Anger and Crack Cocaine Use

angerViolence and Anger has been associated with cocaine use. Cocaine-induced psychiatric symptoms undoubtedly contribute to the emergence of Violence and Anger . In a study of 31 patients with cocaine-induced psychiatric symptoms, 55% had cocaine-related violent behaviors.7 In a telephone survey of 452 cocaine users, the following symptoms were reported: anger (42%), Violence and Anger  (32%), and speciousness or paranoia (84%).6 Violent crimes were committed by 46% of users, usually to get crack.6 In this same report, the authors discuss an additional study, which found that 26% of 200 crack users admitted to committing a crime while on crack; 95% of these crimes were violent.6 The authors of this report hypothesized that violent and angry behavior associated with cocaine use is predictable based on the effects cocaine has on neurotransmitter dysfunction. Besides an increase in levels of neurotransmitters in the brain’s pleasure centers, dramatic change in levels of norepinephrine and serotonin in other parts of the brain might provoke aggression, hyperactivity, impaired judgment, and paranoia.

Inhalation of crack cocaine has been found to produce a greater amount of anger and Violence  than intranasal use of cocaine.14 Similarly, daily use of crack cocaine has been associated with a greater number of illicit activities.15

Homicide and Anger

Homicide and anger also has been associated with cocaine use. In New York City, 31% of 2824 homicide deaths were found to test positive for cocaine or its metabolite, benzoylecgonine.16 A marked number of residents of New York City (27%) who had fatal injuries also tested positive for cocaine use. Fatal injuries secondary to homicide and anger accounted for 29% of these victims.17 Concurrent drug use, including alcohol and marijuana, was cited as an additional factor in this report. Other cities have reported similar disturbing findings. One study found that 18% of homicide victims in New Orleans tested positive for cocaine.18 In Los Angeles, violent death occurred in 61% of individuals who died and tested positive for cocaine at autopsy.19

Suicide and Anger

Suicide can be viewed as a form of self-destructive, violent behavior associated with anger. In one study of 749 cases of suicide in New York City, cocaine was present in 18% to 22% of cases.20 Suicide may be caused by depression, which occurs frequently in people using cocaine.

Connection between Violence and Anger and psychiatric symptoms.

One investigator has postulated that cocaine may produce impatience, irritability, paranoia, and edginess leading to violent behavior.21 In general, all substance use has been associated with the inability to inhibit hostile and aggressive impulses.22 The neurotransmitter norepinephrine, released by cocaine, is also involved in “fight-or-flight” behavior. Individuals who use cocaine are often hyperalert and “armed to the outside world.”23(p565) Any rapid or unexpected movement by those around them “may be interpreted as hostile.”23(p565) All of these factors may contribute to a cocaine-Violence and Anger connection.

Cocaine abusers may have problems with thinking logically. The most frequently reported cognitive difficulties involve impaired executive functioning (decision making, judgment, attention/planning/mental flexibility), and research has shown that this cognitive domain relates primarily to the functional integrity of the prefrontal lobe.24 This area of the brain also regulates impulse control. The resultant effects would be poor judgment in an individual experiencing impulsivity in the face of severe cocaine craving.

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