Drug tolerance happens when your body adapts to a substance that has been in your system for an extended period, and you no longer feel the same desired effects of the drug when you take the same amount. Once you develop tolerance to a drug, you have to either increase the dosage to achieve the same desired effects or switch to a different drug.
Doctors who prescribe painkillers to their patients work around tolerance by increasing the dosage amount or prescribing a different kind of painkiller that the body has not gotten used to yet. Tolerance to drugs can occur when using drugs as prescribed by doctors or recreationally. It can be particularly risky to develop tolerance to drugs used recreationally, as users are more likely to unsafely increase dosages to achieve the desired high and run the risk of overdose.
It is important to note that tolerance is not the same as dependence or addiction to a drug. Tolerance simply means your body no longer responds to a drug like it used to, whereas dependence means your body can’t function without it. Addiction means you have an uncontrollable urge to continue using the drug despite negative consequences. Tolerance does not mean you will develop dependence and an addiction, though it is a risk factor for them to occur.
Additionally, tolerance is not always a bad thing. Many medications prescribed by doctors can have negative side effects. Over time, you might develop a tolerance to the negative side effects and still receive the desired benefits from the medication. For example, you are taking a painkiller that has side effects of nausea and vomiting. Over time, however, you no longer experience nausea and only feel the painkilling effects.
Researchers have found that overuse of stimulants, such as cocaine, usually leads to drug tolerance. Because overuse of such drugs is generally an effort to experience a high, tolerance is usually a precursor to dependence and addiction. If tolerance and later addiction are not addressed promptly, individuals will begin to experience disruptions to the successful functioning of their daily lives. These individuals also run the risk of overdose and potentially death.
Tolerance to cocaine can develop rapidly or over many weeks or months. Some people develop tolerance after just one use of cocaine and already have to take a greater amount the second time they use it to feel the same high. Other people may not build a tolerance to cocaine until after weeks of consistent use. Everyone responds to drugs differently, and there are many factors that influence how quickly you feel tolerance to a drug form. Factors that impact drug tolerance include:
Cocaine is widely known to be highly addictive, but the reasons for why it is so addictive are less understood. Researchers conducted studies in rats to try and understand why tolerance to cocaine forms so quickly. A group of rats was given free access to cocaine for five days and then had the cocaine taken away for either 14 or 60 days. Even after 60 days of no cocaine use, the rats still had full tolerance to the drug.
The results from the rat study suggest that cocaine produces a priming effect where the brain is changed from repeated cocaine use and never fully recovers. Even after the rats’ dopamine levels returned to normal, tolerance to the drug remained present. Researchers still don’t know exactly why tolerance to cocaine develops so quickly, but this finding can help explain why humans have so much trouble with cravings and relapse when trying to recover from a cocaine addiction.
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The approach you take to treating drug tolerance will likely depend on whether you are using the drug recreationally or under doctor supervision. If tolerance has developed to a doctor-prescribed medication, the doctor has two options for how to treat the tolerance:
This technique puts more of the substance into your system than your body is used to processing at once, so you will still feel the desired effects. Your tolerance will only continue to grow, however, so this method puts you at risk for constantly needing more and more of the medication in your system.
This technique is used if you or your doctor do not want to increase the medication, but still wish to use a medication to treat your symptoms.
If you have developed tolerance to a drug following recreational use, treatment may not be as simple as having your prescription changed. Recreational drug use is much more frequently linked to behavioral patterns and environment. If you have been using cocaine recreationally and wish to reduce your tolerance to it, you will need to reduce or completely quit your drug use.
In theory, this sounds simple, but quitting drug use is a very challenging process. Depending on the level of your tolerance, and whether it has already progressed to dependence and addiction, you will likely need various levels of support. Consulting with your doctor is a great place to start. They can help evaluate your current physical and psychological condition as well as current drug use habits, and create a plan for the safest way to reduce your drug use.
If your tolerance to cocaine has already progressed to dependence and addiction, formal treatment is necessary. Addiction to any drug is a complex situation that requires well-rounded and comprehensive treatment. Treatment for cocaine addiction must address the unique needs of the individual, including their personal history, patterns of substance use, environmental influence, and the co-occurrence of any mental health issues.
The National Institute on Drug Abuse (NIDA) explains there currently are no medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of cocaine addiction. Researchers are exploring options for medications that can be used to treat cocaine addiction that have already been approved for the treatment of addictions to other drugs. Disulfiram, for example, is used to treat alcoholism and has shown promise in controlled studies for the treatment of cocaine addiction. Further research is still needed, however, to understand why disulfiram works for treating cocaine addiction and why it is not successful in everybody who tries it.
Traditional and effective forms of addiction treatment that have a history of working well for treating addiction to cocaine include detoxification followed by behavioral interventions. Cocaine withdrawal does not typically present with such severe physical symptoms as withdrawal from drugs like alcohol or heroin, but minor aches and pains can be experienced.
The greater challenge during cocaine detox is the psychological symptoms, such as anxiety, paranoia, and depression. Additionally, cravings to use cocaine can be extremely intense during withdrawal. A comprehensive addiction treatment program will provide medical and psychological support throughout the detox period.
Following detox, it is important to participate in a program that offers a range of therapy opportunities. Many programs include individual, family, and group therapy options. Detox on its own does very little to instill lifelong patterns of sobriety. Therapy, however, helps participants gain an understanding of their habits of drug use and replace harmful behaviors with positive coping skills.
According to NIDA, behavioral interventions that are beneficial for the treatment of a cocaine addiction include the following:
Cocaine is a dangerous drug to use recreationally despite it being one of the most widely consumed drugs around the world. Tolerance develops quickly and can swiftly lead to dependence and addiction.
To avoid developing a cocaine addiction, it is important to safely lower your tolerance as soon as possible. Speaking with your health care provider is the safest way to do this. Together, you can make a plan for how to get cocaine out of your system safely. If your cocaine use has developed past the point of tolerance, however, your doctor may refer you to a formal addiction treatment program that will address all of your recovery needs.
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