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Many people with mental health disorders are diagnosed with more than one co-occurring disorder at the same time, and this has been shown to be particularly prevalent in those with an eating disorder.

Current research suggests that up to 50% of people with eating disorders also abused drugs or alcohol, a figure of five times higher than for the general population.

This is of significant concern due to the significantly increased health risks associated with drug abuse and eating disorders when they are experienced together.[1]

A recent study into the role of weight control as a motivation for cocaine abuse found that almost 50% of the women and 13% of men used cocaine and/or alcohol as a weight control measure, highlighting an important correlation between the two diagnoses.[1]

Eating Disorders (ED) Explained

There are a range of eating disorders, all of which have their own unique traits, although it’s possible to suffer from more than one at a time.

Body dysmorphia is usually the driving force behind eating disorders, and most people struggling with eating disorders are unable to recognise the weight loss resulting from their condition.

Not unlike substance abuse, the presence of an eating disorder can influence compulsive and self-regulating behaviours, alongside cravings for the things that they restrict.

Although there is no specific reason that eating disorders develop, people with certain characteristics are more prone to them.

Eating disorders occur in all genders, but are most prominent in females that are in adolescence or young adults.

Those with certain life goals that relate to weight and size regulation are also susceptible to developing an eating disorder, for example, those seeking a career in modelling or certain sporting events.

It can also be less of a conscious decision for some, who develop eating disorders as a result of traumatic or high stress life events, such as divorce or loss.

As well as weight control, regulating eating patterns can provide people with a general sense of control, a feeling which is often lacking in those who are distressed.

Certain studies have even shown a genetic predisposition to developing an eating disorder is possible.

There are around six distinct eating disorders, the most commonly known being, anorexia nervosa, bulimia nervosa, and binge eating disorder. It is also possible to experience more than one eating disorder concurrently.

1. What is Anorexia Nervosa?

Anorexia nervosa is the practice of restricting caloric intake to dangerous levels. Many people with this disorder have a severe fear of weight gain, and are unable to recognise their own weight loss.

2. What is Bulimia Nervosa?

Bulimia is driven by similar body dysmorphia and fear of weight gain as anorexia, however, sufferers use a binge and purge form of weight control, rather than caloric restriction.

Often larger than normal amounts of food are eaten in one sitting, and then purged through attempts of vomiting, laxatives use, or excessive exercise.

3. What is Binge-Eating Disorder?

Contrary to the other eating disorders where control is the focus, people with binge eating disorder are often unable to control their caloric intake.

Individuals with a binge-eating disorder may be normal weight, overweight, or even obese, whereas those with restrictive disorders are often severely underweight.

4. What Causes Comorbidity Between Eating Disorders and Cocaine Abuse?

There are a number of reasons why people may experience both eating disorders and cocaine abuse.

There are ongoing studies looking at whether either disorder has a causative impact on the other, however, it’s also important to note that both are mental health conditions with a number of similar risk factors and personality traits.

Those with certain brain chemistry, a family history of disordered behaviour and other mental health conditions such as anxiety and depression are at greater risk, as are those with compulsive behaviours and suicidal tendencies.

Although there are a range of opinions on the comorbidity of cocaine use and eating disorders, it is generally agreed amongst the scientific community that there is an existing correlation between eating disorders and substance use, in that people with eating disorders experience substance abuse at a greater rate than other users.

It is also known to occur more prominently in bulimia than anorexia.

4. What is Cocaine?

Cocaine is a highly addictive synthetic narcotic stimulant, which creates a feeling of alertness, enhanced energy and euphoria in users. L

The effects are short term, however, and a comedown will often follow use, leaving feelings of anxiety and depression.

Due to the highly addictive nature of cocaine, dependence and addiction is developed fairly easily and within a short timescale.

Long term use leads to significant mental and physical implications, including mental disorders and heart failure.

Find out how long cocaine stays in your system.

5. How Does Cocaine Affect Appetite?

Cocaine is a central nervous system stimulant that suppresses the appetite. It’s common for those with cocaine addictions to lose a substantial amount of weight very quickly.

Although this is often an unintentional byproduct of cocaine use, it’s reasonable to suspect that those with anorexia, or similarly restrictive eating disorders would see this as a desirable side effect.

Using Cocaine as an Appetite Suppressant

Nearly four times more female cocaine users have eating disorders than not, with studies showing that eating disorders usually precede cocaine use, or the two disorders are experienced simultaneously. [1]

As cocaine is an effective appetite suppressant, it is used by people struggling with various eating disorders as a form of weight control, for example, it can reduce the hunger that results from anorexia and balance the effects of binge eating in both binge eating disorder and bulimia.

As well as the effects of cocaine potentially masking a dangerous eating disorder, the ongoing use of cocaine whilst an eating disorder is present can result in irreversible mental and physical damage.

How Cocaine Use Affects Eating Disorders

Cocaine use impacts metabolism, resulting in rapid weight loss, and reduction in body fat.

Whilst this is dangerous on its own, eating disorders often lead to similar low caloric intake. Both disorders have the potential to cause malnutrition, which leads to organ damage or failure.

When experienced together, eating disorders and cocaine abuse are therefore twice as likely to result in severe and irreparable physical damage.

Cause or Effect, What Links Cocaine use with Eating Disorders?

The findings of a 1998 study by Elsevier Science highlights the need to evaluate cocaine users based on whether there is weight loss motivation present when formulating a treatment plan.

It’s accepted that often cocaine may be sought as a method of weight control by those with eating disorders and therefore it’s important to treat the addiction accordingly.

Different motivational factors for drug use can have a huge impact on the type of treatment that may or may not be successful in treating cocaine addiction.[2]

It’s not yet understood whether use of cocaine can result in the development of eating disorders where they were not already present, however, this is an area of continued study.

Can Cocaine Use Cause An Eating Disorder to Develop?

It’s overall more likely that cocaine abuse develops as a result of an eating disorder, rather than causes one to occur, however, in a 1999 study, it’s suggested that an individual may develop an eating disorder in an attempt to prolong the appetite suppression experienced through the use of drugs such as cocaine.[4]

Those who experience an eating disorder as a result of substance use have been shown to exhibit obsessive-compulsive disorder, panic disorder, and social phobia.

They are typically dependent on multiple substances and have developed drug dependency earlier in life than general drug users.[2]

As more investigation is needed in this area, it’s possible that the co-occurrence of cocaine use and eating disorder development is entirely coincidental, however, it is also possible that those recovering from cocaine addiction could be at a high risk of binge eating disorder, due to the dramatic increase in appetite post cocaine detox.[3]

How to Treat Co-occurring Cocaine Abuse and Eating Disorders

Early intervention is important in the treatment of both cocaine use and eating disorders. Moreover, when the disorders exist concurrently, it’s important to treat them as such.

Successful drug rehabilitation is often achieved through the investigation and mental health support around the psychological triggers.

Where the presence of an eating disorder has either resulted in, or occurs alongside cocaine use, it’s important to look for any connections between the two, as this reduces the risk of relapse.

As one disorder often provides a coping mechanism for the other, if only one is tackled, this can lead to more significant abuse in the remaining disorder.

Dual diagnosis by a professional who understands the links between cocaine use and eating disorders is imperative to sourcing successful treatment.

There are a range of treatment facilities that treat both conditions concurrently, and connections between the two disorders will be explored throughout the process.

The Importance of Finding Suitable Professional Intervention

Although the vast majority of eating disorder clinics are able to help patients who abuse other forms of substance, such as diet pills, laxatives, and diuretics, only specialised treatment centres will be able to provide medical detoxification, which is necessary in the treatment of cocaine abuse.

It’s therefore important to research which facilities are able to help patients with comorbid eating disorders and narcotic addictions.

This will ensure that the treatment received offers them the best possible chance of making a long-term recovery.

How is a Dual Diagnosis of Cocaine Abuse and an Eating Disorder treated?

Where cocaine or other narcotic abuse or addiction are present, professional medical detox will be required as part of the rehabilitation treatment programme.

It’s often possible to minimise the symptoms associated with detox through the use of prescription medications.

Whilst detox is sometimes used in isolation, it’s more likely that this will be part of a broader inpatient treatment programme that also provides residential care and psychological treatment.

Where an eating disorder is present, there is also an often greater focus on nutritional advice and rehabilitation.

Outpatient treatment is also possible for the treatment of both cocaine abuse and eating disorders, however, this is not usually as successful for those with a dual diagnosis.

What sort of psychological care is used?

When it comes to treating any form of addiction, the use of psychological care to uncover the reasons behind disordered behaviours is an essential part of the programme.

Whilst undergoing treatment for a dual diagnosis of an eating disorder and cocaine abuse you may undergo any or all of the following commonly used therapies:

Aftercare Support

As with any rehabilitation programme, it’s important to ensure that the healthier behaviours developed during treatment are maintainable in the long term. For many people, ongoing support will be required to keep disordered behaviour in check.

There are a variety of support groups that can help those in recovery from eating disorders and cocaine abuse to maintain their sobriety and healthy behaviours, such as Narcotics Anonymous, or Overeaters Anonymous. Some people will also benefit from continued private therapy and nutritional support.

It certainly isn’t easy to recover from an eating disorder and a substance use disorder concurrently, however, it is possible.

It’s also essential that help is sought, as the combination of both disorders left untreated can quickly result in serious, and fatal damage.

References

[1] https://pubmed.ncbi.nlm.nih.gov/9573424/

[2] https://journals.sagepub.com/doi/pdf/10.2478/v10199-012-0024-9

[3]https://www.jneuropsychiatry.org/peer-review/the-problem-of-eating-disorders-and-comorbid-psychostimulants-abuse-a-mini-review-13013.html

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629626/#B55

boris

Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field.  His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline.