Do Cocaine Addicts Ever Fully Recover?

Cocaine is a plant-derived illegal stimulant known for its ability to produce addiction by altering the brain’s pleasure-producing chemical environment. Treatment specialists can potentially offset the effects of cocaine addiction with the help of various forms of psychotherapy and participation in mutual assistance groups. In a study published in October 2013 in the journal Biological Psychiatry, a team of American researchers sought to discover whether cocaine addicts who have gone through treatment ever fully recover their mental health and well-being. The members of this team concluded that, even years after successful completion of addiction treatment, former cocaine users still have altered brain function related to their prior drug use.

Cocaine Addiction Basics

Cocaine affects the same area of the brain that produces pleasure in response to such activities as sex and food consumption. However, while food consumption and sex produce relatively modest boosts in pleasure levels, cocaine produces extreme pleasure boosts, at least in the early stages of usage. The risks for addiction occur for two basic reasons. First, the brain eventually gets used to the presence of cocaine and no longer produces the same amount of pleasure as it did when first exposed to the drug. Just as importantly, users of the drug may respond to this drop in pleasure levels by taking more and more cocaine over time. If this cycle reaches a certain point, the affected individual may develop a physical dependence on the presence of the drug and start to orient his or her life around cocaine acquisition. By classic definition, dependence and persistent drug-seeking behavior form the basis for substance addiction.

The Role of Impulsivity

Cocaine addicts commonly exhibit unusually high levels of a trait called impulsiveness or impulsivity. As a rule, this trait is marked by a tendency to act without relying on previously acquired knowledge or experience, as well as a tendency to react to internal urges or external stimulation without fully considering the potential harm of that reaction. High levels of impulsivity make addicts prefer short-term benefits over long-term benefits, and also diminish the ability to make plans, make decisions or follow through on previously made plans or decisions. Cocaine use can increase a person’s level of impulsivity by altering normal function inside a critical part of the brain, according to the results of a study published in 2012 in the Journal of Cognitive Neuroscience. There is also considerable scientific evidence that indicates that people who eventually use cocaine already have unusually strong tendencies toward impulsivity.

Current Findings

In the study published in Biological Psychiatry, researchers from the Olin Neuropsychiatry Research Center and the Yale University School of Medicine used a form of MRI (magnetic resonance imaging) scanning to examine the brains of three separate groups of adults. The first group contained 42 current cocaine addicts, while the second group contained 35 recovered cocaine addicts who had been drug-free for about four years. The third group contained 47 healthy people with no history of cocaine use. The brain functions of the people in all three of these groups were measured during the performance of tasks designed to examine impulsivity, compulsive behavior and the role of rewards and punishments in the decision-making process. After reviewing the results of MRI testing, the study’s authors found that both current and former cocaine addicts have a similarly increased tendency to act in impulsive ways. People with no history of cocaine use do not share this tendency. The authors also found that current cocaine addicts have multiple abnormalities in their brain function that decrease their ability to delay reward. Even after four years of cocaine abstinence, former addicts also have some of these same abnormalities. People who don’t use cocaine typically don’t show signs of reward-related brain problems.

Significance and Considerations

The authors of the study published in Biological Psychiatry believe that their findings indicate that former cocaine addicts only partially overcome the brain dysfunctions associated with cocaine use, even when they remain drug-free for several years or potentially longer. However, they also believe that the high levels of impulsivity found in both current and former active addicts may not stem from the drug’s effects, but instead may exist prior to cocaine use. The authors urge the continuation of future research efforts to help determine whether some of the impaired mental states found in former cocaine addicts result from drug use itself, or predate drug use and therefore act as a significant risk factor for the onset of addiction.

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