Unmasking the addiction cycle: Cocaine

Sometimes, the hardest part of having an addiction is acknowledging its presence. How do we know if we are addicted to cocaine or use cocaine regularly? Addiction is categorised as a type of dependency. But, not all instances of substance use ‘qualify’ as an addiction. For cocaine use to move towards addiction, specific psychological and physiological processes take place. This deepens and complicates the relationship between the user and cocaine. It can lead to a situation where cocaine is inextricably linked with feelings of pleasure, euphoria and relief. At that stage, it becomes extremely difficult to resist.

Cocaine addiction

Many clinicians in the addiction industry use the ‘CAGE AID’ to screen for addiction to drugs. The questionnaire is comprised of four questions:

1. Have you ever felt the need to cut down on your drug use?
2. Have people annoyed you by criticising your drug use?
3. Have you ever felt guilty about your drug use?
4. Have you ever felt you needed drugs first thing in the morning to steady your nerves or to get a rise of a hangover (eye-opener)?

If you answer ‘yes’ to any of these in relation to your use of cocaine, then you would possibly be considered as dealing with a cocaine addiction by clinicians.

Addictions are multifaceted. Cocaine is a stimulant drug, meaning it works by increasing activity in specific areas of the central nervous system. These stimulant effects can be felt in both the body and brain. When this happens repeatedly, specific systems in the body and brain can start to be altered. These changes can be thought of as the ‘mechanisms of addiction’: the cycles that lead to cocaine dependency.

The effects of cocaine addiction

Cocaine addiction can chronically impact your life. The effects of addiction can be seen in the body. They can also be felt on a psychological and emotional level in the mind. Cocaine also takes its toll on behaviour, leading to changes in our personal, professional and social lives.

Effects include:

• Lack of sleep
• Regularly feeling unwell
• Unexplained aches and pains
• Headaches
• Damage to the sinuses and nose
• Damage to the lungs
• Reduction in smell and taste
• Cardiovascular complications
• Stroke and seizures
• Risk of overdose
• Irritability
• Panic attacks
• Paranoia
• Mood swings
• Hallucinations
• Delusions
• Worsening of preexisting mental health conditions
• Tension in relationships
• Social withdrawal
• Deceitful behaviour
• Financial issues
• Difficulties around home management and childcare
• Conflict at work
• Risk of unemployment

Psychological mechanisms of cocaine addiction

Cocaine has the power to become psychologically addictive. This is because we can develop an emotional dependency on it. The cycle of addiction is typically thought to work in the following stages:

1. Binge & intoxication
2. Withdrawal & negative affect
3. Preoccupation/ anticipation

The first stage is initial use. A lot of people often find that using psychoactive drugs can alleviate stress, anxiety, and depression. That means that in a world with increasing cases of mental health issues and burnout, drug use can seem like the perfect way to achieve temporary relief. Drugs can offer us a ‘way out’ of feeling complex emotions. They can provide us with a break from difficult situations. However, this type of use is not a one-off for most people. When we start to understand drugs as a type of ‘cure’ for feeling distressed, then we can become reliant on them to manage difficult situations in our everyday lives.

When we are using maladaptive behaviours to cope, our distress tolerance can be reduced. This means that we may find it even harder to manage feelings and situations, leading to an increase in instances of reaching for cocaine as a crutch. This can mean that cocaine use becomes increasingly regular, subsequently leading to a psychological dependency.

Physiological mechanisms of cocaine addiction

As well as thinking of the psychological aspects of dependency, cocaine addiction can also be understood through its effects on our neurobiology. Cocaine is psychoactive. It primarily works on the brain’s limbic system. The limbic system is the part of the brain that links to memory, emotion and stress response. Anything that affects this system will also alter our feelings and behaviours.

The psychoactive effects of cocaine can be understood through two key processes:

• Short-term effects
• & Long-term effects

Addiction physiology: Short term effects of cocaine

When we take cocaine, we get an initial rush of feelings that characterise the cocaine ‘high.’ This high is thought to occur after cocaine use, as cocaine stimulates the dopamine system. Dopamine is a neurochemical linked to feelings of pleasure, reward and motivation. Short-term stimulation of the dopamine system, then, acts to ‘flood’ dopamine receptors with a build-up of the neurotransmitter. This leads to feelings of euphoria, intense happiness, calm and a sharper perception of sensory input. After some time, the dopamine levels will begin to return to average. This can often be mapped along the timeline of ‘coming down’ from cocaine.

Addiction physiology: Long-term effects of cocaine

Dopamine may be stimulated in the short term. But, if you continue to use cocaine frequently, then you may find that longer-term changes to the dopaminergic system begin to happen. Researchers have found that long-term use of cocaine results in structural changes in the brain. Scientists can track visual changes in nerve cell structure as the dopaminergic reward systems begin to rewire themselves. These changes can last for months. Some studies suggest that these changes can be ‘reversed’ following abstinence. However, the research on this is not fully conclusive.

Help with cocaine addiction

Addiction is a very difficult road to walk, but you do not have to walk it alone. With a range of specialist treatment programmes designed around your needs available, accessing cocaine addiction help can be a powerful first step on your recovery journey. Cocaine addiction works in cycles. But that does not mean those cycles cannot be broken with the right forms of support in place.