Therapeutic Approaches for Cocaine Addiction

Cocaine use in the United States is prevalent, with about 5 million people reporting cocaine use in 2023. Cocaine is highly addictive and comes with many risks, both short and long-term. Overcoming cocaine addiction requires treatment, which involves several evidence-based therapeutic approaches that can help people to achieve sobriety and to navigate a successful long-term recovery.

What Is Cocaine?

Cocaine is a stimulant derived from the coca plant, and comes in white powder form, or as a synthesized crystal, known as crack. Its effects are euphoria and a feeling of energy which only last for a short time. It does have limited approved medical uses, but its use today is mostly illicit.

Short and Long-Term Dangers of Cocaine

Cocaine causes many immediate physiological effects that can lead to health consequences. These effects include:

• Dilated pupils
• Constricted blood vessels
• Increased heart rate
• Increased body temperature
• High blood pressure

Constricted blood vessels can lead to decreased appetite, stomach pain, nausea, vomiting, and constipation. The increased heart rate and blood pressure can increase the risk of a heart attack.

In the short-term cocaine can also cause a person to become erratic and violent, which can lead to reckless behavior and the potential for injury.

Long-term regular cocaine use can wreak havoc on multiple parts of the body.

• Nose, mouth, throat: Snorting cocaine damages the mucus membranes in the nasal system, which can lead to damage to the tissues and cartilage in the nose, and even a perforation of the septum. Snorting can also cause nose bleeds and difficulty swallowing.
• Heart: Chronic cocaine use can lead to coronary artery disease, permanently elevated blood pressure, arrythmias, congestive heart failure, heart attack, and stroke.
• Respiration: Smoking cocaine keeps oxygen from being transported to the body, causing a risk of pneumonia, respiratory distress, and asthma.
• Brain: Cocaine reduces oxygen flow to the brain, which can lead to brain damage, aneurysms, strokes, and seizures. It can also impair cognitive functioning and memory.
• Gastrointestinal system: Reduced blood flow can lead to ulcers and damage to the intestines.
• Kidneys and liver: Prolonged cocaine use can lead to kidney and liver damage.

Cocaine Addiction

If you are a cocaine user but are not sure if you’re addicted to cocaine and need treatment, you can use the formal definition of cocaine addiction as specified in the Statistical Manual of Mental Disorders to evaluate your situation. According to this definition there are 11 criteria that determine if an addiction is present.

• Using cocaine more than intended or for longer than intended
• Wanting to reduce or stop cocaine use but not being able to
• Spending excessive amounts of time using cocaine or recovering from using cocaine
• Feeling cravings for cocaine
• Failing to live up to responsibilities due to cocaine use
• Having relationship problems because of cocaine use
• Giving up activities that you enjoy in order to use cocaine instead
• Engaging in risky behaviors like driving while under the influence of cocaine
• Continuing to use cocaine in spite of negative consequences like health issues
• Needing more cocaine to get the same effects
• Having withdrawal symptoms when you are not using cocaine

Having two to three of these symptoms indicates a mild cocaine use disorder, four to five is considered moderate, while six or more is severe.

Therapies for Cocaine Addiction

Treatment programs usually include several types of therapy, both individually and in groups. Group therapy is essential, allowing peers to learn together and from each other while forming mutually supportive relationships.

The therapeutic approaches that have proven to be effective include:

• Motivational Interviewing: This approach involves helping you to set personal goals for your recovery, and to build your motivation to achieve those goals. This increases your willingness to engage fully in your treatment plan. It works by exploring how cocaine has disrupted your life, and what will drive you to get better, whether it’s your children, your health, or some other aspect of your life.
• Contingency Management: This approach involves positive reinforcement for your good behaviors, such as passing a drug test. You receive some sort of reward for that good behavior, which essentially retrains your brain to expect rewards for the right reasons.
• Community Reinforcement: This approach involves creating a supportive network for you and encouraging you to engage within this community. It may include relationship or family counseling, life skills training, and more.
• Cognitive Behavioral Therapy (CBT): CBT focuses on changing negative or irrational thought patterns into positive, reality-based thoughts. It also teaches healthy coping strategies.
• Dialectical Behavioral Therapy (DBT): DBT is similar to CBT but focuses on accepting negative emotions and learning skills to change negative behaviors. It involves learning mindfulness, emotional regulation, and distress tolerance.
• Relapse Prevention Therapy: This approach involves identifying specific relapse risks and triggers, meaning situations and emotions that put you at risk of relapse. It teaches you how to handle those risks, both with your thoughts, and with specific behaviors.

Treatment Levels for Cocaine Addiction

Treatment comes in three levels, which may be standalone treatments, or preferably, combine into a sequential, comprehensive treatment plan.

Inpatient Treatment

A 30 to 90 day inpatient treatment program includes a period of detox, in which you are kept safe and comfortable while withdrawing from cocaine, and intensive therapy, both individual and in groups. You may also be treated for any co-occurring disorders that you may have, such as anxiety and depression. Medication may be part of the treatment for co-occurring disorders.

Partial Hospitalization Programs (PHPs)

A partial hospitalization program (PHP) allows you to live at home while attending treatment for four to six hours per day, five days a week. The program may last anywhere from four weeks to ten weeks. The treatment consists of therapy similar to that of inpatient treatment, both in groups and individually.

Intensive Outpatient Programs (IOPs)

An intensive outpatient program (IOP) consists of two to three hours of therapy several days a week for eight to twelve weeks. Often, sessions are held in the evenings so that you can still go to work or attend school. Treatment, again, involves individual and group therapy.

Comprehensive Treatment

The most effective treatment for cocaine addiction, particularly if it is severe, is a comprehensive treatment program that consists of an inpatient program, a PHP, and an IOP. Research shows that success rates increase the longer the treatment program. Even after IOP, support should continue through support groups, individual therapy, or both. Recovery from cocaine addiction, or any addiction, is a lifelong process that requires dedication and a strong support network.

In Closing

Cocaine addiction can disrupt your life and affect your health, but several therapeutic approaches to treating cocaine addiction have proven to be effective. If you are ready to get your life back on track, Bridges of Hope is here to help with several treatment options. We are dedicated to providing compassionate, comprehensive care and support so that you can live a healthier, more fulfilling life. Give us a call today.