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Cocaine Related Disorders

Drug Courts

Medication-Assisted Treatment and the Drug Courts. Image: ©Lightspring-Shutterstock

Cocaine Related Disorders

Given the pervasiveness of substance use disorders, the information provided here is relevant not only for addiction psychiatrists, but all mental health providers and primary care physicians.

This brief communication highlights clinically applicable information and take-home points presented at the American Academy of Addiction Psychiatry Annual Meeting.

Dr Edward Nunes discusses the latest evidence from research studies on stimulant and cocaine dependence in this podcast.

Widespread media reports and billboard campaigns decrying a methamphetamine epidemic are drawing attention away from the greater and more entrenched use of cocaine, according to a National Institute of Drug Abuse (NIDA) scientist speaking at the American Society of Addiction Medicine's (ASAM) 38th Annual Medical-Scientific Conference, held in Miami, April 26 to 29.

A new strategy that normalizes neurotransmitter deficits common in withdrawal from long-term cocaine use may reduce cocaine-seeking behaviors.

Cocaine dependence is a devastating disorder that is associated with a host of medical and psychosocial risks. This complex disorder is made up of distinct clinical components that are interwoven into a cycle of addiction (Figure 1). Cocaine activates ancient pleasure centers that dominate our thoughts, behaviors, and priorities, producing a pleasure-reinforced compulsion to use the drug. Repeated use dysregulates brain pleasure centers and paves the way to addiction through craving and impaired hedonic function.1 Euphoria and craving drive the cycle of addiction through positive and negative reinforcement, respectively, and they provide targets for pharmacological interventions.

In 1962, fewer than 4 million Americans had ever tried illegal drugs. By 1983, that number had risen to 80 million. Drug use peaked in 1985 and dropped until 1992. Since then, use has been increasing steadily, particularly among teenagers. This increase is partially a result of a trend back toward glorification of drug experimentation and legalization, and also because there's a general resurgence of smoking. Whether it's marijuana, tobacco, opiates or cocaine, it's still smoking.

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