Name of the Condition

• Cocaine Dependence with Cocaine-Induced Psychotic Disorder with Delusions
• ICD-10 Code: F14.250

Summary

Cocaine dependence with cocaine-induced psychotic disorder with delusions is a severe condition characterized by a physical and psychological dependence on cocaine associated with delusions, a symptom of psychosis. This disorder affects the brain's chemical functions, leading to intense, sometimes bizarre, false beliefs despite evidence to the contrary.

Causes

The primary cause of this condition is the prolonged and excessive use of cocaine, a powerful stimulant drug. Cocaine alters brain chemistry, particularly neurotransmitter pathways, which can trigger psychotic episodes, including delusions.

Risk Factors

• Frequent and long-term cocaine use
• A history of mental health disorders
• Genetic predisposition to addiction or mental illness
• High-stress environments or traumatic experiences
• Age; often begins in young adulthood when drug experimentation is more prevalent

Symptoms

• Persistent delusions
• Intense cravings for cocaine
• Withdrawal symptoms when not using cocaine
• Mood swings and irritability
• Impaired social or occupational functioning

Diagnosis

• Comprehensive psychiatric evaluation
• History of substance use and related behaviors
• Use of standardized assessment tools for substance use disorders
• Possible toxicology screening to detect cocaine and its metabolites

Treatment Options

• Behavioral therapies, like Cognitive Behavioral Therapy (CBT), to address thought patterns and behaviors
• Medications to manage withdrawal symptoms and any co-occurring mental health disorders
• Support groups and peer counseling
• Rehabilitation programs that offer a structured environment for recovery

Prognosis and Follow-Up

• Recovery is possible with appropriate treatment, but the condition is chronic and often requires long-term management.
• Regular follow-up appointments to monitor progress, adjust treatments, and prevent relapse.

Complications

• Risk of relapse or worsening of psychotic symptoms
• Cardiovascular complications due to cocaine use
• Potential for social, legal, or financial problems
• Increased risk of further mental health disorders

Lifestyle & Prevention

• Avoidance of cocaine and other addictive substances
• Healthy coping strategies for stress, such as physical activity and mindfulness
• Building strong social support networks
• Education about the risks associated with drug use

When to Seek Professional Help

• Experience of persistent or severe delusions
• Inability to stop using cocaine despite negative consequences
• Noticeable decline in mental health or daily functioning
• Any thoughts of self-harm or harm to others

Additional Resources

• Substance Abuse and Mental Health Services Administration (SAMHSA): https://www.samhsa.gov
• National Institute on Drug Abuse (NIDA): https://www.drugabuse.gov

Tips for Medical Coders

• Ensure documentation specifies the presence of both cocaine dependence and cocaine-induced psychotic disorder with delusions.
• Verify if there are any co-occurring mental health conditions that also need coding.
• Double-check for coding updates or changes in ICD categorization related to substance-induced disorders.