Cocaine addiction is a biopsychosocial disorder characterized by persistent cocaine use despite adverse consequences, and withdrawal symptoms upon discontinuation. The Diagnostic and Statistical Manual of Mental Disorders classifies cocaine abuse as a “stimulant use disorder”. 

Cocaine use causes euphoria and high amounts of energy, as well as mood swings, paranoia, insomnia, psychosis, high blood pressure, a fast heart rate, panic attacks, seizures, cognitive impairments and drastic changes in personality. Overdose may result in cardiovascular and brain damage, constricting blood vessels, stroke and constricting arteries, causing heart attack.

The symptoms of cocaine withdrawal are dysphoria, depression, anxiety, decreased libido, psychological and physical weakness, pain, and compulsive cravings. Cocaine is a powerful stimulant known to make users feel energetic, happy, and talkative. 

Many people who habitually use cocaine develop a condition not unlike amphetamine psychosis, the symptoms of which include paranoia, confusion and the feeling of insects crawling under the skin, also known as “coke bugs.” 

Differing ingestion techniques come with their own symptoms. Snorting coke can cause a loss of sense of smell, nose bleeds, problems swallowing and an inflamed, runny nose. Smoking cocaine causes lung damage and injecting it puts users at risk of contracting infectious diseases. Heavy users report thoughts of suicide, unusual weight loss and trouble maintaining relationships.

When used habitually, because of its highly addictive nature, coke can change brain structure and function. Circuits within the brain structure that play a part in stress levels become more sensitive. When cocaine is absent, this increases an individual’s feelings of displeasure and negative mood swings. 

Additional withdrawal symptoms are exhaustion, hypersomnia, increased appetite, restlessness, irritability, lethargy, emotional lability, poor concentration, and bowel issues. In 2019, the CDC reported over 16,000 deaths from cocaine overdose in the US alone.

A study consisting of over one thousand US residents who had used cocaine within the previous 24 months for the first time was conducted. It was found that the risk of becoming dependent on cocaine within two years of first use was 5–6%. The risk of becoming dependent within 10 years of first use increased to 15–16%. 

Among recent-onset users individual rates of dependency were higher for smoking (3.4 times) and much higher for injecting. Women were 3.3 times more likely to become dependent, compared with men. Users who started at ages 12 or 13 were four times as likely to become dependent compared to those who started between ages 18 and 20.

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