Cocaine – Systems Viewpoint from Mary-Therese Kelly

Cocaine addiction remains a crisis level problem...
Mary-Therese Kelly, Executive Director of Inpatient Services for Serenity at Summit (Courtesy photo)

Currently, National attention is focused on the opioid crisis, however, it is essential to remember the larger picture of substance use in the United States. Cocaine addiction remains a crisis level problem affecting all levels of our society.  

Cocaine affects most individuals in similar ways. A person who is dependent / addicted to cocaine rarely reaches the same high as the first time they use. The consequences of this potentially deadly cycle include: increased tolerance and drive for more, decreased focus on a structured daily life, anger and resentment toward the people trying to facilitate help, and the surfacing of depression, anxiety and other mental health symptoms.

Short term effects of cocaine use include alertness, elevated mood, irritability, restlessness, and paranoia. Physical effects may include: addiction, chest pain, nausea; raise in temperature, pulse, and blood pressure; and also, tremors. Chronic users may suffer malnutrition, high blood pressure, increased risk of heart attack, impaired immune function with higher risk of HIV and Hepatitis C. In addition, chronic use by snorting will often lead to erosion of the nasal passages.  Paranoia may increase and lead to hallucinations. Withdrawal symptoms include anxiety, depression, fatigue, mood swings, and sleep problems. 

Cocaine use during pregnancy may cause migraines, seizures, placental abnormalities, premature rupture of membranes, preterm labor, miscarriage, neonatal abstinence syndrome (child’s drug/alcohol withdraw following birth), hypertensive crisis.       

Deadly consequences of cocaine abuse and toxicity include cardiac arrhythmias (abnormal heart rhythm), sudden cardiac arrest, convulsions, strokes, and death.

Our role is to help patients navigate the various systems that affect their lives: family, community, society, school, and spiritual community / church. As time moves on and the disease progresses, all areas of the individuals’ life in each system are diminished: interpersonal relationships become negative in focus and lack intimacy, sleep is disrupted, mental health symptoms surface and increase, employment is disrupted or terminated, financial security becomes elusive, outside supports become unimportant, creative pursuits do not get attended to, and a drive for connecting spiritually / religiously is not there.

Cocaine addiction and its related problems exist and are also tracked on a societal level. The Centers for Disease Control, National Institute on Alcohol Abuse, and Alcoholism (NIAAA), and National Center for Health Statistics report in 2016: Tobacco-related deaths 480,000; alcohol related deaths 88,000; opioid overdoses 42,000; cocaine overdoses 10,619.

Center for Disease Control (CDC) National Center for Health Statistics reported the lowest number of cocaine overdoses in 2010, however, this number has unfortunately risen to over 10,000 in 2016. 63% of cocaine overdose deaths also involved opioid use. The combination of cocaine and heroin is known as “speed balling”; this is especially hazardous with the addition of fentanyl into many heroin products by distributers. Users may be under the mistaken impression that adding a stimulant drug like cocaine to an opioid will protect them from the respiratory depression that can cause death with opioid overdose. Cocaine is also particularly dangerous to use with alcohol, because the by-products formed worsen the toxic effects on the heart and circulatory system.

Cocaine availability and use in the United States increased across multiple fronts between 2014 and 2015 and is likely to continue increasing, according to the DEA 2016 National Drug Threat Assessment Summary.

The Surgeon General’s Report on Alcohol, Drugs and Health 2016 reports that 36 million people were current crack / cocaine users, or 1.8 % of the population.  The National Highway Transportation Safety Administration reports that one in five drivers tested positive for drugs in 2014, including cocaine. The National Council on Alcoholism and Drug Dependence(NCADD) reports that alcohol and drugs are implicated in an estimated 80% of offenses leading to incarceration in the United States such as domestic violence, driving while intoxicated, property offenses, drug offenses, and public-order offenses.

Currently there are no FDA approved medications available specifically for cocaine addiction. Disulfiram (Antabuse) has shown some positive results in supporting and maintaining abstinence from cocaine. In addition, researchers have developed and conducted some tests on a cocaine vaccine that could reduce the risk of relapse.

Serenity at Summit provides multiple levels of treatment.  They offer inpatient detox and residential in New Jersey and Massachusetts and also several outpatient options are available and effective for stimulant use disorders. Sustained recovery is very possible.

Serenity at Summit addiction treatment centers utilize all the approved treatments available to support long-term cocaine use disorder treatment and recovery. Assessment Screening, Brief Intervention, Motivational Interviewing, and our Holistic Services. Our holistic services include yoga, Tai Chi, meditation, massage, utilizing essential oils and aromatherapy.  Their holistic approach gives our patients and clients the opportunity to learn and implement self-care strategies, sometimes for the first time in their lives.  Holistic treatment can relieve the difficult symptoms that often accompany early recovery such as; anxiety, stress, fears, worries, restlessness, inability to sleep, depression, lack of motivation, and other withdraw symptoms associated with acute withdraw and post-acute withdraw (PAWS).  They focus on creating a personal and individualized treatment experience while also implementing an environment for a person to begin the process of lasting recovery.

It is important for them to review resources and information about each substance that affects our patients. This systems level perspective will add to our knowledge base and increase the avenues in which we think about services, treatment, and solutions.

At Serenity at Summit we assess the needs of and treat individuals with all Substance Use Disorders says Mary-Therese Kelly

 

References:

https://www.dea.gov/resource-center/2016%20NDTA%20Summary.pdf    Accessed 1/ 2018

https://www.jwatch.org/fw113601/2017/12/05/cocaine-accounts-substantial-overdose-burden-among-black

https://www.drugabuse.gov/publications/finder/t/162/research-reports

https://www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers

https://medlineplus.gov/cocaine.html

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016.

Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/

 https://www.ncadd.org/about-addiction/alcohol-drugs-and-crime  (Accessed 1/2018)

https://americanaddictioncenters.org/rehab-guide/addiction-statistics/   (Accessed 1/2018)

https://www.nhtsa.gov/risky-driving/drunk-driving   (Accessed 1/2018)

 


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