Primary Care Physician
Dr. Orrange received her BA in Biology at the University of California, San Diego, and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health. She received her MD from the USC Keck School of…
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How can I stop smoking crack cocaine? What treatments are there?
Posted in Cocaine Addicti... by Dr. Sharon Orrange on May 27, 2010
"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.

Good luck.

Dr O.

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I stopped cold turkey when I woke up and my girlfriend was lying beside me dead from an OD. Kind of "scared me straight" so you can quit, you just have to have something strong enough to make you quit.
By Gomezy3k  Jun 02, 2010
2
I have a family member on crack cocaine, AND I'M DYING INSIDE FOR HIM. It hurts so much to see him, to see how he looks, to see what he must feel inside of him that he TALKS TO NO ONE. i ache for him so much. These people that put family members thru this is just awful.

They don't realize how much family cares for them but it's hard when they don't care for themselvees. All I could tell him was that he makes it hard for us to like him at times & that I Love him very much. I cannot reach him emotionally and no other family member can so we watch -- helplessly.
By energylost  May 28, 2010
1
i smoked crack for 15 years and stopped i dont mean to be rude but when you get tired of getting arrested and you get tired of giving all your money that you work for to some young yo boy that drives a brand new bends that you and all your friends bought and you cant even afford a brand new pair of sneakers that is what helped me. o and other than the fact that i started herion thinking i was saving money because it would stop me from geekin then i had a herion habit and could not afford the coke but i dont reckamend that route because you talk about withdraw man you havnt seen nothin till you withdraw of herion crack is all in the mind youwill need consuling no drug in the world can help with that you have to get your prioritys straight and decide weather our not you want to keep being crack poor for the rest of your life. good luck and may godbless you dont give up fight the good fight. steven l spiegel
By spiegelsteven  May 28, 2010
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