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The Effects of Cocaine on the Brain

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Cocaine is a stimulant that causes a short-lived, intense high and is powerfully addictive. This drug comes from the leaves of the coca plant, which grows in South America. Cocaine is the second most used illegal drug in the United States. It is also the second most addictive and second most dangerous, exceeded only by heroin. In 2008, cocaine was responsible for 24% of drug-related emergency room visits.

Cocaine does not discriminate. Addicts can come from different economic classes and walks of life. However, cocaine use is most common among people aged 18-25, where 1.5% have used cocaine in the last month. Men tend to use cocaine more than women.

Forms That Cocaine Comes In

Cocaine comes in two forms, powder cocaine and freebase cocaine. Powdered cocaine, commonly known as “snow” or “blow,” is a white water soluble powder that can be snorted or injected. Freebase cocaine comes in rock-like lumps, is known as “crack” or “rock,” and is smoked. The freebase form is considered more addictive because higher amounts of the chemical reach the brain in a shorter burst, but crack addiction recovery is possible. The high of crack lasts 5-10 minutes. Powdered cocaine, on the other hand, has a longer high (15-30 minutes from snorting.)

Anatomy of a High

The brain has chemicals called neurotransmitters that help the neurons signal emotions. A neuron receives an impulse and releases the neurotransmitter molecules. The receiving end of the next neuron receives these neurotransmitters and either transfers the impulse to the next neuron or somehow changes. The neurotransmitters, having done their job, are mopped back up by the signaling neuron. This is called re-uptake.

Different neurotransmitters do different things. Dopamine, the neurotransmitter affected by cocaine use, is responsible for reward and motivation. The areas that are most affected by dopamine are the ventral tegmental area (VTA), where the signal originates, and the nucleus accumbens, which produces the feeling of reward; together, these areas make up the reward pathway. Dopamine is released from normal, healthy activities as well, but cocaine artificially blocks dopamine re-uptake. The excess of dopamine that results causes the high.

Excessive amounts of dopamine in the brain cause delusions and hallucinations. Psychiatrists often have trouble telling people addicted to cocaine and people with paranoid schizophrenia apart. This is because an excess of dopamine is the common denominator in both cocaine addiction and paranoid schizophrenia. Users of cocaine report effects such as euphoria, increased energy and movement, increased confidence, and a lessened need for food and sleep. After the initial phase of the high, the user becomes agitated, paranoid, and sometimes violent.

The Aftermath of a High

After the high is over, the user feels depressed and tired, often craving more of the drug. This is due to the neurons running out of dopamine. Paranoia and aggressiveness often persist even after cocaine has left the system.

Long-term use of cocaine causes certain changes in the brain. The neurons adapt to the excess of dopamine by lessening the amount of dopamine receptors on the receiving end of the neurons. This causes tolerance, as users need more of the drug to feel the same effect. In addition, the brain becomes less sensitive to natural rewards, decreasing overall motivation and causing severe depression. Meanwhile, the body actually gets sensitized to the numbing and anxiety-causing qualities of the drug. The risk of seizures goes up with use, as do feelings of agitation.

Many cocaine users go on binges, ingesting multiple doses in a short amount of time to try to prolong the high. Binges often cause irritability, restlessness, and paranoia. Because a lot of cocaine is ingested in a short period of time, the risk of seizure increases even more.

Long-Term Effects

Cocaine is a vasoconstrictor, which means that it constricts blood vessels. Repeated use cuts off blood flow to large parts of the brain, causing brain cells to die off. Brain cells, once dead or damaged, can never regenerate. The brain damage is permanent.

The paranoia, irritability, and aggressive behavior caused by cocaine causes social alienation and disruption in relationships. Additionally, the obsession with the drug leaves little room for anything but attempting to get more of it. Addicts will often steal money and valuables, even from friends and family.

Combinations With Other Drugs

When cocaine is consumed with alcohol, the two drugs combine to form a chemical called cocaethylene. Cocaethylene is more dangerous and addictive than cocaine alone. Out of all two-drug combinations, cocaine and alcohol are responsible for the greatest amount of fatalities.

Some users combine cocaine with heroin; this mixture is known as a “speedball.” Its addictive properties are exponentially more dangerous than either drug alone.

Addiction Recovery

Cocaine addiction is a problem that negatively impacts physical, mental, and social health. Addiction is a complex problem that needs comprehensive treatment that addresses both, the physical and mental aspects of addiction. In 2007, cocaine was responsible for 13% of all drug rehab patients.

Disulfiram, a medication that is used to treat alcoholism, can also help treat cocaine addiction. Additionally, a cocaine vaccine is currently being developed. This vaccine would bind to cocaine molecules, preventing them from entering the brain, in turn preventing relapse.

Behavioral alternatives are a more common way of treating cocaine addiction. Using incentives is an effective short-term approach.

Cognitive behavioral therapy (CBT) is an effective way of preventing relapse. CBT involves examining emotions and situations that trigger cocaine abuse, and then coming up with alternative ways to respond to the trigger.

Residential programs are also helpful in treating cocaine addiction. The person with addiction stays in a rehab center for 6-12 months. The community and environment of the center are geared to provide an environment conducive to recovery. It is important to help the patient deal with problems that have contributed to addiction. For example, if the patient is unemployed, career counseling will help him/her solve occupational problems that may have contributed to the addiction.

Drug rehab helps the patient cope with stresses that contribute to the addiction and discover healthy alternatives to addiction.