Cocaine: tolerance and dependence
People who use cocaine can develop a tolerance to the euphoric effects of cocaine very quickly. This makes it necessary to take more and more cocaine to get the same effect.
In contrast, some people who use cocaine regularly may develop a ‘reverse tolerance’, whereby they experience the adverse effects of cocaine more intensely.
Dependence on a drug can be psychological, physiological, or both.
A person who is psychologically dependent on cocaine finds that using cocaine becomes more important than other activities in their life. Because of its powerful euphoric effects, people who use cocaine may develop a strong psychological dependence upon it.
Physical dependence on a drug occurs when a person gets used to functioning with the drug present. It is less clear as to whether it is possible to develop a physiological dependence on cocaine.
Withdrawal
If a person who is dependent on cocaine suddenly stops taking it, or significantly cuts down the amount they are using, they can experience withdrawal symptoms.
Cocaine withdrawal generally occurs in three phases: the ‘crash’; the ‘withdrawal’; and the ‘extinction’.
The crash, which usually occurs in the first few days, describes the withdrawal symptoms experienced immediately after the person stops using cocaine. Symptoms can include:
- agitation;
- depression or anxiety;
- feelings of intense hunger;
- intense craving for cocaine;
- insomnia or prolonged, but disturbed, sleep; and
- extreme fatigue and exhaustion.
The withdrawal phase may last up to 10 weeks. During this phase, people experience severe cravings for cocaine. Other withdrawal symptoms during this phase include:
- lack of energy;
- anhedonia (inability to feel pleasure);
- anxiety; and
- angry outbursts.
The extinction phase may last indefinitely. It involves intermittent cravings for cocaine. These generally occur in response to people, places or objects that are conditioned cues and provoke memories of taking the drug. These cravings may surface months or years after cocaine use has stopped.
Treatment options
In Australia, there are a number of drug treatment options. Some aim solely for the person to achieve a drug-free lifestyle, while others recognise abstinence as one option in an overall aim of reducing harm and risks related to the person's drug use.
Treatment options include counselling, group therapy, withdrawal (detoxification) and medication (pharmacotherapy). Residential and supervised/home withdrawal programmes are available.
Treatment is more effective if tailored to suit a person's circumstances and usually involves a combination of methods.
For referral to a treatment service, contact the alcohol and drug information service in your state or territory.
For more information, please click on the Australian Drug Foundation's DrugInfo Clearinghouse web site link below.
Last Reviewed: 21 March 2007
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