Cocaine abuse and its treatment

Area of Science:

• Psychiatry
• Addiction Medicine
• Neuroscience

Background:

• Increasing numbers of individuals diagnosed with cocaine abuse are seeking medical and psychiatric care.
• Cocaine is typically inhaled, but intravenous or freebase use increases vulnerability to compulsive patterns and potential organic delusional syndrome.
• Cocaine's systemic effects mimic amphetamines but are shorter in duration, leading to increased alertness, energy, and sociability, followed by negative psychological states.

Purpose of the Study:

• To outline the patterns of cocaine use and its associated health consequences.
• To describe the treatment strategies for cocaine abuse and intoxication.
• To identify psychological factors contributing to cocaine craving and relapse.

Main Methods:

• Review of clinical presentation and effects of cocaine use.
• Description of treatment modalities including behavioral interventions and pharmacotherapy.
• Analysis of psychological factors and comorbid personality disorders in compulsive cocaine users.

Main Results:

• Cocaine use leads to acute tolerance and temporary restoration of psychomotor performance, but is followed by negative mood states and craving.
• Chronic intoxication is associated with adverse psychosocial outcomes.
• Compulsive cocaine users frequently exhibit Axis II diagnoses, such as borderline or narcissistic personality disorder.

Conclusions:

• Treatment must prioritize cessation of cocaine use through various strategies like contingency contracts and hospitalization.
• Pharmacologic agents, including antidepressants, are valuable adjuncts to comprehensive treatment plans.
• Long-term psychodynamic psychotherapy is indicated for compulsive users with personality disorders to prevent relapse.