Cocaine - Treatment for Habitual Users

Treatment for Habitual Users

In an article for the New York Times, Linda Carroll reported that certain people are more likely to become addicted to cocaine than others. The reason for this seems to be some sort of inborn flaw in the brain's wiring. "The leading suspect," noted Carroll, "is a defect in the dopamine system." Studies conducted on monkeys seem to back up this theory. Five monkeys involved in a Wake Forest University medical school experiment were allowed to take cocaine whenever they wanted for a whole year. At the end of the year, the "addicted monkeys ended up with a 15 percent to 20 percent decrease in dopamine receptors," wrote Carroll. The five monkeys were reexamined nine months after the conclusion of the experiment. The brains of three of them had returned to normal, but the brains of the other two still had lower-than-normal amounts of dopamine receptors in them.

Addicts and Addiction

Some people believe that drug addiction is a voluntary behavior—that addicts simply choose to use drugs again and again. However, with continued use over a period of weeks or months, a person can go from being a voluntary drug user to being a compulsive, out-of-control drug user. Addictive drugs can actually change the brain in ways that result in more and more drug use.

Drug use is a very hard habit to break, even for the most determined individuals. It really does not matter which drug a person is abusing. In general, many drugs of abuse have similar effects on the brain. Such effects are discussed in Alan I. Leshner's article "Exploring Myths about Drug Abuse" on the NIDA Web site. Among the effects are:

  • changes in the chemical makeup of brain cells
  • a shift in mood
  • transformation in memory processes
  • alteration of motor skills needed to walk and talk.

These changes greatly impact the addict's behavior. The user's biggest motivation in life becomes obtaining and using the drug. Such behavior is not the result of a weak will or a character flaw. Rather, the drug use has caused major changes in the structure and the functioning of the user's brain—changes that are beyond the user's control.

The biggest challenge to cocaine treatment and rehabilitation is preventing relapse (the return to using drugs) caused by a persistent and intense craving for cocaine. Although cocaine addiction can be treated successfully, there is no single program that is effective for

Frustrated by her failed attempts to give up crack cocaine, a young woman intentionally cut her arm. Addiction to crack is a hard habit to break even when the individual is determined to succeed. Brenda Ann Kenneally/Corbis.
Frustrated by her failed attempts to give up crack cocaine, a young woman intentionally cut her arm. Addiction to crack is a hard habit to break even when the individual is determined to succeed. © Brenda Ann Kenneally/Corbis.

everyone. NIDA recommends a dual approach to treatment, healing both the body and the mind. It suggests behavioral therapies, medications, rehabilitation, and social services. The idea is to treat the whole person.

Regarding medication, NIDA research reports that medications that act on dopamine receptors might reduce the intense craving and depression in former cocaine users. Behavioral therapies can include group and/or individual counseling, popular twelve-step programs, and chemical dependency inpatient and outpatient programs.

A Drug Enforcement Administration (DEA) agent stands guard next to 5,137 pounds of cocaine seized from a Panamanian vessel near Miami, Florida. AP/Wide World Photos.
A Drug Enforcement Administration (DEA) agent stands guard next to 5,137 pounds of cocaine seized from a Panamanian vessel near Miami, Florida. AP/Wide World Photos.

A Simple but Promising New Treatment Approach

On January 5, 2005, the National Institutes of Health (NIH) announced that peer counseling actually helped reduce cocaine and heroin abuse. The study was conducted by doctors at Boston University Schools of Medicine and Public Health and involved 1,175 male and female drug abusers. The process took only twenty minutes and consisted of "a motivational interview with a substance abuse outreach worker who also was a recovering addict," according to the NIH press release.

Members of the study were also given referrals to drug abuse treatment programs and a list of different types of treatment methods. In addition, they received a phone call ten days later to check on their progress. These simple interventions motivated a significantly higher percentage of abusers to stay away from drugs over a six-month period.