Cocaine Use Disorder

Cocaine Use Disorder:

Generally, It can  administer orally, intranasally, either by smoking ( especially free basing) or parenterally, depending on the preparation available. Moreover, Cocaine HCl is the commonest form use, follow by the free base alkaloid.

After that, Both intravenous use also free base inhalation produce a ‘rush’ of pleasurable sensations. Additionally, Cocaine is a central stimulant which inhibits the reuptake of dopamine, along with the reuptake of norepinephrine and serotonin.

In animals, cocaine is the most powerful reinforcer of the drug-taking behaviour. A typical pattern of cocaine use is cocaine ‘runs’ (in other words, binges), followed by the cocaine ‘crashes’ (in other words, interruption of use).

Besides this, Cocaine is sometimes use in combination with opiates like heroin (in other words, ‘speed ball’) or at times amphetamines. Lastly, Previously uncommon, cocaine misuse appears to be recently a growing problem in the metros of India.

The complications of chronic cocaine use i.e.;

• Acute anxiety reaction,
• Uncontrolled compulsive behaviour,
• Psychotic episodes (with persecutory delusions, also tactile and other hallucinations),
• Delirium and delusional disorder.

High doses of cocaine can often lead to i.e.;

• Seizures,
• Respiratory depression,
• Cardiac arrhythmias,
• Coronary artery occlusion,
• Myocardial infarction,
• Lung damage,
• Gastrointestinal necrosis,
• Foetal anoxia,
• Perforation of nasal septum.

Generally, Before starting treatment, it is essential to diagnose (or rule out) co-existent psychiatric and/or physical disorder, also assess the motivation for treatment. Additionally, Cocaine use disorder is commonly associate with mood disorder, particularly major depression and cyclothymia.

Treatment of Cocaine Overdose:

The treatment of overdose consists of oxygenation, muscle relaxants, also IV thiopentone and/or IV diazepam (especially, for seizures and severe anxiety). IV propranolol, a specific antagonist of cocaine induced sympathomimetic effects, can helpful, administered by a specialist. Moreover, Haloperidol (or pimozide) can be used for the treatment of psychosis, as well as for blocking the cardio stimulatory effects of cocaine. Lastly, These must be administered very carefully by an expert specialist.

Treatment of Chronic Cocaine Use:

The management of underlying (or co-existent) psychopathology is probably the most important step in the management of chronic cocaine use. The pharmacological treatment includes the use of bromocriptine (e.g. a dopaminergic agonist) and amantadine (an antiparkinsonian) in reducing cocaine craving. Other useful drugs are desipramine, imipramine also trazodone (both for reducing craving and for antidepressant effect). Besides this, The goal of the treatment is total abstinence from cocaine use. Finally, The psychosocial management techniques, such as supportive psychotherapy and contingent behaviour therapy, are useful in the post-withdrawal treatment and in the prevention of relapse.

Frequently Asked Questions

What is Cocaine Use Disorder?

Cocaine is an alkaloid derive from the coca bush, Erythroxylum coca, found in Bolivia also  Peru.

What are the symptoms of Cocaine Intoxication?

• Pupillary dilatation
• Tachycardia
• Hypertension
• Sweating
• Either, Nausea or vomiting
• Increased psychomotor activity
• Grandiosity
• Elation of mood
• Hypervigilance
• Increased speech

What is the treatment of Cocaine use disorder?

• Oxygenation
• Muscle relaxants
• IV thiopentone
• IV diazepam
• IV propranolol
• Haloperidol
• Bromocriptine
• Amantadine
• Imipramine
• Trazodone

Give the symptoms of cocaine withdrawal Syndrome?

• Agitation
• Depression
• Anorexia
• Craving
• Fatigue
• Depression
• Sleepiness
• Exhaustion
• Hypersomnia with intermittent  awakening
• Hyperphagia
• Normal sleep, also improved mood