“Cocaine-induced Trichotillomania”

The case report I dug up, titled, “Cocaine-induced Trichotillomania,” discusses the case study of a twenty-four year old woman suffering from trich-like symptoms, attributed to her cocaine abuse. Her case evaluation states, “she also complained of constantly pulling out hair from her scalp, eyebrows, arms, axilla and pubic area. Noticeable hair loss from these areas was evident. On detailed enquiry, it became clear that she experienced this urge to pull out her hair only ‘under the influence’ of cocaine and this had been ongoing for the last year”(George/Hamdy 255).

It would appear that since the chemical components of cocaine (benzoylmethyl ecgonine) and Adderall (amphetamine and dextroamphetamine) are so similar, including their effect of the brain (increase norepinephrine and dopamine), that my Adderall abuse might of played a major role in the escalation of my trichotillomania symptoms. Since my trichotillomania developed before my substance use disorders, it’s safe to say that the Adderall wasn’t the entire problem, but after reflecting I definitely can say the urge to pluck became unbearable while under the influence.

“Patients abusing cocaine can experience tactile hallucinations, described classically as a sensation of bugs crawling under the skin—often called cocaine bugs”(George/Hamdy 255). These “bugs” are exactly what it felt like during an intense, ritualistic, picking, often during times of extreme intoxication while focusing to work on something. Before, or even while I was not under the influence, the only time I would pick would be on rare occasions of stress. In fact, I can’t even tell you most of the times because I don’t really remember. It was more unconscious in these instances. While under the influence of Adderall I would notice I was doing it, and couldn’t stop myself because of the “bugs,” nor did I really care to stop by that point in the first place….it felt good, what was “needed.”

George, Sanju, and Hamdy Moselhy. "Cocaine-induced trichotillomania." Addiction 100 Issue 2 (2005): 255-6.