Cocaine, one of the oldest known drugs, has been an abused substance for over 100 years. However, it has gained greatly in popularity especially within the last two decades. The White House Office of National Drug Control Policy reports that Americans spend more on cocaine than on all other illegal drugs combined. Between the years of 1988 to 1995, it was estimated that around $38 billion was spent on cocaine alone. Other costs attributed to cocaine use is money spent on cocaine treatment and prevention programs, emergency room visits and related healthcare costs, lost job productivity, lost earnings, cocaine-related crime, and social welfare are all estimated to cost billions annually. According to the National Institute on Drug Abuse (NIDA), there are about 1.7 million people in the U.S. who regularly use cocaine, and so it is not surprising to see that cocaine is the leading cause of heart attacks and strokes for people under the age of 35. In order to combat this problem, we must understand how cocaine acts on the brain.

Cocaine addiction causes lasting changes in brain function that are very difficult to reverse. The answer lies within the brain’s reward system, which is beneath the cerebral hemispheres called the nucleus accumbens. This area is connected to the ventral tegmental area (VTA), which produces the neurotransmitter dopamine. In a normally functioning brain, when an action is performed that satisfies a need, dopamine is released into the nucleus accumbens, which produces a pleasurable feeling: the reward. Therefore, the action will most likely be repeated to achieve the reward again. Normally, rewards come only with effort and after a delay. However cocaine and other drugs provide a shortcut to this sequence5. Once cocaine has crossed the blood-brain barrier and enters the VTA it accumulates rapidly, and begins to act upon the nucleus accumbens. There it binds to dopamine transporters and inhibits the brain from reabsorbing the neurotransmitter, causing a build-up of dopamine. A euphoric rush is given that may last several minutes. After multiple uses, the brain can no longer produce the amount of dopamine to feel the same effects. Therefore, the need for it becomes stronger, and more cocaine must be taken to release the dopamine, thereby causing addiction.

An individual under the grips of a cocaine addiction often has many underlying issues that act as contributing factors for their need for cocaine. Many times, these factors are not attended to during treatment, which can cause the individual to relapse into drug abuse. These issues may include mental disorders such as depression, schizophrenia, post-traumatic stress, and anxiety disorders along with poor diet, nutrition, and coping mechanisms. Behavior patterns should also be identified to serve as predictors of treatment outcomes such as, impulsivity, aggression, and sensation seeking. These patterns have been linked to cocaine relapse7. Vitamin supplements should be taken to rebalance the body; usually, those addicted to cocaine have deprived their body of many nutrients during their addiction. Amino acid therapy will replace the lost building blocks of neurotransmitters lost to cocaine abuse. Caffeine, processed food products, and excess sugar should be heavily avoided during the recovery process from cocaine addiction. Healthy exercise will raise endorphins to give the individual a natural “high” along with decreasing boredom and inactivity; things that are usually triggers for relapse. Steam baths and sauna sessions should be used to detoxify remaining impurities in the system. Therapy that may involve medication for mental disorders should be used where necessary. If these underlying disorders are not controlled, the individual will compensate by self-medication with other illegal drugs, including cocaine. Vocational and educational assistance is also very important to the recovering individual as this will enable them to feel increased self-worth and productivity, another factor to staying clean and sober.

One such complementary modality that is quite popular for a variety of functions is acupuncture therapy. Acupuncture is most widely used for its pain relieving properties through sensory stimulation1. More recently, acupuncture has been shown to successfully treat depression3,4. The relief acupuncture causes works through local tissue healing effect and central anti-stress mechanisms1. Acupuncture detoxification therapy uses the application of acupuncture needles to the ear, also called auricular acupuncture. These points target different bodily functions and organs. The effects witnessed on the individual include relaxation, decreased anxiety and restlessness, reduced perspiration, intestinal cramps, watery eyes, and sneezing. It also aids in the excretion of toxic substances for a speedier recovery2,6. Acupuncture for addicted individuals supports a positive mood, relieves stress, and aids in craving control. This therapy also appears to assist in the healing process of the mind based on the client’s affect.

Eye Movement Desensitization and Reprocessing (EMDR) is an approach to psychotherapy that uses eye movements to stimulate the information processing in the brain. This therapy provides much faster results than traditional therapy. It is often used for treating trauma such as: sexual abuse, domestic violence, war, crime, depression, addiction, phobias, and self-esteem issues. Overall, EMDR allows the brain to heal its own wounds at the same rate that the rest of the body is able to heal its physical ailments, making a long and tedious recovery a thing of the past.

Neuro-feedback is a cutting-edge technique that trains the brain in order to help it improve body function regulation and overall brain health. When there is poor brain functioning, it is recognized through the EEG (Electroencephalogram). By challenging the brain, much like muscles are challenged in physical exercise to improve their strength, normal brain functionality can be restored. The benefits of neuro-feedback include healthier sleep patterns, relief from anxiety and depression, and attention and emotional management. Emotional management is very important in how an individual reacts to a particular situation.

The holistic model of drug addiction treatment should be used to address these issues and halt future cocaine or drug use. Treatment strategies that focus only on symptom reduction are inadequate and unsuccessful. Addiction may affect many aspects of psychosocial function, therefore optimal outcomes require that the needs of the whole patient—mind, body, and spirit are met.

References:

1. Carlsson CP. (2001). Acupuncture therapy today. Background, clinical use, mechanisms. Lakartidningen, vol. 98(46): 5178-82, 5185-6.

2. Fidler S. (n.d.) The successful use of auricular acupuncture in the supported withdrawal and detoxification of substance abusers. Retrieved 4/2/04 from: www.acupuncture.com/Research/addictres.php

3. Gallagher SM, Allen JJ, Hitt SK, Schnyer RN, Manber R. (2001). Six-month depression relapse rates among women treated with acupuncture. Complement Ther Med., vol. 9(4): 216-8.

4. Han C, Li XW, Luo HC. (2002). Comparative study of electro-acupuncture and maprotiline in treating depression. Zhongguo Zhong Xi Yi Jie He Za Zhi, vol. 22(7): 512-4, 521.

5. Hyman SE. (1994). Why does the brain prefer opium to broccoli? Harvard Review of Psychiatry, vol. 2(1): 43-6.

6. Miller J. (n.d.). An evaluation of an acupuncture program for drug treatment in San Diego county. Retrieved 4/2/04 from: www.acupuncture.com/Research/DrugSD.php

7. Patkar AA, Murray HW, Mannelli P, Gottheil E, Weinstein SP, Vergare MJ. (2004). Pre-treatment measures of impulsivity, aggression and sensation seeking are associated with treatment outcome for African-American cocaine-dependent patients. Journal of Addiction Disease, vol. 23(2): 109-22.

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