The use of various substances to modify mood or behavior has generally been regarded as acceptable in our society despite wide cultural differences. Many people drink coffee or tea for stimulant effects or engage in social drinking of alcohol. In addition, society condones the use of certain drugs to use medically to relieve tension or pain or even to suppress the appetite. When symptoms and behavioral changes associated with the regular use of these substances becomes maladaptive, however, substance use becomes substance abuse.

Common substance abuse is the misuse of alcohol and cigarettes which are both legal. However, illegal drugs have also become a widespread problem. Alcohol and drug abuse combined affect approximately twenty five million Americans. Very often a distinction is made between substance abuse and substance dependence. Substance abuse involves the inability to control the use of alcohol or other drugs. The individual becomes intoxicated on a regular basis.

Usually daily, however, weekend or binge use is also common. Often, the drug is often needed for normal functioning. In addition there may be repeated attempts to stop using the drug, which fail. Even though the individual knows that the use of the drug interferes with family life, social relationships, etc. he or she is unable to stop.

Substance dependence victims on the other hand suffer all of the symptoms of abuse plus an increasing tolerance for the drug. As a result, increased amounts are necessary for the desired effect. Alcohol, opiates, such as morphine, etc. lead to physical dependence as well and the individual will develop withdrawal symptoms when attempting to stop use of the drug.


During the early 1980's cocaine began gaining popularity particularly among young adults. Cocaine is a white powder, produced from the leaves of the South American Coca plant. Cocaine is a stimulant, and causes temporary delusions of limitless power and energy. Most cocaine users snort the powdered drug through there nose; however, the drug can be dissolved and injected into a muscle or vain. Crack is form of cocaine that is chemically altered so that it can be smoked. It belongs to a category of cocaine known as "Freebase", because the process converts the drug into a chemical base, as apposed to an acid or salt. Smoking the drug allows high doses of the drug to reach the brain almost instantly. As result, Crack produces the most dramatic Cocaine "high". This rapid high, however, is followed by a profound "low" that becomes the door to addiction.

Cocaine is one of then most potent drugs abuse. It can cause profound changes in the brains chemistry which leads to more intense cravings for the drug. Dependence on this drug is so powerful that it tends to rule all aspects of the user's life. Cocaine abuse and dependence usually follow one of two patterns of use. Episodic, or Chronic (daily) use. Episodic use usually occurs on weekends or once or twice during the week. Users who smoke cocaine, or use the drug intravenously, binges are common. These binges terminate only when the user collapses from physical exhaustion, or the supply of cocaine is depleted. Usually, an intense or unpleasant crash occurs, which can require at least two days of recuperation.

The effects of cocaine on the body are wide ranging, the immediate effect increases blood pressure, heart rate, breathing rate and body temperature. Dilated pupils, narrowing of blood vessels, loss of appetite, and insomnia. As these progress, a loss of interest in physical appearance, and upper respiratory infections may become apparent. Those who snort the drug, may also experience a continuous "runny nose".

Chronic cocaine and crack use can also trigger brain seizures, and psychological effects can become very profound. Individuals who use the drug chronically, can show very erratic behavior, and at times can become very violent. This "cocaine psychosis" tends to occur much sooner in crack users. Baby's exposed to cocaine in the womb ("Crack Babies"), tend to be very irritable, and unresponsive, failing to cuddle and nurse normally after birth. Some of these babies are believed to have suffered strokes before birth and may suffer strokes or heart attacks following delivery. Infants born to mothers who have used cocaine throughout pregnancy, also have a high incidence of mal formed kidneys, and genitals, and are at increased risk of developing seizure disorders, and "Crib Death" (Sudden Infant Death Syndrome). In addition, children who survive cocaine pregnancies, tend to suffer long term psycho-neurological problems. They tend to exhibit a number of symptoms associated with Minimal Brain Dysfunction, that include: poor coordination, difficulty concentrating in school, hyperactivity, etc.


Recovery form cocaine addiction is possible; although, treatment usually tends to be long term. The craving for the drug can be long lasting and difficult to overcome. The first step in treatment is admission by the abuser that he or she has a problem. This is often the biggest obstacle to treatment. Denial is a very powerful force with drug abusers. If denial persists, it may be necessary for the family to take serious steps to force a loved one into treatment.

Many professional therapists recommend a method called a family action intervention. After several meetings with an experienced drug counselor, psychologist or, social worker, the family confronts the user. Each member openly communicates how the users behavior has effected him or her personally. This at times can become very emotional, and the user is forced to confront the effects of his or her substance abuse. While family members are normally present, other participants in the intervention can include: friends, and co-workers.

During the actual confrontation, the user made to choose between them, and their continued use of the drug. The intervention is intended to catch the addict of guard, and to over come the denial. A crucial part of the program is presenting treatment alternatives that can be started immediately after the intervention meeting. Very often, attempts are made to take the individual directly to the hospital from the meeting.

Usually, residential treatment is necessary. The standard residential stay is 28 days. Initially the individual goes through detoxification, which is the process of ridding the body of the drug.  This can take several days, and should not be done outside of a hospital or treatment setting. Very often antidepressant drugs are needed to relieve the depression and associated cravings, which accompany the withdrawal. The goal of the treatment is to improve the user's self-image, and to promote healthful, drug free living. Continued strength and support by family members is also crucial to a recovering individual. It is also important for the addict to continue outpatient treatment, and to become involved with a self help group on a regular basis, such as Alcoholics Anonymous, Narcotics Anonymous, or Cocaine Anonymous. Professional support from these organizations is also available to family members, who very often themselves need therapy to help deal with the consequences of the addict's behavior. For more information, the National Institute on Drug Abuse can be contacted at 1-800-662-HELP.