| 词条 | Cocaine dependence |
| 释义 |
| name = Cocaine dependence | synonyms = | image = | caption = | pronounce = | field = Psychiatry | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }}Cocaine dependence is a psychological desire to use cocaine regularly. Cocaine overdose may result in cardiovascular and brain damage, such as: constricting blood vessels in the brain, causing strokes and constricting arteries in the heart; causing heart attacks.[1] The use of cocaine creates euphoria and high amounts of energy. If taken in large doses, it is possible to cause mood swings, paranoia, insomnia, psychosis, high blood pressure, a fast heart rate, panic attacks, cognitive impairments and drastic changes in personality. The symptoms of cocaine withdrawal (also known as comedown or crash) range from moderate to severe: dysphoria, depression, anxiety, psychological and physical weakness, pain, and compulsive cravings. Signs and symptomsCocaine is a powerful stimulant known to make users feel energetic, happy, talkative, etc. In time, negative side effects include increased body temperature, irregular or rapid heart rate, high blood pressure, increased risk of heart attacks, strokes and even sudden death from cardiac arrest.[2] Many habitual abusers develop a transient, manic-like condition similar to amphetamine psychosis and schizophrenia, whose symptoms include aggression, severe paranoia, restlessness, confusion [3] and tactile hallucinations; which can include the feeling of insects under the skin (formication), also known as Formication"coke bugs", during binges.[4] Users of cocaine have also reported having thoughts of suicide, unusual weight loss, trouble maintaining relationships, and an unhealthy, pale appearance.[3] Withdrawal symptomsAfter using cocaine on a regular basis, some users will become addicted. When the drug is discontinued immediately, the user will experience what has come to be known as a "crash" along with a number of other cocaine withdrawal symptoms, including paranoia, depression, exhaustion, anxiety, itching, mood swings, irritability, fatigue, insomnia, an intense craving for more cocaine, and in some cases nausea and vomiting. Some cocaine users also report having similar symptoms to schizophrenia patients and feel that their mind is lost. Some users also report formication: a feeling of a crawling sensation on the skin also known as "coke bugs". These symptoms can last for weeks or, in some cases, months. Even after most withdrawal symptoms dissipate most users feel the need to continue using the drug; this feeling can last for years and may peak during times of stress. About 30–40% of individuals with cocaine dependence will turn to other substances such as medication and alcohol after giving up cocaine. There are various medications on the market to ease cocaine withdrawal symptoms. RiskA study consisting of 1,081 U.S. residents who had first used cocaine within the previous 24 months was conducted. It was found that the risk of becoming dependent on cocaine within two years of first use was 5–6%. The risk of becoming dependent within 10 years of first use increased to 15–16%. These were the aggregate rates for all types of use considered, such as smoking, snorting, and injecting. Among recent-onset users individual rates of dependency were higher for smoking (3.4 times) and much higher for injecting. Women were 3.3 times more likely to become dependent, compared with men. Users who started at ages 12 or 13 were four times as likely to become dependent compared to those who started between ages 18 and 20.[5][6][7] However, a study of non-deviant[8] users in Amsterdam found a "relative absence of destructive and compulsive use patterns over a ten year period" and concluded that cocaine users can and do exercise control. "Our respondents applied two basic types of controls to themselves: 1) restricting use to certain situations and to emotional states in which cocaine's effects would be most positive, and 2) limiting mode of ingestion to snorting of modest amounts of cocaine, staying below 2.5 grams a week for some, and below 0.5 grams a week for most. Nevertheless, those whose use level exceeded 2.5 grams a week all returned to lower levels".[9] TreatmentTherapyTwelve-step programs such as Cocaine Anonymous (modeled on Alcoholics Anonymous) have been widely used to help those with cocaine addiction. Cognitive behavioral therapy (CBT) combined with motivational therapy (MT) have proven to be more helpful than 12 step programs in treating cocaine dependency.[10] However, both these approaches have a fairly low success rate. Other non-pharmacological treatments such as acupuncture[11][12] and hypnosis have been explored, but without conclusive results.[13][14]MedicationsNumerous medications have been investigated for use in cocaine dependence, but {{asof|2015|lc=y}}, none of them were considered to be effective.[16] Anticonvulsants, such as carbamazepine, gabapentin, lamotrigine, and topiramate, do not appear to be effective as treatment.[15][16] Limited evidence suggests that antipsychotics are also ineffective for treatment of cocaine dependence.[17] Few studies have examined bupropion (a novel antidepressant) for cocaine dependence; however, trials performed thus far have not shown it to be an effective form of treatment for this purpose.[18] The National Institute on Drug Abuse (NIDA) of the U.S. National Institutes of Health is researching modafinil, a narcolepsy drug and mild stimulant, as a potential cocaine treatment. Ibogaine has been under investigation as a treatment for cocaine dependency and is used in clinics in Mexico, the Netherlands and Canada, but cannot be used legally in the United States.{{citation needed|date=July 2016}} Other medications that have been investigated for this purpose include acetylcysteine, baclofen,[19] and vanoxerine.[20] Medications, such as phenelzine, have been used to cause an "aversion reaction" when administered with cocaine.{{efn|[21] ←Page #928 (4th page of article) ¶4. §(1), (2) & (3); Lines 10—12 & 15—18 of aforementioned 4th ¶.}} EpidemiologyIn the United States, cocaine use results in about 5,000–6,000 deaths annually.[22] ResearchKim Janda has been working for years on a vaccination that would treat cocaine use disorders[23] by limiting its rewarding effects.[24]Transcranial magnetic stimulation (TMS) is being studied as a treatment for cocaine addiction. So far studies have been undertaken by Medical University of South Carolina (MUSC), National Institute on Drug Abuse (NIDA), and Mexican National Institute of Psychiatry.[25]See also
Notes1. ^Cocaine Use and Its Effects 2. ^{{Cite journal |url=http://www.inspirationsyouth.com/treatments/teen-drug-rehab/teen-cocaine-addiction-rehab/ |last=Walsh |first=Karen |title=Teen Cocaine Use |date=October 2010}} 3. ^1 {{Cite book|title=Drugs: The Facts About Cocaine|last=LeVert|first=Suzanne|publisher=Marshall Cavendish Benchmark|year=2006|isbn=|location=New York|pages=41, 76|via=}} 4. ^{{cite journal | last=Gawin|first=F.H. | title=Cocaine addiction: Psychology and neurophysiology | journal = Science | year= 1991 | volume=251 |pages=1580–6 | doi=10.1126/science.2011738 | pmid=2011738 | issue=5001|bibcode=1991Sci...251.1580G }} 5. ^{{cite web|last=Tierney|first=John|title=The Rational Choices of Crack Addicts|url=https://www.nytimes.com/2013/09/17/science/the-rational-choices-of-crack-addicts.html?pagewanted=all&_r=0|publisher=New York Times|accessdate=16 September 2013}} 6. ^{{citation|last=Wagner|first=FA|title=From first drug use to drug dependence; developmental periods of risk for dependence upon marijuana, cocaine, and alcohol|pmid=11927172|doi=10.1016/S0893-133X(01)00367-0|volume=26|issue=4|year=2002|journal=Neuropsychopharmacology|pages=479–88}} 7. ^{{cite journal| author = O'Brien MS, Anthony JC|year = 2005| title = Risk of becoming cocaine dependent: epidemiological estimates for the United States, 2000–2001|journal = Neuropsychopharmacology| volume = 30| pages = 1006–1018| doi = 10.1038/sj.npp.1300681|pmid = 15785780| issue = 5|last2 = Anthony}} 8. ^The study's authors stated that they wanted to know which effects and consequences of cocaine use would become visible with persons who are mainstream citizens or as close to that social stratum as possible 9. ^Cohen, Peter; Sas, Arjan (1994). Cocaine use in Amsterdam in non deviant subcultures. Addiction Research, Vol. 2, No. 1, pp. 71-94. 10. ^{{cite web |url=http://ebmh.bmj.com/content/2/2/51.full |title=Cognitive behavioural therapy reduced cocaine abuse compared with 12 step facilitation |accessdate=25 August 2012 |website= |publisher=ebmh.bmj.com |date=17 January 2008}} 11. ^{{Cite journal |url=http://jama.jamanetwork.com/article.aspx?articleid=194524 |title=Acupuncture for the treatment of cocaine addiction: A randomized controlled trial |last=Margolin |first=Arthur |journal=The Journal of the American Medical Association |date=2 January 2002 |volume=287 |number=1|display-authors=etal}} 12. ^{{Cite journal |title=Auricular acupuncture as an adjunctive treatment for cocaine addiction: A pilot study |first1=Katharine C. |last1=Otto |first2=Colin |last2=Quinn |first3=Yung-Fong |last3=Sung |journal=The American Journal on Addictions |volume=7 |issue=2 |pages=164–170 |date=Spring 1998 |doi=10.1111/j.1521-0391.1998.tb00331.x|pmid = 9598220}} 13. ^{{Cite journal |title=The use of hypnosis in cocaine addiction |last1=Page |first1= R.A. |last2=Handleya |first2=G.W.|year=1993 |journal=American Journal of Clinical Hypnosis |volume=36 |number=2 |pages=120–123 |doi=10.1080/00029157.1993.10403054|pmid=8259763 }} 14. ^{{Cite journal |title=Intensive therapy: Utilizing hypnosis in the treatment of substance abuse disorders |last=Potter |first=Greg |pages=21–28 |journal=American Journal of Clinical Hypnosis |volume=47 |issue=1 |year=2004 |doi=10.1080/00029157.2004.10401472|pmid = 15376606}} 15. ^1 {{cite journal|last1=Minozzi|first1=S|last2=Cinquini|first2=M|last3=Amato|first3=L|last4=Davoli|first4=M|last5=Farrell|first5=MF|last6=Pani|first6=PP|last7=Vecchi|first7=S|title=Anticonvulsants for cocaine dependence|journal=Cochrane Database of Systematic Reviews|date=April 2015|volume=17|issue=4|page=CD006754|doi=10.1002/14651858.CD006754.pub4|pmid=25882271|type=Systematic Review & Meta-Analysis}} 16. ^{{cite journal|last1=Singh|first1=M|last2=Keer|first2=D|last3=Klimas|first3=J|last4=Wood|first4=E|last5=Werb|first5=D|title=Topiramate for cocaine dependence: a systematic review and meta-analysis of randomized controlled trials|journal=Addiction|date=August 2016|volume=111|issue=8|pages=1337–46|doi=10.1111/add.13328|pmid=26826006|type=Systematic Review & Meta-Analysis }} 17. ^{{cite journal|last1=Indave|first1=BI|last2=Minozzi|first2=S|last3=Pani|first3=PP|last4=Amato|first4=L|title=Antipsychotic medications for cocaine dependence|journal=Cochrane Database of Systematic Reviews|date=March 2016|volume=3|page=CD006306|doi=10.1002/14651858.CD006306.pub3|pmid=26992929|type=Systematic Review and Meta-Analysis}} 18. ^{{cite journal|last1=Mariani|first1=JJ|last2=Levin|first2=FR|title=Psychostimulant treatment of cocaine dependence|journal=Psychiatric Clinics of North America|date=June 2012|volume=35|issue=2|pages=425–39|doi=10.1016/j.psc.2012.03.012|pmid=22640764|pmc=3417072|type=Review}} 19. ^{{cite journal |author=Karila L |title=New treatments for cocaine dependence: a focused review |journal=Int. J. Neuropsychopharmacol. |volume=11 |issue=3 |pages=425–38 |date=May 2008 |pmid=17927843 |doi=10.1017/S1461145707008097 |url=http://journals.cambridge.org/abstract_S1461145707008097|name-list-format=vanc|author2= Gorelick D |author3= Weinstein A |display-authors=etal}} 20. ^{{cite journal |author=Cherstniakova SA, Bi D, Fuller DR, Mojsiak JZ, Collins JM, Cantilena LR |title=Metabolism of vanoxerine, 1-[2-[bis(4-fluorophenyl)methoxy]ethyl]-4-(3-phenylpropyl)piperazine, by human cytochrome P450 enzymes |journal=Drug Metab. Dispos. |volume=29 |issue=9 |pages=1216–20 |date=September 2001 |pmid=11502731 |doi= |url=http://dmd.aspetjournals.org/cgi/pmidlookup?view=long&pmid=11502731|last2=Bi |last3=Fuller |last4=Mojsiak |last5=Collins |last6=Cantilena }} 21. ^[https://www.erowid.org/archive/rhodium/pdf/cocaineanalogs.pdf "Chemistry, Design, and Structure-Activity Relationship of Cocaine Antagonists"]. Satendra Singh et al. Chem. Rev. 2000, 100. 925-1024. PubMed; Chemical Reviews (Impact Factor: 45.66). 04/2000; 100(3):925-1024 American Chemical Society; 2000, {{ISSN|0009-2665}} ChemInform; May, 16th 2000, Volume 31, Issue 20, DOI: 10.1002/chin.200020238. [https://www.scribd.com/doc/77191354/Satendra-Singh-Chemistry-Design-and-Structure-Activity-Relationship-of-Cocaine-Antagonists Mirror hotlink.] 22. ^{{cite journal|title=Unintentional Drug Poisoning in the United States|url = http://elevatedrugtreatment.com/wp-content/uploads/2016/08/unitentional-drug-poisonings.pdf|publisher = Center for Disease Control}} 23. ^{{cite news|title=An Addiction Vaccine, Tantalizingly Close|author=Douglas Quenqua|url=https://www.nytimes.com/2011/10/04/health/04vaccine.html|newspaper=The New York Times|date=3 October 2011}} 24. ^{{cite web |url=http://www.cocainehelp.org/Article75641.html |title=Baylor Doctors are Working on Cocaine Vaccine |accessdate=11 September 2008 |website= |publisher=CocaineHelp.org |date=17 January 2008}} 25. ^{{cite web|last1=Wadman|first1=Meredith|title=Brain-altering magnetic pulses could zap cocaine addiction|url=http://www.sciencemag.org/news/2017/08/brain-altering-magnetic-pulses-could-zap-cocaine-addiction|website=Science Magazine|publisher=American Association for the Advancement of Science|accessdate=1 September 2017|date=29 August 2017}} ReferencesReference notes{{Notelist}}External links{{Medical resources| DiseasesDB = | ICD10 = {{ICD10|F|14||f|10}}.2 | ICD9 = {{ICD9|304.2}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = med | eMedicineTopic = 3116 | MeshID = D019970 }}{{Addiction}}{{Psychoactive substance use}}Kokain#Kokainismus 2 : Cocaine|Substance dependence |
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