Crack Cocaine Addiction Treatments

Crack cocaine is a potent brain stimulant and one of the most powerful addictive drugs of abuse. Crack cocaine produces euphoria by causing the brain to release higher than normal amounts of dopamine, a neurotransmitter linked to excitement related to new experiences and pleasure (A neurotransmitter is a chemical that sends signals from one nerve cell to another). Dopamine controls the part of the brain that seems to say "do it again", and taking one dose often leads to the desire for another.

With the increasing use of cocaine as an illicit stimulant since the late 1960s, a complex health problem has emerged: dependence and addiction to cocaine or crack (processed cocaine to be smoked), that requires medical treatment and a control of withdrawal, usually a main obstacle for the recovery of addiction.

Withdrawal symptoms affect people accustomed to regular cocaine use who either decrease their use or stop taking the substance completely. Because once it reaches the brain reward system, cocaine affects neurotransmitters, the chemicals control the flow of information within the brain between the neurons or brain cells, forming a synapse, and alter people's moods and feelings. Crack cocaine mainly acts on dopaminergic and serotonergic neuro-receptor systems, as it blocks the dopamine transport sites, which are responsible for the reuptake of dopamine in dopaminergic synapeses in this region. Therefore, dopamine is not removed from the synaptic gap, and it remains free there, in ever increasing amounts, because successive nervous stimuli continue to arrive and to release dopamine. The effect remains until cocaine is removed from the presynaptic terminals.

It is believed that the abnormally long presence of dopamine in the brain is responsible for the pleasure effects associated to the use of cocaine. The prolonged use of cocaine makes the brain to adapt to it, and the overall synthesis of dopamine by the neurons is decreased. Between cocaine doses, or when the use of cocaine is interrupted, the drug user experiences the opposite of pleasure, due to the low levels of dopamine: fatigue, depression and altered moods, all of them symptoms of withdrawal.

Summing up, with chronic use of cocaine or crack, the brain shows a change in its circuitry, and it only functions normally under the effects of cocaine. Only when the use of the substance is suddenly stopped do brain disorders ensue, known as withdrawal or abstinence syndrome. The withdrawal symptoms are relieved by taking cocaine again, and that is what makes hard for dependents to abandon use.

Signs and symptoms of crack cocaine withdrawal

Crack cocaine withdrawal is not as physically evident as withdrawal from other highly addictive drugs: there are often no visible physical symptoms like the vomiting and shaking that accompanies heroin withdrawal or the seizures and delusions that can follow alcohol withdrawal. In the past, people used this lack of physical symptoms to argue that cocaine was not addictive, ignoring that each drug has it own unique effects, which in the case of cocaine and crack are very powerful, In fact, the compulsive drug-seeking behaviour, that is the behavioural hallmark of addiction, accompanies chronic use of cocaine earlier and in a more powerful way than many other illicit drugs.

Withdrawal from crack cocaine generally takes place in three phases. The first, called 'the crash', describes withdrawal symptoms experienced immediately after the cessation of use (usually the first 2-4 days of abstinence), and that it usually last from 4 to 7 days. Symptoms may include agitation, depression, high craving and fatigue. The physical symptoms include excessive sleepiness, excessive appetite, abdominal pain, chills tremors and aching muscles.

The second phase is that of withdrawal, and appears at 7-10 days after last use of crack cocaine. This phase may last up to 10 weeks and is characterised by depression, anhedonia, lack of energy and anxiety, high craving and angry outbursts. The last phase, extinction, may last for years after drug use has ceased, and is characterised by episodic cravings for cocaine, usually in response to conditioned cues.

Detoxification without withdrawal is possible

The harshness of the withdrawal syndrome leads to a very high risk of relapse during the early withdrawal period, in part because drug craving is easily triggered by encounters with or thinking of drug-associated stimuli. And that is why withdrawal is a main obstacle in crack cocaine addiction treatments must be carried out with an appropriate medical management and level of care.

But detoxification without withdrawal syndrome is possible. The crack cocaine withdrawal syndrome is NOT an imperative start to the drug treatment process. Ultra rapid crack cocaine addiction treatments are available at specialized centers since begining of 90s.

To avoid withdrawal syndrome, it is necessary to restore brain functions that have been damaged by addiction to cocaine. But this is not possible just with “traditional” detoxification. Neurons must be recovered. Only pharmacological intervention to recover the normal neural functioning of the brain structures harmed by cocaine, allow detoxification without withdrawal symptoms and without craving. Moreover, it allows the recovery of higher cognitive and affective processes such as attention, reading abilities, conciousness or serenity.

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