Cocaine

Cocaine dependence

Case definition
Cases meet DSM-IV (304.20) or ICD-10 (F14.2) criteria for cocaine dependence, excluding cases in remission.

Substance dependence
Presence of at least three of the following criteria at some time during the previous year:

Tolerance
Withdrawal
Discontinuation of important social activities and other pleasurable events and/or failure to meet occupational obligations
Increased dosage and/or duration of use
Significant amount of time spent obtaining, using or recovering from the substance
Persistent use despite significant associated problems
Compulsion to take the substance*
Desire to cut down use, or unsuccessful attempts to cut down**

*ICD-10 only
**DSM-IV only

Cocaine dependence (specifically)

Periods of abstinence may occur, but are commonly followed by relapse.
Aggressive behaviour, anxiety, paranoid ideation, depression and weight loss may occur.
Binges take place, followed by a withdrawal syndrome. First comes “the crash”, when people are exhausted, depressed, sleepy, and experience minimal craving. This is followed by a second phase, lasting from days to weeks, characterised by fluctuating mood and energy levels, craving, disturbed sleep, and poor concentration. It is a time when there is a high risk of relapse. The third phase is extinction, or chronic withdrawal, characterised by cravings, fluctuating mood and energy levels, and sleep disturbance.

Discussion Papers

A discussion paper on cocaine-related mortaliy is available. Please send requests for this document to

Flowcharts

Cocaine mortality flowchart