Cocaine is a highly addictive stimulant drug. Cocaine’s addictive properties are related to its effect on the body’s reward pathways. It is a strong central nervous system stimulant that increases levels of dopamine, a brain chemical associated with pleasure, in the brain’s reward circuits. This release of dopamine causes the euphoric “high” that users experience when cocaine is ingested. The “reward” effect causes powerful cravings of the drug. Studies in mice found that if you give mouse cocaine every time it hits a lever, it will continue hitting the lever until it has overdosed, not stopping to eat, drink, or sleep.
Researchers have shown a single dose of methylphenidate (brand name Ritalin), a stimulant drug prescribed to treat attention-deficit hyperactivity disorder (ADHD), may normalize the nerve pathways that go haywire in cocaine addicts’ brains. Ritalin is similar to cocaine because it increases dopamine in the brain. The only difference is that it’s taken orally, causing a person to reach peak effect over a longer period of time, and resulting in a lower potential for abuse.
About 800,000 Americans older than 12 are dependent on cocaine. Cocaine increases alertness, causes feelings of euphoria, and enhances energy. Anxiety, paranoia, and restlessness are common, with tremors and convulsions occurring at higher doses. Three routes of administration are typically used for cocaine: snorting, smoking, and injecting. The intensity and duration of cocaine’s effects are dependent on the route used to administer the drug; injection and smoking produce a quicker, stronger effect than snorting cocaine.
Ritalin will likely be used for cocaine addicts in the same way that methadone and Suboxone are currently used to treat heroin and prescription painkiller addicts. In some cases, these drugs are used to wean a person off drugs and treat withdrawal and cravings for a short period of time. In others, Ritalin will likely be used in a medication maintenance program. Maintenance therapy differs from simply detoxifying addicts until they are completely abstinent. Instead, it acknowledges that continued treatment with certain medications, which can include some of the very drugs that people are misusing, could be required for years.
The main goal of maintenance therapy is “harm reduction treatment” rather than “addiction treatment.” Cocaine was involved in nearly 423,000 emergency room visits in 2009 according to SAMHSA — more than marijuana, heroin, and other stimulants and illicit drugs.
Unfortunately, we have yet to come up with a maintenance program that works better than an abstinence based, 12 step program. For over 75 years, once hopeless drug addicts and alcoholics have found redemption in the AA principals. No one really knows how it works, but in the 78 years since Bill Wilson founded the program, experts have yet to design a program that works better, despite the wealth of knowledge we have amassed in subjects like psychology, medicine, and human behavior.
While Ritalin maintenance therapy may prove effective in reducing emergency room visits and overdoses for cocaine addicts that refuse to embrace an abstinence-based program, it will not “cure” cocaine addiction any more than methadone “cures” heroin addiction. It does, however, offer hope to abstinence based treatment models that use medication during the detox process.
If you or someone you know is trying to suffering from cocaine addiction, call us at 800-951-6135.