"I'm a 32 year old male, have been on crack for a year and a half. What are the treatments that are used to help stop smoking crack?"
This will be a long battle for you, but you can do this. First, you will want to know what withdrawal symptoms you may expect since you’ve been smoking crack for over a year. Second, what are your treatment options?
Heavy chronic cocaine use results in a withdrawal syndrome that has prominent psychological features but is rarely medically serious. Symptoms include depression, anxiety, fatigue, difficulty concentrating, decreased ability to experience pleasure, increased cocaine craving, increased appetite, increased sleep, and increased dreaming (due to increased REM sleep). Symptoms usually resolve within one to two weeks without treatment. Physical symptoms like musculoskeletal pain, tremors and chills may also occur.
Treatment of crack cocaine withdrawal involves sleeping as much as you want and eating whenever you feel hungry. No medication has proven effective in treating the withdrawal symptoms. A short-acting benzodiazepine such as lorazepam (Ativan) may be helpful in people who develop severe agitation or sleep disturbance. Persistent (more than two to three weeks) depression or suicidal ideation may require antidepressant treatment. The risk of relapse is high during the early withdrawal period, in part because drug craving is easily triggered by stress. At this point, you should be referred to an addiction treatment program for ongoing care.
The mainstay of treatment for cocaine addiction is psychosocial treatment. No medication is FDA labeled for the treatment of cocaine addiction. Your needs for what it takes to successfully stay off crack cocaine are best met in a dedicated substance abuse treatment program. Most cocaine addiction treatment occurs in the outpatient setting, while an inpatient or residential setting may be best for those with a history of past failures in intensive outpatient treatment. More intensive treatment (ie, more frequent visits) and longer duration of treatment (minimum of three months) are associated with better outcomes. Involvement with peer self-help groups such as Cocaine Anonymous improves treatment outcome.
Medications including antidepressants, antipsychotics, and antiseizure medications have been tested and have NOT demonstrated consistent effectiveness for treatment of cocaine dependence. Early clinical trials, however, have shown promise with Provigil (Modafinil), Topamax, Baclofen, Celexa and Zofran which may diminish cocaine intake in some patients. Neither acupuncture, nor herbal remedies such as ginkgo biloba have been found to be effective.
Information about Cocaine Anonymous, including meeting locations, is available at http://www.ca.org
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