Cocaine Addiction Treatment – How to Get Started
You want cocaine addiction treatment but you don’t know where to start or what you need? Well, this article is designed to help you understand, step-by-step, what you need and how to find it.
By the end of this article you will know:
- About the 5 or 6 most common types of addiction treatment
- How to find a treatment program in your area
- Whether you need residential treatment (rehab) or outpatient treatment
- The kinds of therapies that are proven to work best for cocaine addicts
- The questions you need to ask when choosing between programs
- More about possible treatment medications
Your Cocaine Addiction Treatment Options
Although when many people think of addiction treatment they immediately think of rehab, there are actually a number of treatment options to consider, residential treatment (rehab) being just one of these options.
Your cocaine addiction treatment options include:
- Getting counseling with a licensed addiction counselor, licensed therapist, clinical social worker or psychologist
- Getting family or couples therapy, with an emphasis on addressing your substance abuse problems. Research shows that a stable and supportive romantic or familial relationship can help you to maintain recovery, especially when all family members are trained in ways to reduce the substance abuse
- Joining an intensive outpatient addiction treatment program (these tend to occur during the evening and weekend hours, so as not to interfere with your work or school responsibilities)
- Joining a day treatment program – In day treatment you travel each day to an addiction treatment facility for a full day of therapy, 12 steps meetings, group counseling, educational groups and other programs. Day treatment is quite similar to the experience you’d have in a residential rehab, except you go home each night, rather than residing within the facility
- Residential addiction treatment (rehab) – you can enter a residential treatment environment for varying lengths of time, such as for a week or so, during the initial stabilization phase, or for 1 to 3 months, for a primary treatment phase.
- Psychiatric hospital care – some people, such as those experiencing withdrawal psychosis or those with symptomatic co-occurring disorders may need psychiatric hospital care for the initial phase of treatment
Finding Treatment - How to Get Started
So you’ve decided you want treatment, but if you’re like most people, you don’t know about all of your local addiction treatment options… and you don’t even know for sure how to go about finding out!
Even before you decide on what you need or want, it can be helpful to take a look at what’s available in your area, and to find this out, all you need to do is visit the Substance Abuse and Mental Health Agency’s (SAMHSA) treatment locator website, where you can search for addiction treatment programs in your area by zip code.
From there you can use the advanced search functions to narrow down your options and then spend an afternoon or so on the phone calling possible programs to get more details on availability, program costs and other specifics.
It’s a good way to get started.
What Kind of Treatment Do You Need?
OK, so if you decide you want to join a specialized addiction treatment program, then the first major decision you need to make is whether to go with outpatient or residential treatment.
As a general approach, especially if this your first treatment attempt, outpatient treatment programs are usually a good place to start. Some advantages of an outpatient treatment program include:
- They are much less expensive and they tend to be longer (which is a plus)
- You can continue to work or go to school (and do whatever else you need to do) while attending outpatient sessions during evening and weekend time-slots
- You can put what you learn in therapy sessions into real-world practice right away
But outpatient programs won’t work for everyone - some people really need a more structured and temptation-free environment to maintain even short periods of abstinence.
You likely need residential treatment if:
- You have a co-occurring mental health disorder
- You are also dependent on other drugs and or alcohol
- You have a medical condition that may be affected by changes to your substance use habits
- You lack a safe and sober living environment
- You have no transportation/are unable to make it to regular outpatient meetings
- You have recently completed an outpatient program, and despite your real efforts, outpatient treatment did not help you1
Evidence Based Therapies Proven to Work
To choose an addiction treatment program, first you have to see what’s out there, then you have to decide on whether you want residential or outpatient treatment…and then you have to narrow down your choices by looking for treatment programs that feature the kinds of therapies and treatments that you want – the ones that are proven to work!
What you choose will depend a lot on factors like local availability, what you can afford or what your insurance company will approve – but if possible, you should search for programs that offer evidence based therapies proven to help stimulant abusers (cocaine and meth) quit using best.
Some general features of effective cocaine addiction treatment programs include:
- Treatment lasts at least 90 days and preferably longer
- They offer a blend of recovery programs (for example, the 12 steps, individual, group and family counseling, relapse prevention training, cognitive behavior therapy and more)
- The treatment plan is tailored to fit your needs
- The treatment program incorporates cognitive behavioral strategies and teaches relapse prevention skills
- Someone works as an individual case manager for you, to ensure that all aspects of treatment are coordinated and fulfilled
- The program makes use of contingency management (you get small reward vouchers for achieving goals)
- The program makes use of frequent urine testing for cocaine use2
One research-backed addiction treatment program that meets all of the above criteria is called The Matrix Program.
The Matrix is a treatment program that was developed specifically to meet the needs of people addicted to stimulants like cocaine or meth – and research shows that it works pretty well.
Find out more about The Matrix Program.
Questions to Ask before You Choose a Program
So once you’ve narrowed down your choices a bit and you're left with a few programs to choose between, how do you decide which is best for you?
Well, there’s no single right or wrong way (see our guide on choosing a treatment program for more information) but to get you started, here are some questions to ask that should give you some valuable information to work with:
- How long is the treatment program? If it's shorter than three months, why is this?
- Is the program designed to meet the needs of cocaine addicts specifically, or is it a more generic general addiction treatment program?
- Does the program make use of treatments that are scientifically proven effective? Which treatments, and if not..why not?
- Is treatment individualized? How does that work? Does treatment change over time as your needs change? How does this happen? Is there a continuing care or aftercare element to the program?3
- Does the program make use of any treatment medications?
Potential Cocaine Addiction Treatment Medications
The truth is, addiction treatment works best when you combine psychosocial therapies, like counseling, with medications that reduce cravings or symptoms of withdrawal.
Though the FDA has yet to approve any medications specifically for the treatment of cocaine addiction (March 2013), researchers have identified a number of medications which have been proven helpful against cocaine addiction in clinical trials.
Talk to your doctor about the pros and cons of medications. Research continues and prescribing practices evolve over time, and in some cases, your doctor may recommend the off-label use of one or more of the following medications:
Disulfiram is well known as an alcohol addiction medication – if you take disulfiram and drink alcohol you get violently ill - so for as long as you take this medication, you are unlikely to also drink alcohol.
As a cocaine addiction treatment medication, disulfiram works in the same way. If you use cocaine while on disulfiram you experience lessened or no euphoria, anxiety and paranoia.
The evidence is far from conclusive, but some studies have shown that people using disulfiram stay clean longer than people given a placebo.4
Disulfiram is a serious medication that’s not to be taken lightly, especially for people with liver or cardiovascular disease, or mental health problems.5
This beta blocker seems especially helpful for people with the most severe cocaine addictions. Clinical studies show that, compared to people given a placebo, people given propanolol feel fewer cocaine withdrawal symptoms (anxiety and restlessness), stay in treatment for longer, use less cocaine and have longer periods of extended abstinence.6
Topirimate and Amphetamine Salts
In a 2012 clinical trial, cocaine addicted people given a combination of topirimate and amphetamine salts were twice as likely as those given a placebo to achieve three consecutive weeks of abstinence (33% vs. 17%).7
The amphetamine salts are supposed to help with cognitive regulation and by reducing the dysfunction of the brain’s addiction altered reward systems and the topirimate (an FDA approved anticonvulsant medication) reduces the over-action of dopamine systems after stimulant use.
This stimulant drug is FDA approved to treat narcolepsy, but there is some research evidence that it’s also useful as addiction treatment medication.
In one double blind study, cocaine addicted subjects receiving modafinil had fewer cravings and more days of consecutive clean time than subjects who received a placebo medication.8
This GABA (a neurotransmitter) based spasticity medication and muscle relaxer has been shown effective as an alcohol and cocaine addiction treatment medication.
In a study at UCLA in 2003, cocaine addicted subjects were given counseling and a daily dose of either baclofen or placebo - and those given the baclofen had significantly fewer positive urine tests for cocaine.
Unfortunately, larger studies since then have failed to demonstrate similar efficacy, though it does seem to work as an alcohol addiction treatment medication.9
Taking the First Step
Although it can feel overwhelming at first, by breaking the process into manageable steps even the complex and difficult becomes just a matter of perseverance and heart – and as they say, a journey of a thousand miles begins with just a single step.
You don’t have to get everything perfect right from the start – cocaine recovery is a process and along the way you may have to try a few recovery styles on for size before finding what works best for you personally.
So don’t wait! Get started now! Start taking small steps away from a life of addiction and before you know it you’ll have marched miles in the right direction.
- University of California, San Francisco Medical School
- Effective Stimulant Abuse Treatment Strategies
- NIDA: Seeking Drug Abuse Treatment: Know What To Ask
- Cochrane Reviews: Disulfiram as a Medication for Cocaine Dependence
- Harvard Health Reviews: Overcoming Cocaine or Stimulant Addiction
- New Medications for the Treatment of Cocaine Dependence
- Medscape: Combination Drug Therapy Promising in Cocaine Dependence
- Modafinil in the Treatment of Cocaine Dependence
- Baclofen for Cocaine Dependence
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