Psychological dependence on cocaine resulting in habitual use.Cocaine, a drug derived from the leaves of the coca plant and long used as a local anesthetic, is taken by some individuals for its stimulating and pleasurable effects. Though there are fewer cocaine users today than there were after World War I, the drug has its devotees and is sometimes taken by young people for kicks or by addicts as a substitute for morphine or heroin. Unlike these drugs, it does not produce actual addiction, since the user does not develop increasing tolerance or physical craving, nor is he afflicted with severe symptoms when it is withdrawn. Nevertheless the cocaine user may become psychologically dependent on the drug and it may therefore become a habit.In contrast to the opiates, cocaine is not a narcotic but a stimulant. When sniffed or taken by hypodermic, it produces a slight dizziness or headache followed by a state of exhilaration, euphoria, and self-confidence that lasts for several hours. During this period the user becomes extremely active and loquacious and feels he can accomplish anything. He is constantly excited, easily aroused sexually, and finds sleep almost impossible. But as the effect wears off he becomes increasingly weak, depressed, and irritable; and these reactions are usually followed by digestive disturbances, tremors, palpitation, slight confusion, and impotence. If a cocaine habituate does not receive the drug, he may experience episodes of fear or panic which make his behavior dangerous and unpredictable.If large doses of the drug are taken over a long period, acute psychotic reactions may occur. The most common symptoms are terrifying hallucinations, including formication, the conviction that insects are crawling beneath the skin (the “cocaine bug”). In some cases there are delusions of jealousy and persecution which may lead to acts of violence. The expression “dope fiend” was coined with cocaine users in mind. Studies have shown that, on the whole, they lose their self-respect and become morally deteriorated sooner than narcotic addicts, and the chances of rehabilitation are considerably more remote.The patient was a strikingly pretty, intelligent girl of nineteen who had divorced her husband two years previously. She had married at the age of sixteen and stated that she was terribly in love with her husband but that he turned out to be cruel and brutal to her. He would frequently take her to bars, where he would force her to drink while he spent the evening criticizing and berating her for no apparent reason. On several occasions he tried to force her to have sexual relations with his acquaintances under threat of bodily injury.After six months of marriage she became pregnant. Her husband, who did not wish to have any children, flew into a rage. He accused her of betraying him with other men, and hit her several times, finally knocking her into a stove with such force that she had a miscarriage.The girl was too ashamed of her marriage failure (her parents had violently opposed the marriage and she had left home against their will) to return to her home. She moved away from her husband and got a job as a barmaid in the same bar where her husband had been accustomed to taking her. She was severely depressed, and several of his friends insisted on buying her drinks to cheer her up. This process continued for almost a year, during which she drank excessively but managed to hold her job.Following this, she met a man in the bar where she worked who introduced her to cocaine, assuring her that it would cheer her up and get rid of her blues. At this time she was still feeling very depressed and sorry for herself and she thought she would try it out. She states that it both “hopped me up and gave me a feeling of peace and contentment.” For a period of several months she purchased her supplies of cocaine from this same man until she became ill with appendicitis and was unable to pay the stiff price which he asked. Following an appendectomy, she was induced to share his apartment as a means of defraying her expenses and ensuring the supply of cocaine which she had now become heavily dependent upon psychologically. She stated that she felt she could not work without it. During this period she had sexual relations with the man although she considered it immoral and had severe guilt feelings about it.This pattern continued for several months until her “roommate” upped his prices on the cocaine on the excuse that it was getting more difficult to obtain and suggested to her that she might be able to earn enough money to pay for it if she were not so prudish about whom she slept with. At this time the full significance of where her behavior was leading seems to have dawned upon her and she came voluntarily for psychiatric assistance. (Coleman, 1964)

Cite this page: N., Sam M.S., "COCAINE HABITUATION," in, November 28, 2018, (accessed August 17, 2022).


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