Adverse Effects of Cocaine Abuse

Specific, consequences of cocaine abuse on health and psycho-social functioning were assessed in 55 cocaine-abusing subjects who called a telephone “helpline.” Results showed a high incidence and wide range of adverse consequences including: (a) impairment of job functioning, interpersonal relationships, and financial status; (b) disturbances of mood and cognitive functioning; (c) psychiatric symptoms of depression, paranoia, and increased suicidal/violent tendencies; and (d) physical symptoms of exhaustion, weight loss, sleep problems, and seizures. Cocaine-related automobile accidents, suicide attempts, and violent acts, including a cocaine-related homicide, were also reported. Intranasal users reported no fewer and no less severe adverse consequences than free-base smokers or intravenous users. Our findings challenge popular notions that cocaine is a benign “recreational” drug and that the intranasal route of administration guarantees protection against addictive patterns of use and adverse effects. Introduction Cocaine use has escalated to epidemic proportions in the U.S. in recent years. Nationwide surveys estimate that over 22 million American have used cocaine and the numbers continue to soar at an alarming Read more […]

Cocaine abuse treatment strategies

Strategies devised to treat cocaine abuse have existed since its intractable lure for some first became obvious almost a century ago. During this period no generally accepted or successful treatment has emerged. Chronic cocaine abuse has been assumed to cause no physiologic withdrawal state on discontinuation because of insufficient evidence for an abstinence syndrome of major physiological changes like the classic sort characterizing sedative or opiate withdrawal (). Cocaine abuse has thus been assumed to be a “psychological dependence” rather than one involving neurophysiological adaptations, and currently used treatments consist of psychological strategies aimed at modifying addictive behaviors. Issues related to current psychological strategies will be discussed first, followed by a summary of evidence indicating cocaine abuse may cause neuroadaptation. The latter includes a review of pharmacological strategies, aimed at reversal of such adaptation, which may hold future potential as adjuncts in cocaine abuse treatment. Cocaine abuse treatment strategies: Current treatments Potential New Directions in Treatment Despite the past assumption that cocaine abuse is a “psychological addiction,” it is plausible Read more […]

Outpatient Treatment and Outcome of Prescription Drug Abuse

Forty-six consecutive patients who voluntarily sought outpatient treatment for abuse of one or more prescription drugs were studied. Barbiturates, amphetamines, and diazepam were the most common drugs abused. Desired treatments by patients included counseling, medical withdrawal, or medical maintenance with the drug of abuse or a chemically related drug. Twenty-two (47.8 percent) patients left treatment and relapsed within one month; another eight (17.4 percent) patients relapsed between one and three months after entering treatment. Only 13 (28.3 percent) reported abstinence 90 days after entering treatment. This experience suggests that a wide range of medical, social, and psychologic resources are required to treat prescription drug abuse, and that long-term drug abstinence is difficult to achieve with all patients. Treatment of prescription drug abuse has dealt primarily with drug complications such as overdose, toxic reactions, and techniques for medical withdrawal. Other reports describe behavior patterns of prescription drug abuse and often refer to it as poly-drug abuse, since many persons frequently abuse more than one drug. Some reports emphasize the clinical complexity of poly-drug abuse and particularly Read more […]

Cocaine-Related Disorders

DSM-IV-TR describes both cocaine use disorders (cocaine dependence and cocaine abuse) and cocaine-induced disorders (cocaine intoxication, cocaine withdrawal, cocaine intoxication delirium, cocaine-induced sexual dysfunction, cocaine-induced psychotic, mood, anxiety, and sleep disorders). Epidemiological Characteristics An estimated 193,034 U.S. emergency department visits solely for cocaine use were documented in the 2001 Drug Abuse Warning Network (Office of Applied Studies 2003), and cocaine is the most frequently reported drug in emergency department visits. Frequent reasons for psychiatric consultation in the medical setting are cocaine overdose, positive results of a urine toxicological screen, cocaine-induced depression, cocaine-induced cardiac problems, and cocaine-induced psychosis. According to the 1998 National Household Survey on Drug Abuse, 1.8 million individuals in the United States had used cocaine during a 1-month period. Use of crack cocaine is especially high in poor urban areas, but its use is widespread among other populations, such as rural migrant workers. Many cocaine users are polysubstance abusers. Pharmacological Characteristics Cocaine hydrochloride is a white crystalline powder derived Read more […]

Amphetamine-Related Disorders

Amphetamines (speed) have stimulant and reinforcing properties similar to those of cocaine. Amphetamines cause catecholamine release, especially of dopamine. The signs and symptoms of amphetamine intoxication include tachycardia, increased blood pressure, pupillary dilatation, agitation, elation, loquacity, and hypervigilance. In contrast to cocaine, amphetamines rarely cause myocardial infarction. Amphetamine psychosis can resemble acute paranoid schizophrenia. Visual hallucinations are common. Binge episodes (“runs”), which are similar to those experienced with cocaine use, often alternate with symptoms of a severe crash. Polysubstance use is common. CNS stimulants, such as dextroamphetamine and methylphenidate, are prescribed for the treatment of narcolepsy, attention-deficit/hyperactivity disorder, and fatigue in multiple sclerosis, but the doses used infrequently cause adverse effects such as insomnia, irritability, confusion, and hostility. Amphetamine abuse can start in an attempt to lose weight or to enhance energy. Epidemiological Characteristics and Complications Abuse of methamphetamine (“ice”) is a particular problem in the midwestern, western, and southwestern United States but has been spreading into Read more […]

Amphetamines and the Law

Jimmy, 17, was riding his skateboard home on the sidewalk when suddenly, a few hundred feet ahead of him, six police cars rushed in and came to a stop surrounding a small house set back from the street. Jimmy stopped in amazement and watched as the police raced from their squad cars, banging on the door of the house and shouting at the top of their lungs. No one answered, and the police used a battering ram to break down the door and then rushed in. Jimmy and others who were passing by wanted to wait and see what happened next, but a local police officer chased everyone away, telling them to go home, the show was over. On the news that night, Jimmy heard that the house the police had raced into was a clandestine methamphetamine lab. The landlord had apparently grown suspicious and contacted the cops. Amphetamines that are abused may be diverted from legal sources, whether the drug is obtained from people with prescriptions for the drug because they have been diagnosed with attention-deficit/hyperactivity disorder or the drug is stolen from others. It may also be purchased from drug dealers or through an illicit site on the Internet. This is also the case for methylphenidate (Ritalin) that is abused. In contrast, most Read more […]

Internet Sales Of Scheduled Drugs

Some online Web sites offer scheduled drugs for sale, such as methylphenidate (Ritalin, Concerta), dextroamphetamine (Adderall, Dexedrine), and dexmethylphenidate HCl (Focalin). In a comprehensive report by the National Center on Addiction and Substance Abuse at Columbia University, in New York, the researchers noted that Internet users are largely young individuals, such as college students, teens, and even children. Illicit Web sites have few or no protections for children and in fact the researchers reported that a 13-year-old child, under the supervision of adults, ordered Ritalin online when giving her correct age, height, and weight. Of course, some online pharmacies are legitimate and most are certified by the National Association of Boards of Pharmacy under the Verified Internet Pharmacy Practice Sites (VIPPS) program. In 2008, the researchers found 365 sites offering scheduled drugs for sale, a decrease from the 581 sites found in 2007. However, 27% of the sites sold stimulants, more than double the rate of 11% found in 2007. Many of these sites stay in business for a year and then close. The researchers also noted that legitimate payers are opposed to illegal drug sales; for example, PayPal does not Read more […]

Meth And Other Stimulants

Methamphetamine is a synthetic psychostimulant that physicians have legally prescribed as a treatment for attention deficit disorder under the brand name Desoxyn. The drug can be made easily in clandestine labs with over-the-counter ingredients. For addicts, it is relatively inexpensive to purchase and has desired effects that last for hours. The desired effects of meth use can last from six to eight hours, followed by a coming-down period when the user becomes agitated and potentially violent. Drugs, such as meth, labeled as psychostimulants include a diverse range of CNS (central nervous system) stimulants such as amphetamine, cocaine, methylphenidate (Ritalin), methylene dioxy-methamphetamine (MDMA, or ecstasy), caffeine, and nicotine, to name a few. A number of prescription drugs, in addition to Ritalin, such as Dexedrine (dextroamphetamine), Cylert (pemoline), and Adderall (adderall) are psychostimulants as well. Psychoactive stimulants activate the CNS by increasing pulse rate, alertness, blood pressure, restlessness, euphoria, excitement, increased energy, talkativeness, and other changes. Users of psychostimulants experience euphoria, increased sense of well-being, more energy, more confidence or overconfidence, Read more […]

Meth Story: Chris

Chris grew up as the second son of a middle-class family in Southern California. Chris certainly enjoyed a fairly stable childhood and early adolescence. While in high school, he was a popular young man and played the high school basketball team. Chris had always felt that he was a little different from his older siblings in that he was a little more rowdy and a little more likely to get himself into trouble. It was during high school that Chris first began experimenting with drugs and alcohol. At first, he was mainly involved in drinking with high school friends, but then that quickly became regular consumption of marijuana and then occasional use of cocaine. Chris’s cocaine use at first was primarily social in that he would only use it at parties and with friends. However, as the use of cocaine became more and more appealing to him, he eventually reached the point of using it alone and seeking the drug by himself. Chris passed through several years of difficult work and educational experiences, most of which failed because of his excessive drug and alcohol use. Aware of these issues, his parents moved to Arizona to help Chris distance himself from his drug-using friends. He called this move across country a “geographic Read more […]

Drug Info: Therapeutic use. Treatment. Mental and Physiological Effects. Rehab.

Entries are arranged alphabetically and follow a standardized format that allows to easily find information, and also facilitates comparisons of different drugs. Rubrics include: • Official names, Street names: This section lists the alternate names for a substance, including brand names, generic names, and chemical names for drugs, as well as common “street” names for drugs and other substances. • Drug classification: This section lists the type of drug and its classification and schedule by the U.S. Drug Enforcement Administration, if applicable. • Key terms: This is a mini-glossary of terms in the entry that may be unfamiliar to students. • Overview: Historical background is included here, including the drug’s origin, development, and introduction to society. The current impact of the drug is discussed. • Chemical/organic composition: This section includes discussion on the various compositions of the drug, if it is found in pure or altered forms, and whether or not it is often mixed with other substances or drugs. • Ingestion methods: Availability of the drug or substance in different forms, for example, pill or powder, is discussed. • Therapeutic use: This section describes Read more […]