Cocaine Behavioral Effects You Should Know
You’ve seen it in movies. You’ve been offered it at parties. Cocaine is one of the most popular and perhaps the most glamorized street drug in the United States today. Because of its profile, and its association with Hollywood, cocaine is portrayed as the drug of choice for the rich and famous. In practice the perception is often the reality since cocaine is pound for pound one the most expensive street drugs on the market. This high price and high profile makes cocaine highly alluring.
Cocaine is made from the Erythroxylum coca plant that originated at high elevations in South America. People in Patagonia might chew on the leaves of the coca plant to give them a little boost of energy and alertness when climbing high peaks or going about a hard day’s work. From that simple, holistic origin, comes a completely different beast. The drug we call cocaine is the isolated active ingredient from that humble plant.
When it was first isolated a hundred years ago, it gained wide popularity as an additive to over the counter tonics and health aids, but the problem of addiction reared its head quite early on. After it was shown to be a powerful drug, it was regulated and placed under Schedule II in the United States relegating it to very specific medical uses and non public consumption. Illicit drug use saw a resurgence in the 70’s and 80’s. By the early 90’s, a “crack epidemic” had been declared and the negative effects of cocaine abuse were becoming widespread and visible in emergency rooms and elsewhere.
There are two types on the street market. The “pure” form, called cocaine, or “blow”, is a white powder that can be snorted or dissolved in water and injected. The more notorious form is crack cocaine. Also called “rock”, “crack”, or “freebase”, this form of the drug has essentially the same physiological effects but can be smoked, making for an even faster onset of the euphoric high that a user is seeking. With a faster onset comes a quicker duration however. Where a cocaine high from snorting might last 15 to 30 minutes, a crack high can be as short as 5 to 10 minutes.
Cocaine works by hijacking the brain’s pleasure and reward center. When you do something that is necessary for survival – like drinking water or eating tasty food or having sex – your brain is wired to release a chemical called dopamine. Your brain cells, called neurons, receive and send this dopamine molecule creating, for lack of a better term, good vibes through your whole body.
That’s why biting into a piece of really good chocolate is such an enjoyable experience. Cocaine exploits this reward system by triggering a massive flood of dopamine from many neurons. Normally after a dopamine molecule delivers its feel good message to a neuron, it is reabsorbed by its parent neuron to be reused later. Cocaine blocks this action meaning dopamine is trapped in the spaces between neurons (the “synapse”). The result is a huge excess of dopamine that leaves the cocaine user feeling:
The high is short-lived however, and the crash afterward is almost as dramatic as the high. Even moderate or “recreational” use of cocaine can cause confusion, anxiety, depression, high blood pressure, and increased body temperature – which to most people feel like a fever. Long-term use can cause:
⁃ Heart attacks
⁃ Cardiac arrhythmia
⁃ Skin abscesses
⁃ Perforated nasal cavities
⁃ Lung damage
Part of what makes cocaine uniquely dangerous is how fast it is metabolized. Where other drugs have effects that last hours, the human body processes cocaine in minutes. Cocaine is a powerful stimulant and, relative to its dosage, is one of the most dangerous. In simplest terms a normal dose of cocaine is one tenth of an overdose. In one night of partying it is not that hard to hit that threshold since cocaine users almost always binge-consume the drug. Furthermore, cocaine is rarely taken on its own. Most commonly it is paired with alcohol as the sedative effect. Alcohol is known to mellow the crash that is associated with cocaine. Additionally, when cocaine and alcohol mix they create a new substance called cocaethylene, which acts in a similar way to cocaine but lasts longer. Cocaethylene has a greater than cumulative effect meaning it does more harm to the body than simply adding the effect of alcohol and cocaine together. It’s a force multiplier, making a person more sensitive to both cocaine and alcohol. This common and dangerous mix is why cocaine is responsible for the majority of drug-related emergency room visits in the US.
Another common mix is the “speed ball” which is when a user takes both heroin and cocaine. In this case, the cocaine and heroin abuse offset the effects of one another. Because cocaine has a shorter duration, it is possible for a person to take a higher dose of heroin than they’re used to, putting them at a much greater risk for overdosing. Once the stimulation from the cocaine wears off, breathing may slow and death by asphyxiation is possible.
This is not to say that everyone who tries cocaine will overdose. However, it is important to know that when a person uses cocaine, and their brain experiences the dopamine rush, their body compensates. The first action the brain will take is blocking the dopamine receptors to limit dopamine intake. When more cocaine is introduced, whether immediately or later, this interplay continues with the brain trying to maintain balance. Eventually dopamine may be blocked entirely or otherwise shut off, meaning an addict will be faced with a constant up hill climb to maintain the euphoria, or the high, that they initially started with. This can happen over time and it can happen in microcosm in a single evening.
Using any drug will expose someone to a similar situation where an ever-increasing amount of a particular substance is needed for the same effect. Because bingeing is such a common way to maintain a cocaine high, developing a tolerance starts much sooner than other drugs with a first time user able to build up a tolerance after just one use. An increase in tolerance means a user’s brain will shut down dopamine receptors and eventually dopamine production to try to maintain a natural balance.
This results in dependence or a physical need for the drug. Cocaine can eventually become almost the only source of dopamine for an addict’s body, causing life with out cocaine to be seriously painful. When a person with a dependence on this drug goes without, they experience a crash that is also called a cocaine withdrawal. Symptoms of cocaine withdrawal include:
⁃ Lack of concentration
⁃ Formication (the feeling of bugs crawling on their skin)
⁃ Anhedonia (the inability to feel pleasure)
⁃ Body aches
Withdrawal can be so severe that many people would do almost anything to avoid them. Some cocaine addictions are strong enough that a person may need a hit to simply feel normal, let alone high. The cycle of binging and crashing, the resultant tolerance and dependence, and the ultimate onset of withdrawals all have major effects on behavior.
Behavioral Effects of Cocaine
After moderate use
After the immediate high is either worn off, or kept going by more cocaine, the overwhelming positive feelings even a first time user might describe can turn into some bizarre and erratic behavior. A user may become paranoid and violent lashing out at those around them. Or their elevated heart rate and breathing could result in a panic attack. While the real psychological damage of cocaine takes longer to occur, the changes of mood can be almost immediate. Additionally, the physical danger of cocaine use means in rare cases even using it once can cause cardiac arrest, as the muscles of the vascular system are essentially short circuited by the introduction of cocaine.
After prolonged use
There are common behaviors that addicts of cocaine, and indeed other drugs, exhibit. They are related to the mental and physical dependence that they have developed for their drug. It is often the first sign of cocaine addiction when regular, habitual behaviors change. A person who was a model employee stops showing up to work, or a husband suddenly becomes distant. An inability to fulfill obligations because of a desire for drugs is one of the first major behavioral changes any addict exhibits. Their decision making on a day-to-day basis becomes centered around obtaining and using cocaine which leads to ever increasing difficulty in their established social circle, and is perhaps one of the most damaging aspects of addiction.
People who abuse cocaine for a long time suffer multiple negative psychological effects that directly change behavior. In a similar way to its effect on the reward pathways of the brain, cocaine also changes the stress pathways, making a user more prone to stress and the symptoms of stress. This will make them increasingly irritable and prone to angry fits or violence. Also, the severe mood swings associated with binge-use of cocaine become a more regular occurrence even if the drug is not immediately acting on the addict’s system. Long-term abusers of cocaine will also lose their ability to think critically and make judgments about the effects their addiction is having.
Animal studies have shown that cocaine reduces the function of the portion of the brain called the orbitofrontal cortex, a main part of a person’s judgment and decision-making and the part of the brain that regulates how we adapt to negative consequences. This makes a cocaine user who is perhaps already erratic from the confidence and energy of a cocaine high prone to rash, risky decisions.
The effect on the stress pathway is also a major contributor to relapse. Many addicts report that even once they’ve gotten sober and their regular craving for cocaine has subsided, a traumatic or stressful event can send them right back to the drug. This is related to the damage that cocaine does to the orbitofrontal cortex and related areas. Cocaine relapse is high as many as 30-40% of people who manage to get sober will relapse at some point.
The cocaine crash after long periods of habitual use and the ever-increasing tolerance becomes much more severe. The brain of a person this deep into the disease will have reduced dopamine production to almost nothing. When cocaine is not present this can drop them into a deep depression. They become reclusive and sedentary. It is fairly common for a person in this state to develop thoughts of suicide, and self-harm can follow if the situation is not treated. Full psychological breaks are possible where an addict will suffer a manic episode and lose their grip on reality. Symptoms similar to schizophrenia have been reported in cases like this.
For people suffering from the disease of cocaine addiction, there are often two options: get clean or end up in the hospital, or worse, with and overdose. The first thing for an addict to consider when trying to get clean is what behaviors or situations that they are in now contribute or are associated with their habit? Breaking old patterns can be a major factor in overcoming an addiction. The first hurdle will always be the pain of cocaine detox which there is no easy way to overcome except seeking help from those close to you or from your community. There are many options for behavioral therapy to treat cocaine addiction.
At Luminance Recovery, our Orange County rehab center specializes in treating withdrawal symptoms and the teaching strategies for overcoming addiction. Our service offers long term support throughout the entire process of the treatment. What we found is that the key to recovery is to make the decision and take steps to act on it.
If you or a loved one is suffering from a drug addiction, contact Luminance Recovery today.
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