Of the many illicit and harmful drugs, few are more addictive than cocaine and crack. The pharmacodynamics of cocaine creates a very high abuse potential, on par with heroin and methamphetamine. If you or someone you know has become addicted, understanding and treating this addiction are of paramount importance.


Understanding addiction

Cocaine addiction is a chemical dependence. Behind heroin addiction, it is generally regarded as the most difficult to manage. The user comes to rely on cocaine for its pleasurable effects and to mitigate negative thoughts and feelings, at first those caused by everyday life and then, as the addictive process continues, those caused by withdrawal from cocaine. Addiction is often caused by anxiety, depression, and poor stress management, and, in turn, it often leads to the same, forming a feedback loop that continually cycles back to drug use. In order to successfully treat cocaine addiction, it is important for the user to first come to terms with his or her reasons for using.


Finding a reason to quit

When quitting, the withdrawal symptoms can be excruciating and can include insomnia, paranoia, formication (a crawling sensation on or under the skin), and an intense compulsion to seek out and use cocaine. Without a firm resolve to motivate the user, especially in the first weeks of sobriety, a return to cocaine use is all but certain. As with any other addiction, the user must want and choose to quit of your own accord. As withdrawal sets in, it is ultimately the user’s own willpower that will see them through.


The benefits of therapy

Because there is no approved pharmacological intervention for cocaine use, therapy and community are, for now, the most reliable treatments. Twelve-step and other group programs such as Cocaine Anonymous are somewhat successful, and can, at the very least, foster a sense of community and create a therapeutic environment. The solitude of addiction is perhaps the most powerful driver of continued addiction. Other users know best what the user is going through. They can share their strategies for success and lend an empathic ear when difficulties invariably arise. There are other therapeutic approaches, such as psychotherapy, cognitive behavioral therapy (CBT), and motivational therapy (MT), that can be engaged through a professional practitioner. Such individualized approaches tend to be more successful than support group attendance.


Experimental pharmacological approaches

There are several experimental drug-based treatment options, though some utilize substances that are illegal or unapproved for such use in some countries. Because large-scale studies have yet to been done, the evidence about the effectiveness of these treatments is in many cases anecdotal. Some pharmaceuticals have been investigated with uncertain, though interesting, results. Antidepressants such as desipramine (Norpramin), phenelzine (Nardil), and bupropion (Wellbutrin, Zyban) have seen some success as they may treat underlying psychiatric disorders that lead to addictive tendencies or create unpleasant symptoms in combination with cocaine use. Modafinil, sold under the Alertec, Modvigil, and Provigil trade names, seems to show some promise, though its mechanism of action is not understood in this context. Its availability is restricted in the United States, but it can be prescribed by a physician in most other nations. Ibogaine, ayahuasca, LSD, and other entheogenic substances seem to show great therapeutic value in recovering from addiction, though these substances are usually heavily controlled or outright banned in many countries. There are clinics in Canada and Mexico that offer ibogaine treatment, and ayahuasca practitioners can be found within receptive communities, particularly in major cities and in South America. However, unlike pharmaceuticals, the value of such psychoactive substances is in the experiences they offer, rather than any direct pharmacological interaction with cocaine or the addictive pathways it triggers in the brain. These experiences are often described as life-changing, as a form of “super-therapy.”


Moving forward

As treatment moves forward, the user, if they are committed, will learn to open up and understand his or her addiction. There are many avenues to explore and many challenges to face. Luckily, the Internet provides a vast, easily-accessible resource. Knowledge and community are the keys to success in overcoming cocaine addiction, and the Internet can provide both.

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