What is cocaine abuse and dependence?

Cocaine is made from the leaves of the coca plant, which grows in South America. It is a type of drug called a stimulant, which means it increases alertness and energy. Cocaine can be inhaled through the nose in powder form (“snorting”), injected into a vein, or smoked. Crack, a less expensive form of cocaine that is smoked, has made cocaine abuse a widespread problem.

Cocaine abuse and dependence are patterns of using drugs that lead to serious personal, family and health problems. Abuse is when your child keeps taking cocaine even though it causes a problem such as:

• Showing up late or missing work or school and not caring about things that used to matter to him
• Breaking rules or breaking the law
• Not keeping promises, arguing, or even getting violent with other people
• Doing things that are dangerous, such as driving while under the influence

If your child continues to abuse cocaine, he can become dependent. When your child is dependent on cocaine, he:

• Needs to use more and more cocaine or use it more often to get the same effects
• Loses control, which means he keeps using cocaine even though he knows that it is harmful to him or others or he can’t stop using cocaine when he tries
• Craves drugs so much that he spends a lot of time and energy getting drugs, using drugs, and getting over the effects
• Has withdrawal symptoms when he stops using cocaine

Dependence is also called addiction. Cocaine is one of the most addictive drugs. If your child uses cocaine a few times, he can become dependent.

What is the cause?

The brain makes chemicals that affect thoughts, emotions, and actions. Cocaine changes the balance of these chemicals in your child’s brain. When he uses cocaine regularly, his brain starts to get used to it. As a result, your child doesn’t feel right unless he uses cocaine. When he stops using cocaine suddenly, the balance of chemicals in his brain changes, which causes the symptoms of withdrawal.

Your child has a higher risk of becoming dependent on drugs if he:

• Has a family history of drug or alcohol abuse
• Has abused alcohol or drugs in the past
• Is easily frustrated, has trouble dealing with stress, or feels like he isn’t good enough
• Is regularly around people who use alcohol or drugs
• Has a mental health problem
• Has constant pain

What are the signs of cocaine abuse?

The symptoms of cocaine abuse or dependence depend on how much and how often your child uses cocaine. The symptoms can be mild to severe, such as:

• Being overexcited, nervous, or having extra energy
• Having belly pain, nausea, or loss of appetite
• Talking and thinking fast, called “speeding”
• Having a fast heartbeat or sweating
• Seeing, hearing, or feeling something that is not there
• Thinking that others are out to get him when they are not

If your child snorts cocaine, your child may have:

• Sores or broken skin in or around his nose
• Nosebleeds
• A constant runny nose

If your child smokes cocaine, your child may have symptoms of a lung infection, such as a cough or mucus in his lungs.

Your child may also have symptoms of new or worse health problems caused by cocaine use. Health problems caused by cocaine include heart problems, seizures, or a stroke.

The symptoms of cocaine withdrawal can be mild to severe. Your child may have some of these symptoms when he stops taking cocaine:

• Nervousness and restlessness
• Depression
• Cravings for cocaine
• Sleep problems

The feelings that your child gets from cocaine only last a short time. This causes your child to crave more cocaine to get the feelings back. Your child may binge, which means your child take large amounts of cocaine for several days. The binge is followed be a “crash,” where your child feels very sad and depressed. Then your child starts all over again. This pattern of cocaine use can lead to an overdose. A cocaine overdose can be life threatening.

Pregnant girls using cocaine are at high risk of having a miscarriage. Babies born to cocaine-dependent mothers are addicted at birth. The baby will be jittery and will not respond well to people. Cocaine dependent babies have to go through the painful process of withdrawal.

How is it diagnosed?

Your healthcare provider will ask how much and how often your child uses cocaine. Your child needs to be honest about his drug use. Your provider needs this information to give your child the right treatment. He or she will also ask about your child’s symptoms, medical history and give your child a physical exam. Your child may have blood or urine tests.

How is it treated?

Cocaine abuse and dependence can be treated. For any treatment to be successful, your child must want to stop using cocaine. When your child stops using cocaine, his or her healthcare provider may prescribe medicine to help get through withdrawal symptoms. Your child should not use alcohol and other drugs to reduce withdrawal symptoms.

If your child is abusing or dependent on cocaine and wants to quit, get help.

Self-help groups such as Cocaine Anonymous, support groups, and therapy may be helpful. Your child might be treated in a substance abuse treatment program. Your child’s healthcare providers and counselors will work with you and your child to develop a treatment program. If this therapy does not work, your child may need treatment in a hospital or a treatment center. Your child may need to stay for several weeks, or your child may be able to go in each day.

Recovery from dependence is a long-term process. Follow-up treatment is very important so that your child doesn’t go back to abusing drugs.

If your child has overdosed, or is having severe withdrawal symptoms he will need to be treated in a hospital. He will also be treated for any health problems such as a heart attack or stroke, or other life-threatening problems.

How can I help prevent cocaine abuse and dependence?

You can help prevent cocaine abuse if you:

• Teach your child how to make good choices about alcohol and drugs. Teach in a way that fits your child’s age and ability to understand.
  • If you are watching TV with your 6-year-old and cocaine is mentioned on a program, you can say, “Do you know what cocaine is? It’s a bad drug that can hurt your body.” If your child has more questions, answer them. If not, let it go. Short, simple comments, that are repeated often, will get the message across.
  • For your 12-year-old, you might explain what cocaine and crack look like, the different names for cocaine, and how using cocaine will change his or her brain and body. Repeat the message. Talk to your child about drugs whenever you can.
• Listen to your child’s feelings and concerns, so that they feel comfortable talking with you.
• Make your family position on drugs clear. For example “In our family, we don’t use drugs and the children are not allowed to drink alcohol.” Set a good example. Your child is much more likely to use drugs if you use drugs, even if you tell them not to.
• Talk about what makes a good friend. Peer pressure is a big part of why kids get involved with drugs and alcohol. Help your child understand that friends who pressure them to drink or use drugs aren’t friends at all. Role-play ways for your child to say no to drugs, for example:
  • Say, “no, thanks” and walk away.
  • Suggest something else to do, such as go play a video game.
  • Use humor, such as “No thanks. If I want to fry my brain, I’ll get a skillet.”
• Build self-esteem. Children who feel good about themselves are much less likely to turn to drugs. Offer lots of praise for a job well done. If you need to criticize or discipline your child, talk about the action, not the child. For example, instead of saying “you should know better” try saying, “what you’re doing is not safe.” Set aside time every day to talk, play a game, or take a walk with each of your children.

People and resources in your community that can help include your healthcare providers, therapists, support groups, mental health centers, and alcohol or substance abuse treatment programs. You may want to contact:

• National Council on Alcoholism and Drug Dependence
  800-622-2255
  http://ncadd.org