December 7, 2022

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When Occasional Cocaine Use Becomes Serious

Read about one man's struggles with cocaine addiction. Millions of other Americans are at risk of falling into the same vicious cycle.

Amy Keller | 5/1/2008

On a popular social networking site, an 18-year-old honors student named Caitlin describes her struggle with cocaine addiction. “Coke is my best friend, my family, my true love, and my worst enemy. At the end of a hard day, coming home isn’t the same unless I know I have a bag of some coke at home. It’s sad.” In another posting, she laments her inability to kick the habit. “I’ve tried everything. I’ve tried rehab, AA, NA, outpatients, etc. but I just don’t know what’s wrong with me and why I can’t stop.”

In fact, Caitlin’s inability to break cocaine’s grip results from insidious nature of the drug. When cocaine, a stimulant drug made from the leaves of the coca bush, enters the bloodstream, it, like other drugs, triggers the production of dopamine — a “feel-good” neurotransmitter — in the brain’s pleasure center. The drug also blocks the brain’s nerve cells from reabsorbing dopamine, and that build-up of circulating dopamine in the brain causes the sensation of euphoria. As cocaine delivers its euphoric high to users, it hijacks the brain’s normal reward circuitry and over time, the person can no longer find pleasure in anything except the drug.

Confounding one’s ability to get clean is the fact that memories of the cocaine-induced euphoria can continue to trigger cravings for years to come. In fact, scientists at the National Institute on Drug Abuse have discovered that cravings for cocaine increase long after individuals stop using the drug, thus making relapse more likely.

Millions of Americans are at risk of falling into this vicious cycle of addiction. A 2006 National Survey on Drug Use and Health administered by the U.S. Department of Health and Human Services reveals that more than 6 million — 2.5% — of all people aged 12 and older used cocaine in 2005 and 2.4 million were current cocaine users, having used within the past month. Approximately 256,000 people were admitted to treatment for cocaine addiction that same year.

Testifying recently on Capitol Hill about the scope, pharmacology and health consequences of cocaine abuse and addiction, Nora Volkow, director of the National Institute on Drug Abuse, noted that there is no magic pill to treating cocaine addiction. The most effective treatments, currently, are behavioral therapies, delivered both in residential and outpatient settings. And addiction specialists say that that the road to recovery is difficult because so many cocaine users relapse. “Cocaine users are going to have to be treated over and over and over again. It’s a binge addiction,” says Bob Piper, the vice president of residential services for First Step of Sarasota, a substance abuse recovery center.

Lee Brewer, a 46-year-old real estate broker from Sarasota who owns two Mercedes and lives in a "beautiful home," says he started using cocaine in his late 30s at the close of a night of heavy drinking in Ybor City in Tampa. At the coaxing of a friend, he snorted a line and experienced a euphoria that seemed to pull him out of his drunken stupor. "For the beginning, for me, cocaine was more of a safe haven. If I was going to go out drinking, I'd just take a little bit with me so I could drive home."

Like many first-time cocaine users, Brewer thought he could manage his occasional habit, but his casual relationship with cocaine grew serious. After a night of partying with booze and coke, Brewer would awaken with a stuffy nose — cocaine damages the nasal passages — so he’d “do a little bump” to clear the congestion. And the cycle of addiction was initiated.

Clean and sober for 18 months now, Brewer says Cocaine Anonymous helps him with his sobriety. The group uses a 12-step recovery program that was adapted from the program developed by Alcoholics Anonymous and participants in the program attend meetings where they “talk about what’s bothering them” says Brewer. For instance, a former user who hasn’t snorted cocaine in 14 years might be battling intense desire to use again so he’ll attend a meeting to get the support and re-enforcement from others who understand the addiction. Brewer says groups like CA provide an accountability mechanism to help keep recovering addicts on the straight path when their willpower wanes.

A pharmaceutical fix for cocaine addiction, meanwhile, might not be that far down the road. Scientists at Yale University have been testing out a vaccine to combat cocaine addiction. While the vaccine does not diminish cravings for cocaine, it stimulates the immune system to create drug-specific antibodies, which bind to the cocaine and prevent it from reaching the brain where it would normally generate a high. The vaccine, TA-CD, is currently under development by an England-based biopharmaceutical company.

If you are addicted to cocaine and would like to find a Cocaine Anonymous meeting near you, go to http://www.fla-ca.org/ or call 1-800-347-8998.

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