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1. How is the diagnosis made?
Evidence of illegal drugs provides laboratory tests. Further information can found in the
laboratory values table under Cocaine/urine. Also to this laboratory test, tests for other drugs
can do. Laboratory parameters such as liver values, blood gases. Blood clotting disorders
are also decisive for the doctor. Diseases such as myocardial ischemia clarify in a
laboratory, among other things. In some cases, more extensive examinations need. E.g. to
determine diseases/damage to the heart or lungs. To clarify a possible infection (for example
hepatitis, HIV). Special laboratory tests are also unavoidable. It is also relevant for diagnosis
and treatment whether medical advice. And therapeutic measures (such as withdrawal
treatments) have already taken place.
How is the treatment for cocaine use & addiction done?
The therapy base on the needs of the individual. It can be inpatient (often), outpatient, or
outpatient. The doctor decides on the necessary measures. It is not uncommon for patients to
have to convince of the need to end their consumption. And to seek help and to motivate
them to start treatment and later to continue treatment.
Overcoming addiction and treating withdrawal symptoms. And concomitant diseases are
essential pillars of therapy. But, acute complications / medical emergencies can also be in
the foreground.
As part of the therapy of cocaine intoxication, but also in the case of withdrawal symptoms.
Need to calm the affected person (“talking down”). If there pronounce anxiety and panic
states or strong psychomotor arousal. Medication may be necessary (e.g. benzodiazepines).
The psychological situation of those affected is of particular importance. Also to medical
problems - physical and mental illnesses and complaints. Interpersonal conflicts in the social
environment (e.g. family, friends). And a lack of social integration is among the problem
areas for cocaine users. There can also be financial and legal problems.
If long and/or intensive cocaine use stops or reduced. Withdrawal symptoms appear after a
few hours to days. Intensive cocaine use often goes hand in hand with the use of other

2. substances. Some of which are illegal, which can also lead to withdrawal symptoms after
use. Cocaine addiction usually requires extensive medical and psychotherapeutic or
psychosocial treatment.
Cocaine withdrawal
If the consumption stop, a withdrawal syndrome can develop. Especially with intensive and
long-term use of cocaine. Withdrawal from cocaine takes place roughly. In several phases
and can describe using a three-phase model. These phases characterize a depressive
tendency and suicidal thoughts:
Crash phase. After a few hours or days, the "collapse" phase occurs. It dominates partly
strong depressive mood, dejection, lack of energy, tiredness. Dysphoria Gefühlsstörung mit
schlechter Stimmungslage
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, Self-doubt and insomnia.
Withdrawal phase. This takes one to a few weeks. A pronounced desire for cocaine
(craving) is noticeable. Accompanied by fatigue, strong self-doubt, depression, and
listlessness, etc.
Deletion phase. Nightmares arise that relate to drugs and intoxicating experiences and keep
recurring. A strong desire for the substance can express itself again and again.
If necessary, withdrawal phases, but also next therapies, support with medication
(psychotropic drugs). To carry out a withdrawal, an inpatient stay may be unavoidable.
In general, with cocaine, the strong internal urge to consume. The drug is often particularly
pronounced. Those affected often try and by various means and ways to get the substance.
Even long after the withdrawal period, it is possible that a. sometimes violent - craving for
cocaine may arise. The risk of relapse is great. Professional support after withdrawal is so
also important.

3. Mental problems & comorbidities
Cocaine use can lead to physical, psychological, and social problems. Even years later,
consequences and impairments can still expect. Loss of interest, apathy, concentration
disorders. Social withdrawal and much more can also occur afterward.
Comorbid disorders like mood disorders abnormal change in mood and drive
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, schizophrenia, Personality disorders. Post-traumatic stress disorder, eating disorder, etc.
also occur in cocaine users. Also, drug-induced psychoses can develop (cocaine psychosis)
with hallucinations. Paranoid delusions, and impairments of relation to reality, some of
which recede. A spermatozoa delusion, in which sufferers believe that insects, parasites. or
worms locate and moving under the skin, can also occur in connection with cocaine.
Psychological problems can, but, persist in the long term and must treat. The treatment of
concomitant and secondary diseases such as the cardiovascular system. Chronic infections
(Hepatitis C., HIV, etc.), liver disorders. And much more are part of the treatment plan if the
diagnosis is appropriate.
Whom can I ask?
The first point of contact is often an outpatient facility. E.g. addiction counseling center. Or
the corresponding outpatient department in a hospital. Also, the family doctor can start
referrals if necessary. For adolescents, specialists in pediatrics child and adolescent
psychiatry are the contact persons. Doctors from various disciplines and clinical
psychologists involved in the diagnosis process.
Treatment is interdisciplinary and often inpatient (clinic specializing in addiction.
corresponding department of a hospital). Various institutions can entrust this. Also to
doctors from various disciplines, psychotherapists and clinical psychologists involve. As
well as various specialists who specialize in addiction.

4. How are the costs going to cover?
The costs for the medical examination to clarify. An addiction covers the social security
agencies.
The interdisciplinary treatment of addiction disorders (including psychotherapy) also takes
place in specialized. Outpatient and inpatient facilities that have contracts with health
insurance providers. For these treatment cases, the costs are generally covered in full. For
certain services (e.g. psychotherapy for established psychotherapists/psychotherapists). Can
inter alia be an application for a grant by the health insurance carrier.
Addiction and drugs
Addiction is not a marginal problem in society but affects many people in Germany. The
term addiction does not only refer to addiction disorders. But rather the entirety of risky
abusive, and dependent behaviors. In relation to addictive substances (legal and illegal) as
well as non-substance. Related behaviors (such as gambling and pathological internet use).
Addiction is often associated with dramatic personal fates. It affects family members
involved as well as friends or colleagues. Dependency disorders are serious chronic illnesses
that can lead to significant. Health impairments and premature mortality.
Problem in Germany
Drugs and addictive substances cause considerable health. Social and economic problems in
Germany. According to representative studies (in particular the 2018 Epidemiological
Addiction Survey). 12 million people smoke, 1.6 million people addicted to alcohol. And
estimates suggest that 2.3 million people are dependent on drugs. Around 600,000 people
have problematic use of cannabis and other illegal drugs. And a good 500,000 people have
problematic or even pathological gambling behavior. Excessive internet use can also lead to
dependent behavior. It can assume that around 560,000 people in Germany are online
dependent.
The aim of our drug and addiction policy is to reduce the consumption of legal and illegal
drugs. And to avoid drug and addiction-related problems in our society. The legal addictive

5. substances alcohol, tobacco, and psychotropic drugs receive. The greatest attention because
of their great numerical importance. The main fields of action of addiction and drug policy
are:
Prevention
By providing information about the dangers of the addictive substance or drug consumption.
It should achieve that there is no harmful consumption or addiction in the first place.
Counseling and treatment, help to get out of the habit
The diverse counseling and treatment offer for getting out of addictive behavior. Must
maintain and strengthened so that every addict can take advantage. The counseling and
treatment that he needs.
Measures to
Reduce damage Survival aids or measures to reduce damage, such as exchanging syringes.
Stabilize the addict's health and social situation. This is a necessary prerequisite for a later
exit from addiction.
Legal regulations to reduce the supply
Another element of drug and addiction policy are legal regulations. to restrict the supply of
addictive substances and drugs. These include, for example, nonsmoker protection laws.
The youth protection law, and the narcotics law. The fight against drug-related crime also
serves to reduce supply.
Many and very different actors involve. In the implementation of addiction and drug policy.
So that the people affected can help. The best possible coordination and coordination. In
which all social forces are involve, need.
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