective treatment would involve a combination of behavioral and pharmacological treatments.