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COCAINE USE DISORDER Research Paper

Abstract

Cocaine is currently the most abused stimulant drug in the United States. Recently, the drug has become the most involved in emergency department’s visits. Cocaine is not a new drug bust it is usually considered the “caviar” of all recreational drugs. Therefore the distinction between other drugs is reflected in its description. The drug has been described as the gold dust or the yuppie drug among others. Cocaine can be abused through different ways. The most widespread method of using the drug include snorting, Injection, and smoking. Due to poor absorption as well as first-pass metabolism, the drug is rarely injected into the body. Cocaine use disorder is usually associated with some detrimental effects. Various body organs are significantly affected by the use of the drug. Cocaine use disorder has been well documented in the literature. The main objective of this paper is to discuss cocaine use disorder. It will also discuss the fundamental elements  of the theoretical model of  main topic. Finally the limitations and the critics of the model will also be discussedKeywords: Cocaine, Cocaine abuse, Cocaine Use Disorder

Introduction

Cocaine is one of the most addictive drugs in the world. It is also ranked as one of the most destructive drugs. Cocaine use disorder can be described as a condition characterized by harmful repercussions of repeated use of cocaine, the pattern and sometimes the psychologically depending on the drug. This disorder can only be diagnosed when the use of the drug becomes persistent causing significant social or medical impairment. Cocaine together with other amphetamine drugs have the same intoxication and withdrawal symptoms, and therefore they are usually in the same category under the diagnosis and stimulant use disorder.

Literature review

This review focuses on understanding the association between abuse of cocaine and mental disorder. Grant, stated that “the association between cocaine use and mental disorder is a likely reflection of the common contributing factors and brain substrates” (Grant, 2004).One of the common factors between cocaine use and mental illness is depression. However, the primary question that remains among psychologist is the role of drug use in causing mental disorder in people with no previous psychiatric histories. Cocaine induces psychosis since they increase the concentration of dopamine in the brain. However, this does not explain why psychosis continues even after the absence of the drug in the brain

Brooner, et.al broke his research into smaller categories of mental disorders. He found that 43% of individuals with schizophrenia have some problems of substance abuse. Individuals diagnosed with schizophrenia are four times likely to have a substance abuse disorder that people who don’t (Brooner,1997).It is believed that prolonged use of cocaine might trigger mental illness in the users. Individuals that already have mental disorder probably seem to be extremely sensitive to the impact of cocaine and other drugs since they already have some brain disorder.It is important to note that there is no single accepted cause associated with any substance abuse. However many researchers have indicated that cocaine abuse is usually as a result of genetic and environmental factors.

It is quite a substantial period that it is believed that the use of cocaine runs in families. A person who has a relative with a history of cocaine use disorder are usually at higher risk of developing the same disorder than those who don’t. Moreover, there are others who have stated that if an individual has repeated exposure to cocaine, it triggers some genes that in turn alter the levels of certain chemicals in the brain known as dopamine. This is the chemical associated with the rush experienced after taking cocaine. This feeling is the one responsible for addiction. The brain structure is also another cause of abusing cocaine(Crits-Christoph,1999).Certain structures in the brain such as the amygdala have been associated with cocaine craving. In a person with cocaine use disorder, this area has always displayed some differences compared to the same area from a person not abusing the drug.

The use of cocaine has shown adverse impacts on the brain’s pleasure center by stopping it from responding to natural causes of pleasure. This only changes until the brain feel the presence of cocaine. In the absence of the drug, the user will not experience pleasure, hence making him feel depressed to the point of having suicidal ideations. Therefore, the individual is forced to continue taking the drug to avoid the feeling.

A survey consisting of 1,100 US residents who had used cocaine for the last 24 month was carried out by NIDA. The study showed that the risk of cocaine dependence within two years was about 5.5%.The risk of being dependent within ten years since the first use increased to 15.5%.These were the aggregate rates for all ways of using the drug which included smoking, injecting or smoking. Among the recent users, the rate of individual dependence was 3.5 times higher for smoking and much higher for injecting. Women had a 3.3 % likelihood of becoming dependent compared to men. People who started using the drug at the age of 12 were four times likely to be dependent compared to those who began at a higher age(Najavits,2000).

Another study of non-deviant users in Germany by Prinzleve et.al. showed a relative absence of a destructive pattern of using cocaine over a period of ten years since the first use. Therefore, this concluded that users of the drug could do exercise control of the drug. Some of the respondents used two major types of control: 1) restricting cocaine use to particular situations in which the effects of the drug would be positive.2) Limiting the mode of taking the drug to snorting some modest amount of cocaine below 0.5 grams per week. Those who used more than 0.5 grams all went back to lower levels (Prinzleve, 2004).

The rate of prevalence for adults using cocaine within the last 24 months is estimated to be about 3%.The rate for men is 4% while women are 1%.The highest prevalence rate are found between 18 years and 29 years of age. The lowest among the ages is 45 to 64 years old. Regarding ethnic background, the highest record was found among the Native American at 8% while the African Americans recorded a 4%  while the Hispanic 3%  while the Pacific Islanders stood at 1%.

Normally, the brain usually releases dopamine to respond to potential rewards such as a nice smell of food. It then transmits the feeling back to the cells that released it, closing off the signal between the nerve cells. Cocaine blocks recycling of dopamine, resulting in increased build-up between the nerve cells. This increased amount of dopamine then disrupts normal communication of the brain hence causing cocaine high.

Cocaine users can spend a lot of money and resources to get the drug which might result in financial catastrophe. This forces most of them to indulge in activities such as theft, drug dealing or even prostitution in order to support the expensive habit of using cocaine. Acute cocaine intoxication can lead to, headaches, frequent moods of paranoia and hallucinations (Wagner,2002).Mood swings such as depression, irritability, disturbance in attention are all common. If an individual has been using this drug for quite a long time can develop erratic behavior, social alienation, and sexual dysfunction.

Since mood disorder can increase the vulnerability of prolonged use of the drug and addiction, diagnosis and early treatment of the disorder can minimize the risk of using cocaine. Since the inverse might also be true, the early diagnosis and treatment of cocaine use disorder might also mitigate the risks of developing other mental complications, and if in any case, they occur, it is recommended to employ measures that would reduce their severity. Finally, since most of the individuals who use cocaine in the country have developed psychiatric disorder, continued use of the drug has a great contribution to their increased morbidity and mortality.

Numerous remedies have been researched and tested for treating people with cocaine use disorder. However, as of 2016, none of them had proven to be effective. Anticonvulsants such as gabapentin and topiramate are not more effective than treatment. Little evidence shows that antipsychotic drugs are also not effective for treating cocaine use disorder. Several studies have examined the efficiency of bupropion for treating dependence on cocaine. However, the trials that have been conducted so far have not shown any effectiveness for treating this purpose.

The National Institute on Drug Abuse (NIDA) of the United States is currently examining the effectiveness of modafinil and mild stimulant as a potential remedy for the disorder. Ibogaine has been under examination as a treatment option for cocaine use disorder. However, it cannot be used legally in the US. Other options that have been investigated include baclofen and acetylcysteine. Drugs such as Phenalgine have been used to cause aversion reactions when used together with cocaine.

Discussion and Limitation

The use of cocaine has caused significant psychological and social impairment. Some the common signs include euphoria, mood changes, hypervigilance, anxiety, impaired judgment and stereotyped behavior among others. Stimulant effects include euphoria, decreased blood pressure are usually common. Depressant effects include sadness, reduced psychomotor activity and not common but usually emerge if the use of the drug is persistent.

Withdrawals due to cocaine use are only evident if the user reduces its use after a heavy and prolonged use. Some of the most common symptoms associated with prolonged use include; dysphoric moods such as anxiety or anger as well as vivid, unpleasant dreams, an increase in appetite and Insomnia. Cocaine withdrawals require some days of rest. Moreover, depressive signs with suicidal ideas can also occur during the withdrawals.

Despite the theoretical model presented by the theoretical model. Most of the studies in the literature are cross-sectional, providing a descriptive point of view. This represents the limitation of the current review since it is challenging to review the effectiveness of the theoretical model based on such studies. This is a problem that needs to be highlighted as a potential limitation of other studies on this topic because the available conclusions are not addressing change over time. Another possible limitation is that the research carried out in this paper was certain sensitive terms which may have caused us to overlook the important articles.

Conclusion

There is the need to have a better approach that identifies, evaluates and eventually treats cocaine use disorder. Many remedies have been tested by it’s just a few that have proven to be effective. Most of the treatments of cocaine abuse are not designed to handle mental disorder. There should be awareness about the problem so that people can identify any signs and how to approach an individual with the disorder. People with the disorder also need to be aware of the available treatments for them. There is also the need for specialized training for counsellors so that they are equipped with skills to diagnose patients better. For the patient to recover physicians and psychologist successfully should treat a client addiction individually and not utilizing a common system of treatment.

Individuals with cocaine use disorder can also get assistance from their peers. These are people in the recovery process who can utilize their experience to assist others towards recovery. Support from peers is an essential element to treat cocaine use disorder. Most individuals who work in recovery systems as counselors together with peers are central to recovery efforts.

Peers also play a fundamental role as an integral mutual –support group. Such groups include narcotics anonymous together with other 12 programs which provide support to mitigate cocaine use disorders. Such groups provide a support network which many people can depend on in recovering from substance use disorder. These groups are usually integrated into treatment plans in order to provide an active community for individuals trying to transform their life and get away from cocaine abuse as well as other drugs. It is important to note that, while mutual groups do not work for all, they are an essential element of treatments of cocaine use disorder even not considered as a formal treatment.

References

Brooner, R. K., King, V. L., Kidorf, M., Schmidt, C. W., & Bigelow, G. E. (1997). Psychiatric and substance use comorbidity among treatment-seeking opioid abusers. Archives of General psychiatry, 54(1), 71-80.

Crits-Christoph, P., Siqueland, L., Blaine, J., Frank, A., Luborsky, L., Onken, L. S., … & Woody, G. E. (1999). Psychosocial treatments for cocaine dependence: National Institute on Drug Abuse collaborative cocaine treatment study. Archives of general psychiatry, 56(6), 493-502.

Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., … & Kaplan, K. (2004). Prevalence and co-occurrence of substance use disorders and independentmood and anxiety disorders: Results from the national epidemiologic survey on alcohol and relatedconditions. Archives of general psychiatry, 61(8), 807-816.

Najavits, L. M., Crits-Christoph, P., & Dierberger, A. (2000). Clinicians’ impact on the quality of substance use disorder treatment. Substance Use & Misuse, 35(12-14), 2161-2190.

Prinzleve, M., Haasen, C., Zurhold, H., Matali, J. L., Bruguera, E., Gerevich, J. O. Z., … & Gossop, M. (2004). Cocaine use in Europe–a multi-centre study: patterns of use in different groups. European addiction research, 10(4), 147-155.

Wagner, F. A., & Anthony, J. C. (2002). From first drug use to drug dependence: developmental periods of risk for dependence upon marijuana, cocaine, and alcohol. Neuropsychopharmacology, 26(4), 479-488.

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