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Medications for Cocaine Addiction

When you’re trying to beat cocaine addiction, you need a variety of tools to increase your chances of a successful recovery.

Whether coke is smoked, snorted or injected, this powerful drug alters your brain chemistry, creating a strong craving for its euphoric effects. Because cocaine acts directly on the central nervous system, withdrawal symptoms can be severe. When you give up cocaine, you may feel agitated, depressed, exhausted and angry. Cocaine withdrawal can cause an intense emotional and physical crash that drives many addicts back to using.

Although there’s no magic bullet for cocaine addiction, medication can help you get through the initial recovery period and deal with the emotional triggers that can prompt a relapse. The National Institute on Drug Abuse (NIDA) notes that the FDA hasn’t approved any specific medications for cocaine addiction treatment. However, taking certain medications as prescribed by your doctor may restore healthy brain function and help you handle the withdrawal symptoms that make recovery so difficult.

What Makes Cocaine Addiction So Hard to Beat?

Roughly 13 percent of admissions to drug abuse treatment programs in the United States. involved cocaine addiction in 2007, according to the NIDA. During that same year, the U.S. Department of Health and Human Services reported that cocaine use accounted for 29 percent of emergency room visits in the country.

Cocaine’s effects on the central nervous system make this drug highly addictive, and relapse is common in recovering cocaine users.

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Your brain and spinal cord make up the central nervous system, which processes the information gathered by your senses. When you experience a sensation, this reaction is registered by the central nervous system. In response to something pleasant, like the taste of a delicious dessert, certain brain cells release a neurotransmitter called dopamine. The release of dopamine acts as a reward, creating a sense of happiness and wellbeing that will probably motivate you to polish off the rest of that dessert.

Under normal circumstances, the brain cells that release dopamine will also shut off the pleasure signal after the message has been transmitted.

Cocaine interferes with the process that cancels the chemical signal, causing your brain cells to keep releasing dopamine. Instead of feeling a mild sense of pleasure and contentment after taking cocaine, many users feel an intense euphoria that doesn’t seem to quit. Because cocaine acts as a stimulant, you may also feel an unbeatable energy. These positive feelings are the reward that sets up a casual cocaine user for addiction.

With continued use of cocaine, your brain’s natural reward system may no longer function effectively. You may need to take more of the drug to reproduce those euphoric sensations. In addition, the experiences that used to make you happy before you started using cocaine may no longer create pleasurable feelings. The loss of pleasure, a phenomenon called anhedonia, is one of the worst aspects of cocaine withdrawal for many addicts. The Cleveland Clinic reports that anhedonia is often the driving factor behind a relapse. The lack of joy in everyday experiences can make a recovering cocaine addict feel that life isn’t worth living without the drug.

The goal of medication therapy in cocaine recovery isn’t to make the cravings go away or to eliminate withdrawal side effects completely. The goal is to help you get through the worst of the symptoms while you’re recovering, so you can focus on changing your behavior and rebuilding your life.

Side Effects of Cocaine Withdrawal

The National Institutes of Health notes that a user may suffer an emotional crash almost immediately after a cocaine binge, and that cravings can last for months after giving up the drug.

Side effects like these make it hard to beat cocaine addiction:
  • Headaches
  • Muscle tremors
  • Lack of physical energy
  • Nervousness and agitation
  • Difficulty handling stress
  • Marked increase in appetite

What Kind of Medication Will My Doctor Prescribe?

When you go through a medically supervised recovery program, your doctor will consider your health history, age, physical condition, life stressors and other factors to determine which medications may be right for you. Some medications may be prescribed only during the detoxification period, when your body is adjusting to the absence of cocaine. Other medications may be recommended on a long-term basis to help you avoid a relapse in the months ahead.

Many of the medications used in top cocaine inpatient addiction treatment rehabs help to calm the central nervous system. Using cocaine over a long period of time can affect the brain’s natural production of neurotransmitters – the chemical messengers that generate certain feelings or responses. If you’re having trouble with anxiety and agitation, your doctor may prescribe medication that triggers the release of neurotransmitters that make you feel relaxed, like GABA and dopamine. According to the NIDA, many of the medications currently used to treat cocaine addiction are used for treating other conditions, like epilepsy and muscle spasms:

  • Gabapentin: A medication prescribed to prevent seizures, this drug helps to restore feelings of wellbeing by promoting the release of the neurotransmitter GABA.
  • Modafinil: May prevent the fatigue and drowsiness associated with cocaine withdrawal by promoting healthy nighttime sleep and encouraging dopamine production.
  • Topiramate: An anticonvulsant drug that may ease agitation during recovery by reducing activity in the central nervous system
  • Vigabatrin: An anti-epileptic medication that may reduce cocaine cravings by increasing production of GABA.
  • Baclofen: This drug is prescribed as a muscle relaxant. In cocaine recovery, Baclofen may be used to increase the release of GABA.

Out of all the drugs used to treat cocaine addiction, the NIDA reports that disulfiram, or Antabuse, has had the most consistently successful results. Antabuse has been used for years to treat alcohol addiction by inducing an adverse reaction to alcohol. Antabuse has also been prescribed to discourage cocaine use. According to a study published in the August 2009 issue of Molecular Interventions, Antabuse may help prevent cocaine relapse by affecting the way the brain processes dopamine.

The Future of Cocaine Treatment

Researchers at the National Institute on Drug Abuse are aggressively seeking pharmacological solutions that will make it easier to recover from cocaine addiction.

NIDA’s areas of research include:
  • Medications that reduce cocaine cravings and lower relapse risk by modifying the brain’s production and utilization of neurotransmitters
  • Pharmaceutical therapies to help people in cocaine recovery respond to stress and other emotional factors that can trigger a relapse
  • Vaccines that block the passage of cocaine from the bloodstream to the brain
  • New emergency medical interventions for cocaine overdose

What Are the Drawbacks of Medication Therapy for Cocaine?

The anticonvulsant medications prescribed to treat cocaine addiction can have a lot of side effects, ranging from unpleasant to life threatening. According to a study from Consumer Reports, drugs like gabapentin and vigabatrin frequently cause dizziness, nausea and drowsiness. Anticonvulsant medications can have dangerous interactions with other common medications.

These drugs can also interfere with memory and concentration. Serious side effects of anticonvulsant medications may include:
  • Liver failure
  • Life-threatening skin reactions (Stevens-Johnson syndrome)
  • Suicidal feelings
  • Birth defects
  • Blood abnormalities

Disulfiram, or Antabuse, can cause side effects like fatigue, drowsiness, acne and rashes, an upset stomach, impotence and weakness. Before you take medications for cocaine addiction, your doctor should review potential side effects and drug interactions with you.

Taking medication for cocaine recovery requires consistent compliance with your doctor’s orders. For many addicts entering recovery, life has become chaotic and unstructured. You may need to work with your recovery counselors to develop a daily routine that makes it easier for you to take your meds in the right dose at the right time.

Although medication can make recovery easier to tolerate, meds also give some addicts a false sense of security. It’s important not to assume that pharmacological treatment is the only therapy you need to beat cocaine addiction. While pharmacotherapy may make it easier for you to deal with detox, medication is only one aspect of a comprehensive recovery plan.

What Else Can I Do to Succeed at Recovery?

Unless medication is combined with intensive counseling and behavior modification to address the causes and triggers of your cocaine use, you’ll have a higher chance of relapse in the future. Cocaine addicts in recovery must often deal with broken relationships, empty bank accounts, unemployment and criminal charges. Combine these stress factors with the emotional crash of cocaine withdrawal, and you’re going to require a lot of support from multiple sources to ensure a healthy recovery.

Pharmacological therapy is only one aspect of cocaine addiction treatment. You’ll need to rely on medical professionals, counselors, recovery groups, spiritual advisors and supportive friends throughout the process. Medication may curb your cravings and help you avoid the more severe side effects of cocaine withdrawal, but to face the realities of a drug-free life, you’ll need a reliable support system.

Recovery from cocaine addiction can be a profoundly rewarding experience if you draw strength from both medical and non-medical sources.