My cousin Dennis who got addicted to cocaine in the 1980’s glided through school effortlessly. His academic side came easily and did not have any problems making his school friends. Both these strengths came in handy when he started his university to study for accounts. He loved and missed his parents since he studied at a university far from his home but soon he revealed in and living away from his parents with a big circle of friends that kept him entertained. I suppose he spent most of his time with the “cool and rich kids” and sometimes got invited to big house parties. Being his closest cousin, he confessed to me that the first time he tried cocaine was in these parties he couldn’t miss. He found some of his friends taking it in the washrooms and was curious of how one felt when he or she took cocaine as his friends were always high and hyper. His university social life was busy as ever and cocaine was everywhere he went. It was in every party, club, and event in the school halls and he was always first in line for a line of cocaine. He was under pressure to complete his studies but he eventually managed to complete his studies and graduated with a bachelor’s degree in accounting.
After graduating, he spent time with his mother and sister in their home at Bronx, NY and started applying for jobs in various companies. Dennis was lucky to find a job in a well-known company as the chief accountant and always received a good payment. As he continued to work in the company, he managed to buy a house in Queens NY where he lived with his wife and kids. Since he was the senior accountant, he always felt more superior to the rest of the employees in the company. He was always in a bad mood, shouted at employees, calls them names and took actions without consulting the management of the company. He received several warnings but due to his arrogance he lost his job as the senior accountant and lacked funds to maintain his life. When he lost his job, he started using crack cocaine. He could barely manage rent, water and electricity bills and eventually lost his house in Queens NY. Due to stress and frustration, he became violent to his wife and would sometimes beat and call her names and she at time BACK went to the hospital since she had encountered serious injuries from his beatings. With time his wife filed for a divorce and he eventually lost his wife and kids.
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Eventually, he moved back to their Bronx NY home where his mother and sister resided. He started stealing and acting violently towards them when they refused to give him money. We as his family, we always tried to force him into treatment but he would always relapse. Being his closest cousin, I talked to him on one Sunday afternoon about how his condition had affected everyone especially his family. This made him realize that for a long time he hadn’t been paying attention to his family, friends and most importantly his life. He realized that he needed help with his condition and that day he contacted the best-known rehabilitation center for some addiction help. Ten years ago he went to treatment and was able to defeat his addiction.
The addiction counselors were helpful and listened to his problems. They were able to find him a suitable treatment session that was so discrete for his condition. Once he felt “normal” again and had stopped using cocaine for three consecutive months, he told his mother and sister. They were very happy for him as they wanted him to get better. He is now much closer to his mother and sister as a family and has not taken any drugs for nearly a year. He is now a drug counselor in Atlanta Georgia where he encourages, support and rescues other people from cocaine addiction.
Introduction to Cocaine Addiction
Cocaine addiction can occur very quickly and can be very hard to break. Individuals addicted to cocaine can go to lengths to get cocaine and continue to use it even when it affects their jobs or school performance and their relationships with their families or friends. Attempts to stop using cocaine can sometimes fail because the subsequent depression can be sometimes overwhelming, causing the addicted individuals to use more cocaine in an effort of overcoming depression. This overwhelming addiction can lead an addict to try anything to get cocaine. Current studies on cocaine addiction have proved that, during times of abstinence from the use of cocaine, the memory of the individual linked with cocaine or has been exposed to cocaine use, can cause great relapse to using cocaine, even after an extended period of abstinence. Researchers have discovered that cocaine rouses the reward system of the brain encouraging a great feeling of preference than natural functions of the brain. In turn, its influence on the reward trail can result in user by-passing activities of survival and get back to cocaine use. Chronic use of cocaine can result in cocaine addiction and sometimes lead to brain damage or other organs of the body. A cocaine addict will continue to use cocaine even when faced with serious damages. “Crack” is a street name used for cocaine that is processed from cocaine hydrochloride to a free base for smoking. It looks like white to tan chunks that look like soap or salt. Instead of using the more unstable technique of processing cocaine using ether, crack cocaine is administered with baking soda or ammonia and water and is heated to get rid of hydrochloride, therefore producing a type of cocaine that can be smoked. Research on crack cocaine and addiction, have proved that crack has more addictive possessions compared to purely processed cocaine.
Prevalence of Cocaine Addiction
Illegal use in the United States has increased and cocaine use has been a leading player in this growing crisis. In the year 2014, it was estimated that approximately 27 million Americans had used an illegal drug in the last 30 days and nearly 1.5 million used cocaine (Heather, 2016). Of the about 21.5 million Americans that are considered to have a drug use addiction in the last one year and 7.1 million Americans having to depend on illegal drugs particularly, the Office of National Drug Control Policy spikes the recent cocaine addicts to nearly 3.6 million people. Based on illegal drug use, cocaine has been rated third behind the non-medical use of painkillers and marijuana. Under the Controlled Substance Act, cocaine is a schedule II drug which means that it has a high potential for being abused and very rare medical application. Since the continuous cocaine use can lead to many health issues, this highly addictive stimulant continue to be a major concern in the globe
Being the second most used marketed illicit drug in the globe., the most recent statistics prove that international confiscations of cocaine have increased and are now 750 metrics tons in total, with the largest quantities of cocaine being captured in South America followed by North America. A survey conducted by the National Survey on Drug Use in the US in 2006 reported that 35.3 million Americans at the age of 12 or more years were reported to have used cocaine and approximately 8.6 million with 12 years or more had used crack cocaine. Among those aged between 18 to 25 years, nearly 6.9% of individuals surveyed confessed to having used cocaine and crack cocaine within 2005 (Heather, 2016). According to 2006 Monitoring the Future Study by the National Institute of Drug Abuse among twelfth graders in high school, approximately 8.5% has used cocaine in their younger years. According to the European Monitoring Centre on Drugs and Drug Addiction, Cocaine comes second in the most used illicit drug in Europe. Among the young adults, an approximated 7.5 million people had used cocaine at least once in their life and about 3.5 million in 2005 (Heather, 2016).
How Cocaine is used
Cocaine users administer cocaine by inhalation, intranasally, orally or intravenously. When people sniff this drug, they inhale the powder through their nostrils, where it is riveted in the bloodstream through the tissues in the nasal cavity (Cooper, 2002). Users may also take it inform the form of gum through oral means. The intravenous use involves dissolving the cocaine in water and injecting it into the body. This releases the drug directly into the bloodstream and increases its effectiveness. In inhalation, cocaine users smoke cocaine and inhale the vapor in their lung where it is absorbed into the bloodstream which is as fast as an injection. The use of cocaine ranges from infrequent to repeated and obsessive use, with a change in patterns between these extremes.
Ways Cocaine Changes the Brain
Like other drugs, the use of cocaine causes long-term changes in the brain. Research has proved that cocaine affects the pathways that respond to stress in the brain’s reward system (Wagner, 2003). Stress can an individual to have a cocaine relapse and disorders from cocaine use disorders occur at the same time with disorders related to stress. The circuits of the brain that respond to stress are different from the reward pathway, but studies show that there are significant ways that they overlap. The ventral tegmental area acts as a serious incorporation site in the brain that displays information about both drug signals and stress to the parts of the brain include those that lead to cocaine seeking (Wagner, 2003). Research advocates that cocaine raises the stress hormones, encouraging neuro-adaptations that additionally intensify sensitivity to cocaine and cues associated with it. Exposure to chronic cocaine also affects other areas of the brain. For example, research shows that cocaine reduces the normal functioning of the orbitofrontal cortex, which leads to poor decision making, incapacity to familiarize with undesirable consequences of using cocaine and the lack of self-insight.
How cocaine produces its effects in the brain
The mesolimbic dopamine system of the brain is a pathway in the brain that is encouraged by all types of supporting stimuli such as sex, food and many abused drugs including cocaine. This pathway has initiated a part of the midbrain known as the ventral tegmental area and stretches to the nucleus accumbens, one of most significant part of the brain. In the usual communication process in the brain, a neuron produces dopamine into the synapse, where it impasses to particular proteins known as dopamine receptors. Through this process, dopamine acts as a chemical messenger that carries signals from various neurons. Cocaine abuse interferes with the normal communication process. Cocaine binds with the dopamine transporter, stopping dopamine removal from the synapse. It then gathers in the in the synapse to give an augmented signal to the neurons. This process causes euphoria, a condition experienced after taking cocaine.
Causes of Cocaine Addiction
It has been agreed that no one causes the accounts of any type of drug abuse including cocaine. However, there are particular factors that are associated with abuse and addiction of cocaine. One of the causes of cocaine abuse and addiction is genetics (Sommers, 2008). Drug abuse scientists have states that, as with all drug use addiction, those suffering from first-degree abuse or dependence of cocaine have a high possibility of developing addiction than those individuals without any addiction history. Another cause is temperament qualities. Various people are born with particular temperamental qualities that influence them to desire being very alert, stimulated and active which can lead to successive abuse of cocaine to get these feelings on a daily basis. Research suggests that people with temperament abilities that lead to inhibition, shyness or lack of impulsiveness may be predisposed to cocaine abuse. This due to the impacts of cocaine that help an individual correct these aspects helping him become less inhibited, more social and more comfortable around people.
Cocaine addiction can be caused by brain chemistry (Johnson, 2011). Studies have shown that the cocaine present in the brain can interfere with levels particular chemicals that are responsible for neuronal communication. Dopamine, a neurotransmitter in the brain, is linked with senses that produce pleasure and excitement. As the brain recognizes the impacts of cocaine in the brain to be similar to those of dopamine, progressive use of cocaine causes the brain to start substituting cocaine to natural dopamine until the brain produces insignificant portions of the neurotransmitter. This increases the chances of dependence, due to the adverse withdrawal impacts when one tries to reduce the amounts of cocaine taken. Since there are small amounts of dopamine in the brain, the positive impacts caused by dopamine are lost and one experiences a negative state and moods that may be so distressing to the individual. Another cause of cocaine addiction is a need for amplified energy. Addicts of cocaine have times when their expectations in work performance are high and may sometimes feel pressured to do whatever it takes to meet their expectations. This can also lead to increased stress and anxiety which can reduce their ability to perform well. They tend to use cocaine as its effects are expressively greater compared to other over the counter drugs. When a cocaine addict is exposed, they use it with the intention of quitting once they reach their expectations.
Signs and Symptoms of Cocaine Addiction
According to the Diagnostic and Statistical Manual of Mental Disorders, cases of cocaine addiction show various signs and symptoms. One symptom is tolerance whereby with the increased use of cocaine, one tolerates the cocaine and has to continuously increase the amounts to achieve a certain feeling that makes them feel “good.” A cocaine addict will take cocaine in large amounts or for a long period of time that they initially intended. In addition, they lose control and have the need to control cocaine intake but end up failing to do so (Freye & Levy, 2009). They also experience obsessive thinking whereby they spend most of their time thinking about how they will obtain cocaine. They also change their priorities and abandon their recreational and occupational activities. Despite knowing the effects cocaine use has on their bodies and families, cocaine addicts will continue to use it. In addition, they may experience behavioral changes such as restlessness, depression and become violent. Cocaine addicts often isolate themselves from family and friends as they addiction controls their lives and surround themselves with fellow drug addicts or dealers (Freye & Levy, 2009). They also have financial problems with the money they have or get is used for buying cocaine instead of self-growth.
The Cocaine Addiction Cycle
Stage I- Cocaine Consumption
This stage starts innocently enough and when a cocaine user is in his early stages of addiction, he only uses a small quantity of cocaine with friends or in a bar (Matta, 2006). This makes him or she feels good and decides to use more and set himself out to find more cocaine. As the user develops into his addiction, he or she rationalizes his use of cocaine. When he remembers his last episode when he took cocaine, he says that he will take a small amount this time. In the end, he buys a small quantity and as soon as he consumes the amount bought, he experiences immediate cravings for more cocaine. These continuous carvings produce the possessed use of the characteristic of each binge.
Stage II- Early Crash
Stage II starts at the end of the definite splurge of consuming cocaine in the first stage. This stage is characterized by strong feelings of anxiety (Matta, 2006). Drug cravings are very high and the addicted individual will find himself finding ways to get money to buy more cocaine. Despite their full knowledge that there is no other way he or she can obtain cocaine, they will often develop fantasies about the availability of more drugs. Cocaine addicts will search for a cocaine-like powder or flecks of dust that are similar to cocaine. They may think of a stash they have hidden somewhere in spite of their sane minds knowing that they consumed that stash weeks ago. During stage two the hunger for food by addicts is tremendously low since the idea of food is often revolted. His or her body temperature is very high and ends up sweating profusely. In this, several hours of intense craving may be seen as several days.
Stage III-Late Crash
This stage starts when cocaine craving shifts from a high to a low level. It starts within three to five hours of the last use of cocaine (Herman & Frankenheim, 2003). The addict feels highly depressed and regretful but at the same time less anxious. He starts to feel hungry and at some point feel sleepy or dizzy. Later, the addict may start dozing off and if hungry may remain awake and eat rapaciously. In this stage, the addict may feel intense remorse for what they have done. All the shame and remorseful thoughts are extravagant in the third stage and may lead addicts to commit suicide, run away from their homes or consider treatment.
Stage IV-Between Binges
After 24 to 48 hours of this last use of cocaine, the addict experiences an improved outlook on life. He feels relieved to have made it through the horror of the cocaine binge and may feel unique for his ability to cope with cocaine (Herman & Frankenheim, 2003). During this stage, the addict feels that his senses and mood is getting back to normal and may feel more energized or restless. This is followed by with a deep feeling of emptiness since the cocaine has reduced the natural reward mechanisms making him or her see life as being meaningless. This feeling is known as anhedonia. In stage IV, the addict may experience some craving which can be caused by being exposed to cocaine, spending time with cocaine users or sometimes having money. If this craving period is encouraged for a long time, the addict proceeds to stage V.
Stage V- Drug Seeking
In this stage, the addict will often flip from the cured feeling to the cocaine craving characteristic. Since he or she is deceived into believing that he or she can control his cocaine problem, he or she can make foolish and hard decisions frequently. Addicts may often feel that they can handle being around people using cocaine and may sometimes opt to return to selling this illegal drug to make up for the money he lost while using cocaine (Wanberg, Milkman & Timken, 2005). Craving is triggered by other environmental and internal factors. It can be brought about by music, the thoughts of using it or discussing the last binge with a friend. It can also be caused by particular conditions such as gastrointestinal distress or a racing heart. Once the craving starts and he or she will decide to seek for cocaine and may even call his friends at midnight or drive long distances to obtain the drug. The addict is filled with justification. These justifications arise regardless of the fact that after each time the individual used cocaine, he always found himself in trouble. Justification reduces the real impacts of the dependence of cocaine and allows the drug-seeking behavior to progress.
Negative Effects of Cocaine on Families
When individuals become cocaine addicts, their behaviors do not exist in a vacuum. Their negative behaviors have a big capacity of affecting their families and friends. It can be hard for someone to have these responsibilities as a family member of a cocaine addict. Due to the fact that most cocaine addicts are always in denial, they do not understand how their conditions negatively impact their families. One negative impact is losing the relationship (Barnard, 2007). A cocaine addict isolates themselves from families and loses interest in activities they performed together. The isolation is always painful for families and may sometimes lose their best friend, husband or wife like in the case of my cousin Dennis who lost his wife and kids.
Families may disseminate emotional havoc and develop negative mindsets (Barnard, 2007). They may start blaming themselves in a capacity that interferes with their self-love or self-worth. Cocaine addiction results to mistrust, as they lie to their loved ones about their situations, taking great measures of being evasive, dishonest and secretive people. An individual’s spouse becomes disappointed, as their happy life seems to have fallen apart and the addiction takes over the needs and relationships of the family. Anxiety and depression are present in the family and the emotional toil falls greatly on children. Cocaine addiction creates the role of a caretaker to the family. Due to the extensive intake of cocaine, addicts may contract various diseases and disorders, which place families in a role where they have to take care of the individual. This becomes a great burden to the family, as most members have to stop focusing on their needs and shift them to the addicted individual.
Financial instability is another negative effect cocaine addiction has on families (Barnard, 2007). It takes a lot of money and often large amounts. As an individual becomes a frequent user of cocaine, they run out of money to buy cocaine. Due to addiction, they may lose their jobs and may lead them to having problems paying for their rent and various house bills to the extent that their families lack food and shelter. When an individual is unable to provide or financially contribute to their families, it places unwanted stress to their partner and children. Cocaine addiction exposes a child to negative and damaging influences. Parents are always the role models to their kids and cocaine addiction may extensively affect the growth of our children (Hines & Malley-Morrison, 2005). Children may be tempted to try and experiment drugs because they see these behaviors with their parents or one of the family member. In addition, cocaine addiction may result to divorce as the couple is not able to stand the unhealthy environment the addiction has caused in their marriage
Cocaine Addiction Treatment Plan
Cocaine abuse and addiction is a major issue that involves changes in the brain as well as social and environmental factors. Treating cocaine addiction is intricate and should address various factors. Just like any good treatment plan, strategies to treat cocaine addiction needs to evaluate the pharmacological, psychobiological and social factors of the patient’s cocaine abuse. It is vital to match the best treatment plan with the needs of the patient. This may include adding or deducting various components or elements. One intervention to include in the treatment plan is behavioral intervention (First & Tasman, 2011). Many behavioral treatments are found to be active for cocaine addiction including outpatient and residential methods. Behavioral therapies are the most effective approaches of treatment to many substance abusers including cocaine addicts (Ries, 2009). Cognitive behavioral therapy is an approach that focuses on helping cocaine addicts abstain from cocaine. This approach tries to support patients in recognizing conditions in which they likely to use cocaine avoid them when appropriate and cope with problems related to cocaine addiction. Patients should be encouraged to recognize their triggers and reconstruct their lifestyles to avoid these triggers. Another strategy is counseling on emotional and spiritual issues. The most challenging feature of treatment from cocaine comprises of the intense guilt and shame. Dealing with these painful emotions takes a lot of time and interest. A professional counselor, a recovered addict or a trusted person can be of great help. A treatment plan may be inclusive of self-help programs that offer support in helping cocaine addicts embraces their difficulties by learning from other recovered addicts to help understand that people can change and have a good life. These programs emphasize on being responsible for one’s behavior, correcting it and forgiving oneself.
References
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Heather, N. (2016). Addiction and choice .: Oxford Univ Press.
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Matta, W. J. (2006). Relationship sabotage: Unconscious factors that destroy couples, marriages, and family. Westport, Conn: Praeger Publishers.
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