Cocaine and Methamphetamine are powerfully addictive stimulants. Both can be processed to form a rock crystal that is smoked. Crack is rock cocaine.  Cocaine and Meth use is so addictive that users quickly develop tolerance to it.  Chasing the cocaine high leads to escalating doses and often switching from snorting to smoking to IV use.  The only thing that prevents people from overdosing is their bank account.  Once people are addicted, they will sell their soul for another hit.. If a mouse is given cocaine every time it presses a lever, it will do nothing else but press that lever.  It won’t stop for a minute to take a sip of water or a bite to eat, and eventually it will die from a cocaine overdose.

Immediately after use, there is an intense sensation, called a “rush” or “flash,” that is described as extremely pleasurable, but it only lasts for a few minutes.  After the initial “high,” there is typically a state of severe agitation that in some individuals can lead to violent behavior, paranoia or hallucinations.  Other possible immediate effects include increased wakefulness and insomnia, decreased appetite, irritability/aggression, anxiety, nervousness.

Some people say cocaine helps them perform simple physical and mental tasks more quickly or gives them feelings of extreme happiness and high energy.  Some say they use it for Attention Deficit Disorder because they falsely believe it helps them concentrate and focus. It doesn’t.

Cocaine’s effects appear almost immediately and disappear within a few minutes to an hour. People binge on cocaine—taking the drug repeatedly within a short time, at increasingly higher doses to maintain their high.

Common Street Names:

• Cocaine: Crack, Blow, Nose, Snow, Toot, White, Rock, and Flake
• Methamphetamine: Meth, Uppers, Bennies, Crank, and Crystal

• Cocaine and Methamphetamine Misuse
• Cocaine and Meth Substance Use Disorders are classic examples of drugs associated with poly-addictions; dual diagnoses, medical co morbidity and risky addict behaviors;
• Poly Addiction;
• Both cocaine and methamphetamine are typically used in binge patterns or “runs” lasting days or weeks without sleep followed by cognitive impairment and extreme fatigue;
• Often these binge patterns involve a poly-addiction pattern of use that includes alcohol, benzodiazepines, or other sedatives to “come down” from a high.

Medical Consequences

• Cocaine and methamphetamine cause your heart to beat faster and your blood vessels to constrict, resulting in high blood pressure, heart attacks, and strokes. These drugs can actually cause your heart to beat so fast that it can sto;
• Even young patients without a history of heart disease are at high risk for heart attack;
• Emergency room doctors are taught to consider Cocaine overdose as one of the first diagnoses for young people.  What is especially deadly about Cocaine and Meth is that there is no correlation between how many times or how much you’ve used or when you may suffer a cardiac arrest.  Some people die after their first use;
• Cocaine and Meth are often used with alcohol to minimize their side effects so even more of these drugs can be used.  This is often lethal.  When cocaine is used with alcohol, a chemical compound called Cocaehtylene is formed that often results in cardiac death.

Cocaine , Methamphetamine and Dual Diagnoses
These drugs are often associated with psychiatric illness such as Mood Disorders, (depression and anxiety), ADHD or Bipolar Disorders.  These drugs produce changes in mood, behavior, and personality that mimic almost any psychiatric disorder, and can cause paranoia and hallucinations that lead to violent, aggressive behaviors that are intense and longer lasting.

As with all drugs, the most important consequences of cocaine addiction are psychological, social, and emotional.  But with Cocaine and Meth they happen faster and harder than with other drugs.  If you are a cocaine addict, you don’t have to wonder if you’ve hurt your friends and family. You can be sure that you have.

People who use cocaine and methamphetamine are often self-medicating psychiatric and physical pain.

Cocaine and Methamphetamine addiction often occurs when people try to “self-medicate” serious psychiatric  illnesses.  People with both Heroin Addiction and a Psychiatric Disorder are call Dual Diagnosis.

• Many people use Cocaine and Methamphetamine to cope with psychiatric problems.  Long term, this will not work, but will makes matters worse;
• This is why diagnosing and treating co-occurring psychiatric problems is so important in Addiction Medicine;
• Addiction Recovery Models , must address both the Co-occurring psychiatric issues in order to be successful.
• Kittay’s Addiction and Psychiatry Model treats Dual Diagnosis and is effective.

Cocaine , Methamphetamines and Poly Addiction

Both cocaine and methamphetamine are typically used in binge patterns or “runs” lasting days or weeks without sleep followed by cognitive impairment and extreme fatigue.  Often these binge patterns involve a poly-addiction pattern of use that includes alcohol, benzodiazepines, or other sedatives to “come down” from a high.

Risky Behaviors

• There is a strong connection between cocaine and methamphetamine use and high-risk sexual behavior;.
• Cocaine and Meth are associated with high rates of HIV and Hepatitis-C — as a result of IV use and sharing of drug paraphernalia.

Cocaine withdrawal does not make you physically sick like heroin, pain pills or alcohol.

Withdrawal Symptoms of Cocaine and Methamphetamines

• The withdrawal symptoms of cocaine and methamphetamine are psychological and emotional and can be crippling.  There are no physical withdrawal symptoms from cocaine, which is why people sometimes trick themselves into thinking they aren’t addicted to it.
• The emotional withdrawal symptoms are: Fatigue and low energy, lack of motivation and enthusiasm, mood swings including depression and anxiety.  Users often take sedatives to “sleep” through the withdrawal period.

Medications used in the treatment of Cocaine and Methamphetamine Use Disorders:

Medications are prescribed to treat these symptoms and fears of being sick during withdrawal and recovery. This approach helps people comfortably and safely get off and stay off cocaine.  Some of the medications stop the urges to use, others prevent the pleasure from the high.

There are several medications that can be helpful in treating Cocaine Use Disorder. Some are used to reduce drug use or treatment dropout, others to decrease cravings. Often combinations of medications are used to achieve the best results. Medications shown to be helpful include:

• Naltrexone
• N-acetylcysteine, NAC
• Disulfiram
• Baclafen
• Topamax
• Medications are also used to manage withdrawal symptoms such as anxiety or sleep

The vast majority of cocaine and methamphetamine addictions can be safely and comfortably treated outpatient, and do not need inpatient care.

Your  Individual Evaluation & Treatment Plan for Cocaine and Methamphetamine care  includes:

• Addiction, Medical and Psychiatric Evaluation ;
• Evaluation and Treatment of Co-occurring Medical Disorders and Poly-Addictions;
• Medically Supervised Home Outpatient Detoxification;
• Medications to reduce cravings and relapse;
• Medication Management of Anxiety, Sleep and/or Co-Occurring Psychiatric Disorders;
• Psychological, Social and Family Interventions;
• Cognitive Behavioral Restructuring of Stresses and Cues;
• Relapse Prevention.

Treatments are individually tailored for safety, comfort and effectiveness to minimize withdrawal symptoms and avoid medical complications. Medications are prescribed to help prevent cravings, reduce use and prevent relapse.  Medications target the brain’s reward systems, and the way nerve cells communicate restoring balance in brain chemistry. Psychiatric problems and symptoms are medically treated as necessary.