Medical Detoxification is a process that systematically and safely withdraws people from addicting drugs, usually under the care of a physician. Drinking alcohol or using drugs can cause physical dependence over time and stopping them can result in withdrawal symptoms in people with this dependence. The detoxification process is designed to treat the immediate bodily effects of stopping drug use and to remove toxins left in the body as a result of the chemicals found in drugs and/or alcohol.
While at the present time, no proven pharmacologic therapy for cocaine addiction exists, several kinds of medications 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 medications 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, a drug used to treat 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 drug used to treat high blood pressure, may be useful for severe cocaine withdrawal symptoms, as it slows down the effects of adrenaline, thereby calming the body's "fight or flight" response to stressful situations. This type of drug has been used to treat general anxiety and anxiety associated with alcohol withdrawal. Propranolol's lessening of symptoms such as palpitations and sweating has helped reduce cocaine craving. Its use, however, is not risk free in patients who have taken cocaine and can be associated with decreased blood flow to the heart and other changes that predispose patients to arrhythmia and a severe increase in blood pressure that can lead to a stroke. Delayed toxic effects are possible. Any use of beta-blockers in this setting requires careful monitoring and caution.