Cocaine’s dangers tend to be misrepresented or underrepresented in media and popular culture. The drug is portrayed as fun or glamorous. Withdrawal is portrayed as dramatic and agonizing. Neither of these images is accurate.
Use may seem pleasurable at first, but every cocaine hit causes serious damage. Even a first or single use of cocaine can be deadly or have other serious consequences. A first or single hit can set the stage for addiction. BBC News shares, “Taking cocaine can change the structure of the brain within hours in what could be the first steps of drug addiction.” The longer the drug is used, the more changes occur. These changes are both mental and physical. They contribute to dependence and addiction. For example some of the longer-term effects include serious changes in brain function and neurochemistry. The National Institute on Drug Abuse (NIDA) shares that many of these changes involve glutamate. Cocaine causes, “profound changes in glutamate neurotransmission—including how much is released and the level of receptor proteins—in the reward pathway.” Cocaine makes it more difficult for individuals to experience pleasure and reward without the drug. It also changes how individuals experience stress. NIDA explains that cocaine also affects, “a critical integration site in the brain that relays information about both stress and drug cues to other areas of the brain, including ones that drive cocaine seeking…Cocaine elevates stress hormones, inducing neuroadaptations that further increase sensitivity to the drug and cues associated with it.” Cocaine causes stress. It also causes the brain and body to crave more cocaine in response to this stress. Cocaine use reinforces itself. It does so through pleasure channels, stress channels and by changing how individuals think and make decisions. NIDA shares, “Cocaine diminishes functioning in the orbitofrontal cortex (OFC), which appears to underlie the poor decision-making, inability to adapt to negative consequences of drug use, and lack of self-insight shown by people addicted to cocaine.” Changes caused by cocaine explain why it is hard for individuals to stop using or why they won’t choose to try stopping at all. Changes in brain chemistry lead to changes in thought and behavior. They lead to excuses for continued use and explain why cocaine withdrawal is challenging.
Cocaine withdrawal involves few of the symptoms associated with withdrawal from drugs like opioids or alcohol. These substances creates potentially dangerous physical reactions. Because cocaine causes so many changes in how the brain functions, its withdrawal symptoms are largely psychological. They are no less serious for being so. They do require a different approach for treatment and management.
Cocaine withdrawal symptoms include depression, dysphoria, trouble sleeping and irritability. These seem mild compared to the physical pain, potential seizures and additional symptoms other drugs cause. Cocaine withdrawal symptoms are mostly psychological. They cannot be ignored for being less visible. Cocaine withdrawal is serious and difficult. It requires professional support and supervision as much as any other withdrawal experience. Addiction treatment needs to begin with supervised detox services. Psychiatry explains, “The presence of cocaine withdrawal symptoms may make it difficult for cocaine users to attain a period of initial abstinence…Patients who enter treatment with severe cocaine withdrawal symptoms are more likely to drop out of treatment prematurely and are less likely to attain abstinence from cocaine in outpatient treatment programs.” Cocaine’s psychological effects make withdrawal serious. This early phase of recovery sets the stage for successful long-term abstinence.
 https://www.drugabuse.gov/publications/cocaine/what-are-some-ways-cocaine-changes-brain. “What Are Some of the Ways Cocaine Changes the Brain?” National Institute on Drug Abuse. May 2016. Web.15 Feb 2017.
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2994240/#__sec2title. “New Medications for the Treatment of Cocaine Dependence.” Psychiatry. 2005. Web. 15 Feb 2017.
 http://www.nytimes.com/2010/08/31/health/views/31mind.html. “Lasting Pleasures, Robbed by Drug Abuse.” New York Times. 30 Aug 2010. Web. 15 Feb 2017.