Dependence, addiction and overdose risk

The high from cocaine can be intensely rewarding but the experience is very short lived. The euphoria initially experienced produces an intense craving which can develop quickly into an addiction. Addiction rates are high for smoking and much higher for injecting.

Many dependent users develop a transient manic like condition similar to amphetamine psychosis and schizophrenia. Symptoms of this include aggression, severe paranoia, tactile hallucinations as well as feelings of insects crawling under the skin.

Because cocaine is a highly addictive substance with shorted lived effects, users sometimes go on binge sessions resulting in overdose. Overdoses can lead to rapid heartbeat, raised blood pressure, heart attack, seizures, kidney failure, stroke and repeated convulsions. Death may result. There is no specific antidote for cocaine overdose.

Withdrawal symptoms occur when a dependent user decides to stop use or significantly cuts down the amount they are using. Cocaine withdrawal commonly occurs in three phases:

1. 'Crash': occurs immediately after the person stops using cocaine and especially after a cocaine binge session. Symptoms include:

• agitation
• depression
• intense craving for the drug
• fatigue.

2. Withdrawal: depending on individual history of use, this can last up to ten weeks. Symptoms include

• depression
• lack of motivation
• anxiety, shaking
• intense craving foe the drug
• angry outbursts
• nausea and vomiting
• muscle pain.
• sleep disturbances.

3. Extinction: Even after withdrawal symptoms have ceased, sporadic cravings for cocaine may surface months or years after the user has ceased using cocaine.