Cocaine Use Disorder in Children

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KEY POINTS

• Cocaine use disorder is a pattern of using cocaine that lead to serious personal, family, and health problems.
• For any treatment to be successful, your child must want to stop using cocaine. If your child wants to quit, get help from your healthcare provider.
• Self-help groups such as Cocaine Anonymous, support groups, and therapy may be helpful.

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What is cocaine use disorder?

Cocaine is made from the leaves of the coca plant, which grows in South America. It is a type of drug called a stimulant, which means it increases alertness and energy. Cocaine can be inhaled through the nose in powder form ("snorting"), injected into a vein, or smoked. Crack, a less expensive form of cocaine that is smoked, has made cocaine abuse a widespread problem.

Cocaine use disorder is a pattern of using cocaine that leads to serious personal, family, and health problems. The more of these statements that apply to your child, the more severe his cocaine use disorder is.

1. Your child uses more or uses cocaine for longer than planned.
2. Your child wants to cut down or quit, but is not able to do so.
3. Your child spends a lot of time and energy getting drugs, using drugs, and getting over the effects.
4. Your child craves cocaine so much that he has trouble thinking about anything else.
5. Your child has problems at work, school, or at home.
6. Your child has relationship problems because he doesn’t keep his promises, or argues or gets violent with other people.
7. Your child stops doing things that used to matter to him, such as sports, hobbies, or spending time with friends or family, because of his cocaine use.
8. Your child uses cocaine even when it is dangerous, such as while driving or operating machinery.
9. Your child keeps using cocaine even though he knows that it is hurting his physical or mental health.
10. Your child needs to use more and more of the drug, or use it more often to get the same effects. This is called tolerance.
11. Your child has withdrawal symptoms when he stops using.

Cocaine use disorder may also be called drug abuse, substance abuse, dependence, or addiction.

What is the cause?

The cause of cocaine use disorder is not known. The brain makes chemicals that affect thoughts, emotions, and actions. Cocaine changes the balance of these chemicals in your child’s brain. When he uses cocaine regularly, his brain starts to get used to it. As a result, your child doesn't feel right unless he uses cocaine. When he stops using cocaine suddenly, the balance of chemicals in his brain changes, which causes the symptoms of withdrawal.

Your child has a higher risk of becoming dependent on drugs if he:

• Has a family history of drug or alcohol abuse
• Has abused alcohol or drugs in the past
• Is easily frustrated, has trouble dealing with stress, or feels like he isn’t good enough
• Is regularly around people who use alcohol or drugs
• Has a mental health problem
• Has constant pain

What are the signs of cocaine abuse?

The symptoms of cocaine use disorder depend on how much and how often your child uses cocaine. The symptoms can be mild to severe, such as:

• Being overexcited or nervous
• Having angry outbursts
• Runny nose, bloody nose, hoarseness, and reduced sense of smell Having belly pain, nausea, or loss of appetite
• Talking and thinking fast, called "speeding"
• Having a fast heartbeat or sweating
• Nausea and vomiting
• Large, dilated pupils
• Seeing, hearing, or feeling something that is not there
• Thinking that others are out to get him when they are not

If your child snorts cocaine, your child may have:

• Sores or broken skin in or around his nose
• Nosebleeds
• A constant runny nose

If your child smokes cocaine, your child may have symptoms of a lung infection, such as a cough or mucus in his lungs.

Your child may also have symptoms of new or worse health problems caused by cocaine use. Health problems caused by cocaine include.

• Eating and sleeping disorders
• Chest pain
• Cardiac arrest (the heart suddenly stops beating)
• Kidney failure
• Seizures
• Trouble breathing or stopping breathing

The symptoms of cocaine withdrawal can be mild to severe. Your child may have some of these symptoms when he stops taking cocaine:

• Nervousness and restlessness
• Feeling very tired
• Depression
• Cravings for cocaine
• Sleep problems

The feelings that your child gets from cocaine only last a short time. This causes your child to crave more cocaine to get the feelings back. Your child may binge, which means your child take large amounts of cocaine for several days. The binge is followed be a "crash," where your child feels very sad and depressed. Then your child starts all over again. This pattern of cocaine use can lead to an overdose. A cocaine overdose can be life threatening.

Pregnant girls using cocaine are at high risk of having a miscarriage, premature delivery, or low birth weight baby. Babies born to mothers who use cocaine are addicted at birth. The babies have to go through the painful process of withdrawal.

How is it diagnosed?

Your healthcare provider will ask how much and how often your child uses cocaine. Your child needs to be honest about his drug use. Your provider needs this information to give your child the right treatment. He or she will also ask about your child’s symptoms, medical history and give your child a physical exam. Your child may have blood or urine tests.

How is it treated?

Cocaine use disorder can be treated. For any treatment to be successful, your child must want to stop using cocaine. When your child stops using cocaine, his or her healthcare provider may prescribe medicine to help get through withdrawal symptoms. Your child should not use alcohol and other drugs to reduce withdrawal symptoms.

If your child wants to quit, get help.

Self-help groups such as Cocaine Anonymous, support groups, and therapy may be helpful. Kinds of therapy may include:

• Cognitive-Behavioral Therapy (CBT). CBT helps your child look at his thoughts, beliefs, and actions, and understand which ones cause problems for him. Then your child learns to change unhealthy ways of thinking and acting.
• Family therapy. Often people with substance use disorders don’t realize they have a problem or aren’t ready to accept treatment. This leaves loved ones frustrated and confused. Family therapy treats all members of the family rather than working with one person alone. It helps the whole family understand each other better and make changes.
• Substance use disorder treatment programs. Your child’s healthcare providers and counselors will work with you to develop a treatment program. Your child may be able to go to therapy a few times a week (outpatient therapy). Or your child may need treatment in a hospital or rehab center. Your child may need to stay there for several weeks, or may be able to go to a clinic or hospital each day.

Recovery is a long-term process. Many people with substance use disorders try to quit more than once before they finally succeed. Don't give up. Your child can quit and quit for good. Get help and try again. Follow-up treatment is very important so that your child doesn’t go back to using drugs.

If your child has overdosed, or is having severe withdrawal symptoms he will need to be treated in a hospital. He will also be treated for any health problems such as a heart attack or stroke, or other life-threatening problems.

How can I help prevent cocaine abuse and dependence?

You can help prevent cocaine abuse if you:

• Teach your child how to make good choices about alcohol and drugs. Teach in a way that fits your child's age and ability to understand.
  • If you are watching TV with your 6-year-old and cocaine is mentioned on a program, you can say, "Do you know what cocaine is? It's a bad drug that can hurt your body." If your child has more questions, answer them. If not, let it go. Short, simple comments, that are repeated often, will get the message across.
  • For your 12-year-old, you might explain what cocaine and crack look like, the different names for cocaine, and how using cocaine will change his or her brain and body. Repeat the message. Talk to your child about drugs whenever you can.
• Listen to your child's feelings and concerns, so that they feel comfortable talking with you.
• Make your family position on drugs clear. For example "In our family, we don't use drugs and the children are not allowed to drink alcohol." Set a good example. Your child is much more likely to use drugs if you use drugs, even if you tell them not to.
• Talk about what makes a good friend. Peer pressure is a big part of why kids get involved with drugs and alcohol. Help your child understand that friends who pressure them to drink or use drugs aren't friends at all. Role-play ways for your child to say no to drugs, for example:
  • Say, “no, thanks” and walk away.
  • Suggest something else to do, such as go play a video game.
  • Use humor, such as "No thanks. If I want to fry my brain, I'll get a skillet."
• Build self-esteem. Children who feel good about themselves are much less likely to turn to drugs. Offer lots of praise for a job well done. If you need to criticize or discipline your child, talk about the action, not the child. For example, instead of saying "you should know better" try saying, "what you're doing is not safe." Set aside time every day to talk, play a game, or take a walk with each of your children.

People and resources in your community that can help include your healthcare providers, therapists, support groups, mental health centers, and alcohol or substance abuse treatment programs. You may want to contact:

• National Council on Alcoholism and Drug Dependence
  800-622-2255
  https://www.ncadd.org/
• The Addiction Recovery Guide
  https://www.addictionrecoveryguide.org/resources/recovery/