Medical Detoxification is a process in which individuals are systematically and safely withdrawn from addicting drugs, usually under the care of a physician. Drinking alcohol or using drugs causes physical dependence over time in some people. Stopping the use of alcohol or drugs results in physical withdrawal from these substances in people with physical dependence. The detoxification process is designed both to treat the acute physiological effects of stopping drug use and to remove residual toxins in the body left as a result of using the chemicals found in drugs and/or alcohol.
While at the present time, no proven pharmacologic therapy for cocaine addiction exists, several kinds of pharmaceutical drugs have been used in the detoxification of cocaine. Withdrawal from chronic cocaine use produces anxiety, depression, and intense cravings for the drug. Several types of pharmaceuticals address these issues in different ways.
Antidepressant drugs such as desipramine or a combination of phentermine and fenfluramine have been used to reduce cocaine withdrawal symptoms such as anxiety and depression. Benzodiazepines, tranquilizers such as Diazepam, have been used to reverse anxiety induced by cocaine withdrawal. Amantadine, an antidyskinetic used in Parkinson’s Disease, may be an effective treatment for cocaine-dependent patients with severe cocaine withdrawal symptoms and may reduce cocaine craving. Bromocriptine, a drug that works on the brain’s dopamine system, has been used to decrease the craving for cocaine during detoxification and to reduce mood disturbance.
Propanolol, a beta-blocker antihypertensive drug, may be useful for severe cocaine withdrawal symptoms, as it inhibits the effects of adrenaline, thereby calming the body’s “fight or flight” response to stressful situations. Beta-blockers have been used clinically to treat general anxiety and anxiety associated with alcohol withdrawal. Propranolol’s lessening of symptoms such as palpitations and sweating has helped to reduce cocaine craving associated with such symptoms. The use of beta-blockers in patients who have ingested cocaine, however, is not risk-free and can be associated with decreased coronary blood flow and increased coronary vascular resistance, predisposing patients to arrhythmia and triggering a hypertensive crisis. Delayed toxic effects are possible. Any use of beta-blockers in this setting requires careful monitoring and caution.