Understanding Cocaine Addiction

As a Schedule II controlled substance, the recreational use of cocaine is illegal in the United States. It carries this federal classification because it is considered a substance with a high potential for misuse and severe psychological or physical dependence. When defining cocaine's addiction potential, the short answer is that cocaine is addictive. But not everyone who uses cocaine gets addicted, so the long and most complete answer is that many factors affect whether someone who uses will develop a cocaine addiction.

One of the primary issues with conversations about substance addiction is the focus on the drug rather than the mental health and history of the person taking it. Statistically, the rate of substance use disorders among people who have taken cocaine is low. A 2006 epidemiological study showed that about 80% of people who use cocaine are not chemically dependent two years later. However, the remaining 20% are at risk of developing a use disorder. But as with any drug, all who take it are at risk of its negative side effects.

6 Things to Know About Cocaine Addiction

  1. The exact time that it takes for cocaine's subjective effects to be felt varies depending on the route of administration—whether it is smoked, injected, taken orally, or snorted.
  2. The so-called "binge and crash" pattern of cocaine use, often followed by periods of abstinence or low use, has been linked to an increased risk of dependence.
  3. Smoking crack cocaine and being younger at the time of first cocaine use are both significant risk factors for addiction.
  4. You can reduce, although not eliminate, the risks associated with cocaine use with harm reduction strategies.
  5. After the initial "crash," cocaine withdrawal symptoms can last for weeks or months.
  6. Cocaine addiction, referred to as stimulant use disorder in the DSM-5, is a disorder characterized by a number of criteria, of which the experience of withdrawal symptoms is but one.

Factors That Influence Addiction Potential

Cocaine is a central nervous system stimulant. The pharmacological mechanism of cocaine influences how users can develop stimulant use disorder. Cocaine takes effect quickly and wears off quickly, giving people who use it a tendency to want to use more, often over a short period of time. Cocaine has a relatively short half-life, which means that the subjective effects (also known as the "high") occur quickly—under one minute if smoked, under two minutes if injected, around 30 minutes if taken orally, and 15 to 60 minutes if snorted.

Consequently, the comedown occurs relatively soon after, typically between one and three hours after taking the drug, and the quick onset of withdrawal effects can encourage a pattern of use known as "binge and crash." This pattern of excessive use for a period, followed by exhaustion and much more limited use, followed by a higher rate of consumption, has been observed in animal and human studies to increase the risk of dependence and addiction.

The purity of the cocaine used also has a large influence on whether a person develops stimulant use disorder. Cocaine purchased in underground markets may be as little as 10% pure, with up to 90% of the substance being made up of other substances that are mixed in. Often, the substances used to "cut" cocaine are chosen because they look, taste, or feel like cocaine, such as pseudoephedrine, levamisole, benzocaine, or caffeine. Some of the substances used, such as amphetamine and methamphetamine, carry their own addiction potential. Others have cross-tolerance with cocaine.

How Set and Setting Affect Cocaine Addiction

Research with people who use recreational drugs has shown that set and setting, or the psychological and physical contexts of drug use, can influence whether a person develops a substance use disorder. Even animals have a tendency to use cocaine in areas they associate with the drug, over and above areas they preferred before cocaine exposure. Using cocaine in situations that feel good may make it more difficult to enjoy the same situation without the drug in the future.

Animal and human studies have also shown an increase in cocaine self-administration when food is restricted. This finding has important implications for people who are restricting their food intake to aid weight loss, particularly if they are also using cocaine as an appetite suppressant, to increase their energy level, or to increase their metabolism.

Things to Consider About Cocaine Use

While it can be a pleasant high for some people, cocaine can be unpredictable, causing over-stimulation, erratic social behavior, the risk of mental and physical health problems, and even death from overdose.

A person is more likely to develop stimulant use disorder if they have low self-esteem, if they have a mental health problem such as anxiety, depression, or psychosis, if anyone in their family has a substance use disorder, or if they have a history of abuse. If any of these issues are affecting you, you should avoid cocaine use, or indeed any substance use, and seek help for the underlying issues, rather than try to overcome or avoid it through cocaine use. Your family doctor can help you with this and refer you to a specialist who can give you appropriate treatment.

Treatment for Stimulant Use Disorder

If you are already into a pattern of using cocaine, seek help from your doctor or an addiction clinic. Your doctor can help you manage your withdrawal symptoms to increase your comfort and reduce the risk of relapse.

Effective treatment for stimulant use disorder also requires treatment of any comorbid conditions. Often, excessive cocaine use is a coping mechanism for dealing with other challenges in a person's life. The reality is that those challenges will still be there after a person stops using cocaine. Without the coping mechanism and perhaps in the midst of withdrawal, people are often ill-prepared to deal with them.

As a result, if you are trying to stop using cocaine it's very important that you also seek supportive mental health treatment. There are effective treatments, and your doctor can help you determine which is right for you.

A Word From Verywell

Most people who use cocaine don't have long-term problems with addiction, but the risks that come with even occasional use are serious. If you or a loved one has a problem with cocaine use, there is help available.

If you're unsure where to turn, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers an anonymous online treatment locator, or you can call their National Helpline for a referral at 1-800-662-HELP (4357).

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