11 Mar Recovering From Cocaine-Related Psychiatric Disorders
Cocaine-related psychiatric disorders are a group of 10 officially recognized mental health disorders that can occur in the aftermath of cocaine use. This group of conditions includes cocaine intoxication, cocaine intoxication delirium, cocaine withdrawal, cocaine-induced sleep disorder, cocaine-induced sexual dysfunction, cocaine-induced psychotic disorder with delusions, cocaine-induced psychotic disorder with hallucinations, cocaine-induced anxiety disorder, cocaine-induced mood disorder and cocaine-related disorder not otherwise specified. Each of these disorders has its own distinctive symptoms and potential mental health consequences. Recovery programs for people experiencing cocaine-related mental health issues vary according to the particular disorder involved.
Basics of the 10 Disorders
As with all other officially recognized mental health disorders in the US, the definitions for the 10 cocaine-related psychiatric disorders were created by the American Psychiatric Association. According to the Association’s guidelines, cocaine intoxication occurs when a person has recently used cocaine and shows clear signs of psychological or behavioral alterations such as euphoria, anxiety, unusual anger or mental tension, unusual talkativeness, difficulty paying attention, and judgment impairment. The affected individual must also have two or more physical problems such as unusually fast or slow heartbeat, unusual sweatiness, unusually high or low blood pressure, nausea that results in vomiting, disorientation, chest pain, or spontaneous physical demonstrations such as pacing or hand-wringing.
If a cocaine user has extreme forms of the thought impairments associated with cocaine intoxication, he or she may receive a diagnosis of cocaine intoxication delirium. These manifestations of extreme thought impairment typically make it difficult for the affected individual to maintain a train of thought, focus on others, process incoming information or engage in any form of reasoning. Cocaine withdrawal must occur in the aftermath of a halt or serious reduction in long-term and/or heavy cocaine use. Potential symptoms of this disorder include insomnia, excessive sleepiness, abnormal fatigue, vivid nightmares, depression, suicidal thinking, unexplained appetite increases, and spontaneous hand-wringing or pacing.
Cocaine-induced sleep disorder occurs when a cocaine user experiences serious sleeping problems within or following a month of active drug use. These problems may manifest as insomnia, excessive sleepiness (hypersomnia) or a group of phenomena known collectively as parasomnias; this group includes sleepwalking, sleep eating, sleep paralysis, and night terrors. Some people develop mixed symptoms of insomnia, hypersomnia and/or parasomnia. Cocaine-induced sexual dysfunction produces distressing or disruptive symptoms such as pain during sex, impotence, difficulty reaching orgasm, or reduced or absent sexual desire. These symptoms must appear within or following a month of active cocaine use.
Cocaine-induced psychotic disorder with delusions and cocaine-induced psychotic disorder with hallucinations both center on psychotic symptoms that demonstrate an ongoing break with reality. As its name implies, the first of these two disorders features additional symptoms of delusional thinking, which involves a tenacious belief in clearly unbelievable facts or ideas. The types of hallucinations most commonly associated with the second of these two disorders are tactile (touch-related) and auditory (sound-related) in nature. Cocaine-induced anxiety disorder features panic attacks, anxiety, obsessive behaviors, or compulsive behaviors that appear within or following one month of cocaine use. Cocaine-induced mood disorder features manic, depressive, or mixed manic-depressive mood swings that also appear within or following a month of cocaine use. Cocaine-related disorder not otherwise specified is a catchall category for cocaine-related mental health problems that don’t fit neatly into the definition of any of the other disorders.
Steps in Recovery
Recovery from a basic, uncomplicated case of cocaine intoxication typically involves nothing more than close observation under a doctor’s care while cocaine levels in the body drop. Additional treatment with sedative drugs called benzodiazepines may also be required to ease potential complications such as extreme agitation, seizures or high blood pressure. Examples of these drugs include midazolam (Versed), lorazepam (Ativan) and diazepam (Valium). Recovery may also involve additional treatments-such as aspirin, nitroglycerin or supplemental oxygen-designed to address other specific intoxication-related effects. For people suffering from cocaine withdrawal, simple observation under a doctor’s care is also the most common recovery option.
In people affected by cocaine-related mood swings, psychotic delusions, psychotic hallucinations or anxiety, the course of recovery commonly includes use of appropriate medications. Lithium is the main medication used to address manic mood swings, while treatments for depressive mood swings include antidepressants such as sertraline (Zoloft), fluoxetine (Prozac) and venlafaxine (Effexor). Antipsychotic medications used in treatment include quetiapine (Seroquel), droperidol (Inapsine) and olanzapine (Zyprexa). Medications used to treat the effects of anxiety include benzodiazepines and specific antidepressants called SSRIs (selective serotonin reuptake inhibitors). Cocaine-induced sleep disorder often corrects itself when an affected individual establishes a proper sleeping pattern and corrects the sleep deficits that often appear in heavy cocaine users.
In cases that involve mild or moderate symptoms, people recovering from cocaine-related psychiatric disorders typically receive outpatient treatment after initial contact with their doctors or emergency room personnel. However, people with severe symptoms-such as violence toward others or clear suicidal intention-commonly need to undergo at least part of their recovery in an inpatient psychiatric facility.
Long-term recovery from cocaine intoxication, cocaine withdrawal and all other cocaine-related psychiatric disorders depends largely on the affected individual’s ability to stop using cocaine. Unfortunately, cocaine is highly addictive for most people and, when compared to most other common drugs of abuse, the chances for recurring relapses during recovery are quite high. Measures used to reduce relapse chances and improve long-term recovery prospects include ongoing involvement in a 12-step self-help group and participation in a form of psychotherapy called cognitive behavioral therapy. Periodic psychiatric evaluation may also prove helpful.
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