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Cocaine: Tolerance, Dependence and Withdrawal

Cocaine is often taken in conjunction with other drugs to offset the negative side effects of the former. Hence tranquillizers, alcohol, marijuana, and heroin are often used to bring the user “down” and to help them sleep.

This unfortunate situation means that the regular cocaine user who is dependent on the drug now finds him or herself dependent or a raft of other legal and illegal medications.

Use of cocaine during pregnancy increases the risk of miscarriage, or if the baby is carried to full term, may result in a low birth weigh baby, premature delivery, and signs of cocaine withdrawal in the newborn.

Tolerance can be developed by any user and as mentioned in previous articles (see links below) it comes on slowly and insidiously. Tolerance to a drug simply means that additional amounts are required to obtain the same effects.

Dependence on the other hand means that much of the person’s time is used in thinking about taking the drug, thinking about obtaining the drug, undertaking activities associated with buying and using the drug, difficulties in interpersonal relationships as a result of the obsessive thoughts associated with dependence. See the link below for the diagnostic criteria for dependence.

Cocaine-dependent users may find it difficult to withdraw from the drug due to the range and intensity of withdrawal symptoms. These include cravings for cocaine, feeling angry and emotional, vomiting and nausea, uncontrolled shaking, weakness, tiredness, disturbed sleep, muscle spasms, depression and suicide ideation.

Withdrawal from cocaine often produces feelings of apathy and boredom, which is a potentially dangerous psychological situation since it encourages the person attempting to withdraw to have another hit of cocaine to get back that wonderful all-powerful high. However, in most cases, symptoms are usually short-lived and don’t commonly require additional medication, but may involve the assistance of a specialized drug rehab unit.


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