Causes of Mental and Behavioral Disorders Due to Cocaine Use
Cocaine exists in the form of cocaine-HCl, a cocaine base. The first has a bitter taste and is soluble in water. Cheaper stimulants are added to the powder, as well as local anesthetics, the “freezing” effects of which are taken as the effect of cocaine. Cocaine alkaloid crystals are obtained by heating or smoking (crack) cocaine base powder when mixed with water and baking soda. The drug is administered iv, it is smoked, sniffed. It increases synaptic levels of dopamine, norepinephrine, serotonin by inhibiting their reuptake in the synaptic cleft.
Symptoms of Mental and Behavioral Disorders Due to Cocaine Use
Acute intoxication
Euphoria, a surge of energy, an increase in the resolution of perception, an increase in mental activity, a decrease in appetite, anxiety, a decrease in the need for sleep, and increased self-confidence.
Harmful use
Pain behind the sternum, myocardial infarction, sudden death, pneumothorax, pulmonary edema, keratitis, ulcerative gingivitis, change in sense of smell. Depression and episodes of anxiety, a tendency to suicide and accidents, convulsions, hyperthermia.
Addiction syndrome
The rapid development of physical and mental dependence.
Withdrawal syndrome
After a withdrawal period of 1-5 days, withdrawal syndrome is noted. Depression, depression, irritability, insomnia, apathy, lethargy are typical.
Psychotic disorder
Cocaine delirium with tactile and olfactory hallucinations, incoherent thinking, disorientation. Cocaine delusional disorder with ideas of harassment, suspicion, bouts of aggression. Schizophrenia-like cocaine disorder with inadequate behavior, dysphoria, auditory, visual and tactile hallucinations (cocaine bugs swarming under the skin). Impact ideas.
Amnestic syndrome
Fixative amnesia, retro-, anterograde amnesia.
Residual state and psychotic disorder with delayed debut
In the residual period, tics, echolalia, ataxia, obsessive and compulsive disorders. Delayed psychoses with depression, delirium, schizophrenia-like conditions.
Diagnosing Mental and Behavioral Disorders Due to Cocaine Use
Symptoms of cocaine intoxication, in particular, perforation of the nasal septum, cocaine marks at the injection site (orange-pink bruising), crack keratitis, crack finger as a result of repeated contact of the finger with the lighter wheel, crack hand with hyperkeratosis and burn changes, tooth erosion.
Differential diagnosis
Mental and behavioral disorders due to the use of other psychoactive substances should be distinguished.
Treating Mental and Behavioral Disorders Due to Cocaine Use
Detoxification using bromocriptine and antidepressants. Benzodiazepines, cooling wraps, beta blockers and calcium channel blockers, activated carbon and laxatives. Psychotherapy against relapse, behavioral therapy.