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Cocaine dependence: a case series from India.

Debasish Basu1, Sunil Gupta1, Naresh Nebhinani2

  • 1Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India - Drug De-addiction and Treatment Centre, Department of Psychiatry.

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Cocaine dependence is emerging in India, affecting young men who primarily snort cocaine. This first case series highlights the need for awareness and treatment strategies for this growing public health issue.

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Area of Science:

  • Psychiatry
  • Addiction Medicine
  • Public Health

Background:

  • Cocaine dependence is prevalent in Western countries but underreported in India.
  • Recent media reports suggest increasing cocaine use and seizures in India.
  • This study addresses the lack of medical literature on cocaine dependence in India.

Observation:

  • A case series of 5 male patients (ages 20-27) with cocaine dependence seeking treatment in Chandigarh, India.
  • Patients were unemployed or in medium-level occupations.
  • All patients used cocaine via snorting (intranasal cocaine hydrochloride); none smoked crack cocaine.

Findings:

  • Patients exhibited intense cocaine craving and met criteria for dependence (ICD-10).
  • Three patients were also dependent on opioid preparations (heroin, dextropropoxyphene, codeine).
  • Treatment involved opioid detoxification (clonidine, naltrexone) and cognitive behavioral relapse prevention counseling, with variable outcomes.

Implications:

  • Cocaine dependence is a present reality in India, not limited to affluent individuals.
  • This case series serves as an initial report, raising awareness of cocaine dependence in India.
  • Highlights the need for further research and tailored interventions for cocaine use disorder in the Indian population.