Cocaine Dependence

1. Cocaine abuse: A destructive pattern of cocaine use, leading to significant social, occupational, or medical impairment.
2. Must have three (or more) of the following, occurring when the cocaine use was at its worst:
   1. Cocaine withdrawal symptoms:
      Either (a) or (b).

      (a) Two (or more) of the following, developing within several hours to a few days of reduction in heavy or prolonged cocaine use:

      • sweating or rapid pulse
      • increased hand tremor
      • insomnia
      • nausea or vomiting
      • physical agitation
      • anxiety
      • transient visual, tactile, or auditory hallucinations or illusions
      • grand mal seizures

      (b) Cocaine is taken to relieve or avoid withdrawal symptoms.

   2. Greater use of cocaine than intended:

      Cocaine was often taken in larger amounts or over a longer period than was intended

   3. Unsuccessful efforts to cut down or control cocaine use:
      Persistent desire or unsuccessful efforts to cut down or control cocaine use
   4. Great deal of time spent in using cocaine, or recovering from hangovers
   5. Cocaine caused reduction in social, occupational or recreational activities:
      Important social, occupational, or recreational activities given up or reduced because of cocaine use.
   6. Continued using cocaine despite knowing it caused significant problems:

      Continued cocaine use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been worsened by cocaine (e.g., current cocaine use despite recognition of cocaine-induced depression)

• Learning Problem
• Psychosis
• Euphoric Mood
• Depressed Mood
• Somatic or Sexual Dysfunction
• Hyperactivity
• Addiction
• Sexually Deviant Behavior
• Odd or Eccentric or Suspicious Personality
• Dramatic or Erratic orAntisocial Personality

Some disorders display similar or sometimes even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which one needs to be ruled out to establish a precise diagnosis.

• Nonpathologic cocaine use for recreational or medical purposes;
• Repeated episodes of Cocaine Intoxication.