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  • Writer's pictureThe Paladins

A detailed guide to cocaine addiction psychosis


Many people recently have asked us about cocaine addiction psychosis. Some people seem to think it does not exist. Yes it does, and it is common after habitual usage of cocaine for one to two months after starting consumption (no matter how small one's initial consumption or how infrequently one pretends to oneself that one takes cocaine).


This article is intended to spread awareness of this form of mental illness; to reduce stigma; to assist patients in understanding what is happening to them; and in pursuit of the greater good, which is that cocaine usage is reduced because it is a great evil.


'Cocaine addiction psychosis' means that if you take a lot of cocaine, your mind acquires psychotic qualities: that is to say, you think things are happening 'behind your back' that are not (this is paranoia); you see things that aren't there (hallucinogenic psychosis); and you believe things that are not true (behavioural psychosis). In other words, you have gone mad and you don't realise it. If you have been taking cocaine for an extended period, then we regret to inform you that this has happened to you and you need to get help - now.


This is one of our articles in the series about the Belgrade Drug Policy Clinic.


And now some details about cocaine addiction paychosis.


  1. There is one reason you first take cocaine. It is because you are drunk and a friend, already addicted, invited you to do so, in the hope that he or she will find a companion in their addiction.

  2. The first line of cocaine is harmless. The problem is that the subsequent ones are not, and you build up to having a problem without noticing it or even admitting it.

  3. The distinction between those who continue and those who do not after the first consumption is mental distress, as we have alreaady explained. Cocaine becomes addictive for those suffering from medium to long term mental distress as a sort of self-medication.

  4. After a short while, cocaine consumption becomes a routine part of daily life as one consumes the narcotic on an ongoing basis as a relief from the ongoing mental distress one is suffering.

  5. One persuades oneself this is entirely normal (the first sign of psychosis; it is not normal) and then one starts lying to others and quickly to oneself about the fact that there is no problem when in fact there is.

  6. Soon one loses all one's friends who are not similarly addicted to cocaine, because people adopt an aversion to people who are suffering from psychosis; it ends up that the only people one knows and trusts are other people addicted to cocaine. Hence paranoia and psychosis are shared and mutually reinforced. Also it is of course silly to trust people who have psychosis. Only people with psychosis do that.

  7. As loneliness increases, and one's inability to work and debt problems increase (the more cocaine you take, the less you can effectively work, and cocaine is very expensive), the patient consumes ever more cocaine to thwart the increased mental distress.

  8. Due to the craving for cocaine, the patient, once out of money, starts doing highly undesirable things, such as prostitution (women) or drug dealing (men) to be able to find the funds to continue the habit.

  9. Obviously this is a downward cycle the ultimate conclusion to which is a total nervous breakdown. It tends to end in prison; a mental hospital; or one relocating countries to escape the narcotic. Even then one may take one's debt and other problems with you.

  10. Unless one can escape this cycle of psychotic self-belief that there is no problem to solve, one will die early.


Cocaine addiction psychosis has a number of common incidental qualities, e.g.:


  1. Going up to 48 hours without sleep, taking cocaine on a frequent basis. (Unlike amphetamine, cocaine cannot keep you awake longer than that. If the patient is staying awake for longer periods, consider both the possibility that the cocaine is cut with amphetamine sulphate (or some similar amphetamine substrate) or the possibility that the patient has sleep deprivation psychosis (this has more explicit hallucinatory effects such as seeing patches in the sky as having unusual colours); or both.

  2. After 'come-down' from a prolonged period of cocaine usage, one suffers from an unnaturally long period of sleep, e.g. 24-36 hours, as the body just collapses. This is not a healthy process of exercise and rest such as after running a marathon; cocaine users are not fit and healthy people. But they may be unnaturally thin.

  3. The cocaine user is always looking for ways to come down, so tends to consume illicitly psychoactive pharmaceutical anxiolytics. We have written about the dangers of Xanax in that regard already.

  4. Cocaine users tend to check their mobile phones over-frequently, as cocaine usage causes both psychotic anxiety and a desire to communicate with others. Of course lots of people check their phones over-frequently; only consider this criterion if you suspect the patient to be addicted to cocaine. Otherwise it is not relevant.

  5. Heavy cocaine use causes necrotic nasal reactions. Look for an unusually drippy nose. Other drugs taken per nasum may have similar long-term effects but because cocaine is a necrotic and an anaesthetic, this symptom is more distinctive and recurrent with cocaine.

  6. Cocaine users seldom admit they are wrong about something. It can be a good test of whether they have cocaine addiction psychosis, whether they can accept with reasoning explained to them that even obviously wrong things they are saying are actually wrong.

  7. Connectedly, reasoning with people with cocaine addiction psychosis is difficult because they believe they are right about everything or that all the evidence 'adds up'. Cocaine users become 'super-barristers', finding forensic fault in anything they are told that they do not like.

And now we explain how to treat cocaine addiction psychosis. It is not easy. You need money.


  1. The mid-term goal must be to take the patient out of an environment where cocaine is available. So a good vacation is a typical example.

  2. The problem is to persuade the patient to get on the 'plane. Firstly you need lots of money credibly to tempt the patient. Secondly you need virtually to march them to the aeroplane, if necessary feeding them cocaine as far as check-in, to ensure that they take the flight.

  3. Then you commence a straightforward cocaine addiction detoxification programme, substituting cocaine for benzodiazepenes and then tapering off the benzodiazepenes over a period of 48-72 hours.

  4. Then you need to overcome the patient's mental anguish, understanding what it is and what its cause is, and providing credible assurances that it need not recur.

  5. Then you let the patient relax without stress.

  6. If you have resolved the patient's underlying misery, then within a period of one to two months it should be safe to allow them supervised return to their original environment, without becoming embroiled in the habitual cocaine toxicity available to them.


This is a very complex process that may involve psychiatrists, friends, lovers, family and/or sympathetic persons unknown to the patient. It is very rare to find someone able to give advice about this subject, and no solutions are 'off the shelf'. For this reason be particularly wary of the advice of psychiatrists who mostly just reel off what they have read in a textbook.


But, with effort, it can be done.


Incarceration as an option


Every effort should be made to avoid incarcerating cocaine addicts. They are very sick, and they are unlikely to receive the specialist attention they need in prison.


Moreover cocaine is freely available in many if not most prisons in western Europe and the United States. So you just place more of the damaging substance before the patient in an environment full of criminal persons.


Finally incarceration is liable to increase mental distress, not reduce it; therefore the patient, once released from prison, is liable to return to cocaine consumption in even greater quantities because he now has a new network of criminal friends to buy it from.


Incarcerating people for drug use offences is, as a general rule, an appalling idea. The proper penalty to be imposed by a court or other judicial authority is referral to a specialist in cocaine addiction on some sort of mandatory basis, if society's public resources so allow. Also the Court may make orders requiring people to live with caring persons and to be subject to a curfew for a period.


Cocaine dealers


These people are the scum of the earth. The reason why is that they tempt sad or lost souls with cocaine often at a discount early on, with an intention of getting the patient addicted to a very high margin drug (the street dealer or deliverer typically takes a 50pc+ margin, at least in Europe).


So in fact they do their best to wreck people's lives and make them dependant upon cocaine and to hand over all their money to the dealer. Then, when the patient has run up debts with the cocaine dealer, he may force the patient to commit acts of prostitution or drug dealing to 'pay off their debts'; all the while the patient is falling more into the debt and the thrall of the dealer and consuming more cocaine to cope with the increased mental distress of sex work or drug dealing (both of which can be very harrowing forms of labour).


Eventually, having juiced all they can from the victim, the dealer beats them up, rapes them and/or leaves them for dead and starts again with new victims. Should an abandoned victim revert to financial fluidity, the cocaine dealer will revert to them to start the cycle again.


For these reasons we are of the view that possession of cocaine with intent to supply is one of the wickedest crimes on God's earth, and should be invariably punished with life in prison without possibility of parole save in the most exceptional circumstances (for example, if the defendant can demonstrate that he was pulled into drug dealing through a similar cycle and hence is also a victim; some leniency might be afforded to such people.) But life imprisonment without the possibility of parole should be the standard penalty for intentionally destroying many people's lives in the pursuit of one's own financial gain.


The PALADINS Organization

We are here to serve.


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