Regularly snorting cocaine, for example, can lead to loss of sense of smell, nosebleeds, problems with swallowing, hoarseness, and an overall irritation of the nasal septum, which can lead to a chronically inflamed, runny nose. Ingested cocaine can cause severe bowel gangrene, due to reduced blood flow. Persons who inject cocaine have puncture marks and tracks, most commonly in their forearms. Intravenous cocaine users may also experience an allergic reaction, either to the drug, or to some additive in street cocaine, which can result, in severe cases, in death. Because cocaine has a tendency to decrease food intake, many chronic cocaine users lose their appetites and can experience significant weight loss and malnourishment. The human liver combines cocaine and alcohol and manufactures a third substance, cocaethylene, which intensifies cocaine's euphoric effects 3. The mixture of cocaine and alcohol is the most common two-drug combination that results in drug-related death.
Many behavioral treatments have been found to be effective for cocaine addiction, including both residential and outpatient approaches. It is important to match treatment to the needs of the individual. A behavioral therapy component that is showing positive results in many cocaine-addicted populations, is contingency management. Contingency management uses a voucher-based system to give positive rewards for staying in treatment and remaining cocaine-free. Based on drug-free urine tests, the patients earn points, which can be exchanged for items that encourage healthy living, such as joining a gym, or going...
Cognitive-behavioral coping skills treatment, for example, is a short-term, focused approach to helping cocaine-addicted individuals become abstinent from cocaine and other substances 5.
Therapeutic communities, or residential programs with planned lengths of stay of 8 to 12 months or more, offer an alternative to those in need of treatment for cocaine addiction. Therapeutic communities are often comprehensive, in that they focus on the re-socialization of the individual to society, and can include on-site vocational rehabilitation and other supportive services. Therapeutic communities typically are used to treat patients with more severe problems, such as co-occurring mental health problems, behavioral problems, or criminal involvement 5.
References
1. Quaglio G, Lugoboni F, Pajusco B, Fornasiero a, Mezzelani P, Lechi a. [Clinical manifestations of cocaine abuse]. Ann Ital Med Int. Oct-Dec 2004;19(4):291-301; quiz 302-293.
2. White SM, Lambe CJ. The pathophysiology of cocaine abuse. J Clin Forensic Med. Mar 2003;10(1):27-39.
3. Velasquez EM, Anand RC, Newman WP, 3rd, Richard SS, Glancy DL. Cardiovascular complications associated with cocaine use. J La State Med Soc. Nov-Dec 2004;156(6):302-310; quiz 311.
4. Sofuoglu M, Kosten TR. Novel approaches to the treatment of cocaine addiction. CNS Drugs. 2005;19(1):13-25.
5. Rounsaville BJ. Treatment of cocaine dependence and depression. Biol Psychiatry. Nov…
