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Cocaine dependence

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Cocaine dependence

Cocaine dependence is a neurological disorder that is characterized by withdrawal symptoms upon cessation from cocaine use. It also often coincides with cocaine addiction which is a biopsychosocial disorder characterized by persistent use of cocaine despite substantial harm and adverse consequences. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) classifies problematic cocaine use as a stimulant use disorder. The 11th revision of the International Classification of Diseases (ICD-11) includes "Cocaine dependence" as a classification (diagnosis) under "Disorders due to use of cocaine".

The use of cocaine creates euphoria and high amounts of energy. If taken in large doses, it is possible to cause mood swings, paranoia, insomnia, psychosis, high blood pressure, a fast heart rate, panic attacks, seizures that are extremely difficult to control, cognitive impairments and drastic changes in personality. Cocaine overdose may result in cardiovascular and brain damage, such as: status epilepticus, constricting blood vessels in the brain, causing strokes and constricting arteries in the heart; causing heart attacks.

The symptoms of cocaine withdrawal range from moderate to severe and includes symptoms such as dysphoria, depression, anxiety, decreased libido, weakness, pain, and cravings to consume more cocaine.

Cocaine is a powerful stimulant known to make users feel energetic, cheerful, talkative, etc. In time, negative side effects include increased body temperature, irregular or rapid heart rate, high blood pressure, increased risk of heart attacks, strokes and even sudden death from cardiac arrest.[self-published source] Many people who habitually use cocaine develop a transient, manic-like condition similar to amphetamine psychosis and schizophrenia, whose symptoms include aggression, severe paranoia, restlessness, confusion and tactile hallucinations; which can include the feeling of something crawling under the skin (formication), also known as "coke bugs", during binges. Different ingestion techniques have their own symptoms that accompany them. Snorting it can cause a loss of sense of smell, nose bleeds, problems swallowing and an inflamed, runny nose. Smoking it causes lung damage and injecting it puts users at risk of contracting infectious diseases like HIV and hepatitis C. Heavy users of cocaine have also reported having thoughts of suicide, unusual weight loss, trouble maintaining relationships, and an unhealthy, pale appearance.

Assessment tools like the Obsessive Compulsive Cocaine Use Scale (OCCUS) may be employed to quantify obsessive and compulsive thoughts related to cocaine consumption; it has been used and validated in a clinical study with cocaine-dependent individuals.

Cocaine-induced midline destructive lesions (CIMDL), colloquially known as "coke nose", is the progressive destruction of nasal architecture with the erosion of the palate, nasal conchae, and ethmoid sinuses associated with prolonged insufflation, colloquially 'snorting', of cocaine.

When used habitually, cocaine can change brain structure and function, resulting in addiction. Circuits within the brain structure that play a part in stress signals become more sensitive. When cocaine is not being used this increases an individual's displeasure and negative moods. In 1986, Gawin and Kleber led an important study on the withdrawal symptoms of cocaine users. In this study, three distinct phases were reported. These phases are the 'crash', 'withdrawal' and 'extinction'. The 'crash' phase or phase 1 occurs directly after cocaine is not being used anymore. Withdrawal symptoms for this phase are exhaustion, hypersomnia, no cravings to use, dysthymia, increased appetite, restlessness, and irritability. The second phase, or 'withdrawal' phase occurs 1–10 weeks after cocaine users quit. Symptoms include lethargy, anxiety, erratic sleep, strong craving, emotional lability, irritability, depression, poor concentration, and bowel issues. Finally, the last phase or the 'extinction' phase occurs up to 28 weeks after discontinued use. Symptoms include episodic cravings and some dysphoria.

In the United States, past year cocaine users in 2019 was 5.5 million for people aged 12 or older. When broken into age groups, ages 12–17 had 97,000 users; ages 18–25 had 1.8 million users and ages 26 or older had 3.6 million users.

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