Cocaine and Crack Abuse

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

What is the treatment for cocaine and crack addiction?

An unfortunate aspect of the treatment of cocaine and other substance-use disorders is that it continues to be unutilized by most addicted individuals. For example, less than 40% of those with a substance-use disorder receive treatment. That statistic seems to be independent of socioeconomic or other demographic characteristics but seems to be associated with the presence of other mental-health disorders (comorbidity).

The primary goals for the treatment of addiction (also called recovery) are abstinence, relapse prevention, and rehabilitation. When the addicted individual first refrains from using drugs, he or she may need help avoiding or lessening the effects of physical withdrawal. That process is called detoxification or detox. That aspect of treatment is usually conducted in a hospital or other inpatient setting (often called detox facilities), where medications used to decrease withdrawal symptoms can be given and frequent medical assessments can be performed. The medications used as part of detox depend on the substance the individual is dependent upon. As with many other drugs of abuse, the detox process from cocaine is the most difficult part of coping with the physical symptoms of addiction and tends to last for days. Medications that are sometimes used to help cocaine addicts refrain from using drugs use include propranolol (Inderal, Inderal LA, InnoPran XL), which decreases some of the physical symptoms associated with cocaine withdrawal, as well as vigabatrin (Sabril), a medication that treats seizures. Some medications may help reduce the likelihood that a person with cocaine addiction relapses. Examples of this include another antiseizure medication like topiramate (Topamax) and antidepressants like citalopram (Celexa).

Often much more complicated, challenging, and time-consuming than recovery from the physical aspects of cocaine addiction is treatment of the psychological addiction. Individuals who seem to have less severe psychological symptoms of cocaine dependency may be successfully treated in an outpatient treatment program. People who have a more severe addiction, have relapsed after participating in outpatient programs, or also suffer from a severe mental illness might need the higher level of structure, guidance, and monitoring involved in an inpatient drug treatment center, often referred to as "rehab." After inpatient treatment, many cocaine addicts may need to live in a sober-living community, that is, a group-home setting where counselors provide continued sobriety support and structure on a daily basis.

Research indicates that every aspect of treatment is improved when the customs and culture of treatment recipients are considered and incorporated into the process. Another important part of treating cocaine addiction is helping family members and friends of the addicted person avoid supporting addictive behaviors (codependency). Since codependent loved ones may provide financial support, make excuses for the drug use, or fail to acknowledge the addictive behaviors of the cocaine addict, discouraging such codependency of loved ones is a key part of the recovery of the affected person. Focusing on the cocaine-addicted individual's role in the family and friend groups likely becomes even more urgent when that person is a child or teenager, given that minors almost always come within the context of a family, and teens' identities tend to be intimately related to their friend groups. Cocaine dependency treatment for children and adolescents differs further from that in adults by the younger addict's tendency to need help completing their education and considering higher education or job training compared to addicts who may have completed those life goals before developing the addiction.

While treatment of cocaine-use disorder with acupuncture has been explored somewhat, there has yet to be large scale evidence of its effectiveness.

Medically Reviewed by a Doctor on 1/25/2016

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