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Posts Tagged ‘Cocaine’

Neurons That Control Overeating Also Drive Appetite for Cocaine

Posted by Sun on June 30, 2012

ScienceDaily (June 24, 2012) — Researchers at Yale School of Medicine have zeroed in on a set of neurons in the part of the brain that controls hunger, and found that these neurons are not only associated with overeating, but also linked to non-food associated behaviors, like novelty-seeking and drug addiction.

Published in the June 24 online issue of Nature Neuroscience, the study was led by Marcelo O. Dietrich, postdoctoral associate, and Tamas L. Horvath, the Jean and David W. Wallace Professor of Biomedical Research and chair of comparative medicine at Yale School of Medicine.

In attempts to develop treatments for metabolic disorders such as obesity and diabetes, researchers have paid increasing attention to the brain’s reward circuits located in the midbrain, with the notion that in these patients, food may become a type of “drug of abuse” similar to cocaine. Dietrich notes, however, that this study flips the common wisdom on its head.

“Using genetic approaches, we found that increased appetite for food can actually be associated with decreased interest in novelty as well as in cocaine, and on the other hand, less interest in food can predict increased interest in cocaine,” said Dietrich.

Horvath and his team studied two sets of transgenic mice. In one set, they knocked out a signaling molecule that controls hunger-promoting neurons in the hypothalamus. In the other set, they interfered with the same neurons by eliminating them selectively during development using diphtheria toxin. The mice were given various non-invasive tests that measured how they respond to novelty, and anxiety, and how they react to cocaine.

“We found that animals that have less interest in food are more interested in novelty-seeking behaviors and drugs like cocaine,” said Horvath. “This suggests that there may be individuals with increased drive of the reward circuitry, but who are still lean. This is a complex trait that arises from the activity of the basic feeding circuits during development, which then impacts the adult response to drugs and novelty in the environment.”

Horvath and his team argue that the hypothalamus, which controls vital functions such as body temperature, hunger, thirst fatigue and sleep, is key to the development of higher brain functions. “These hunger-promoting neurons are critically important during development to establish the set point of higher brain functions, and their impaired function may be the underlying cause for altered motivated and cognitive behaviors,” he said.

“There is this contemporary view that obesity is associated with the increased drive of the reward circuitry,” Horvath added. “But here, we provide a contrasting view: that the reward aspect can be very high, but subjects can still be very lean. At the same time, it indicates that a set of people who have no interest in food, might be more prone to drug addiction.”

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Current, Not Prior, Depression Predicts Crack Cocaine Use

Posted by Sun on May 23, 2012

ScienceDaily (July 14, 2011) — Even after accounting for current crack use, a new study finds that women in drug court who are experiencing current major depression are more likely to use crack within four months than other women in drug court. The paper’s lead author argues that depression screening and treatment may be important components of drug court services for crack-using women.

Women who are clinically depressed at the time they enter drug court have a substantially higher risk of using crack cocaine within four months, according to a new study. Because current but not past depression was associated with a higher risk of use, the study published in the journal Addictionsuggests that addressing depression could reduce the number of women who fail to beat crack addiction in drug court.

“We found that current major depression increased the risk of crack use, but depression in the past year that had gotten better did not,” said Jennifer Johnson, assistant professor (research) of psychiatry and human behavior in the Warren Alpert Medical School of Brown University and lead author of the study. “This suggests that if the depression remits, the risk of crack use goes down. Screening for depression and effective depression treatment may be important components of drug court services.”

Addiction and depression are closely associated, said Johnson, who is also affiliated with Brown’s Center for Alcohol and Addiction Studies. It isn’t always clear how the two affect each other, especially at an urgent moment such as entry into the court system. Johnson set out to untangle the two by analyzing data gathered by researchers at Washington University in St. Louis as part of an HIV prevention study.

Among the 261 women in the study, 16 percent had a current major depressive episode and 40 percent had experienced a major depressive episode in their lifetime. Among the women currently depressed, 46 percent used crack during the next four months. Among women who weren’t currently depressed, only 25 percent used crack in the next four months.

At the beginning of the study, the analysis statistically adjusted for whether women were using crack, which is highly addictive, and took the timing of the women’s depression into account, said Johnson, who is also affiliated with the Center for Prisoner Health and Human Rights, a collaboration of Brown University and The Miriam Hospital.

Women who had been depressed at some time in the past, even in the last year, did not have an increased risk of crack use compared to women who had never been depressed, Johnson found. Women who were currently depressed, however, were significantly more likely to use crack than women who were never depressed. Furthermore, currently depressed women had nearly four times the odds of using crack during follow-up compared to women who had been depressed at some point in their past. The odds were nearly six times greater compared to women who were depressed within the last year, but not currently.

“It doesn’t matter if they’ve been depressed in the past,” she said, “only how they’re doing right now.”

The data hint that depression may have contributed to crack use in this population, Johnson said.

“It is well known that crack use can cause depression and depression can contribute to crack use,” Johnson said. “However, in this study baseline depression [at the beginning of the study] was not associated with baseline crack use, but was associated with future crack use, suggesting that depression may have led to crack use and not vice versa.”

If women in drug court can be successfully screened and treated for depression, Johnson said, the resulting reduction in crack use predicted by the analysis might benefit not only the women but also the community.

“The public ends up paying the cost of drug court and incarceration,” she said. “Depression treatment isn’t that expensive.”

In addition to Johnson, the paper’s other authors are Linda B. Cottler, Catina O’Leary, Catherine W. Striley, Arbi Ben Abdallah, and Susan Bradford, all of Washington University. Cottler’s grant from the National Institute of Nursing Research funded the original HIV-prevention study for which the data was acquired. Johnson’s analysis of addiction and depression was supported by a grant from the National Institute on Drug Abuse

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Computer Model Shows Changes In Brain Mechanisms For Cocaine Addicts

Posted by Sun on May 19, 2012

ScienceDaily (Sep. 22, 2009) — About 2 million Americans currently use cocaine for its temporary side-effects of euphoria, which have contributed to making it one of the most dangerous and addictive drugs in the country. Cocaine addiction, which can cause severe biological and behavioral problems, is very difficult to overcome.

Now, University of Missouri researchers Ashwin Mohan and Sandeep Pendyam, doctoral students in the Department of Electrical and Computer Engineering, are utilizing computational models to study how the brain’s chemicals and synaptic mechanisms, or connections between neurons, react to cocaine addiction and what this could mean for future therapies.

“With cocaine addiction, addicts don’t feel an urge to revolt because there is a strong connection in the brain from the decision-making center to the pleasure center, which overwhelms other normal rewards and is why they keep seeking it,” Pendyam said. “By using computational models, we’re targeting the connection in the brain that latches onto the pleasure center and the parameters that maintain that process.” Glutamate is the major chemical released in the synaptic connections in the brain; the right amount present determines the activity of those connections.

Using the computational model, MU researchers found that in an addict’s brain excessive glutamate produced in the pleasure center makes the brain’s mechanisms unable to regulate themselves and creates permanent damage, making cocaine addiction a disease that is more than just a behavioral change.

“Our model showed that the glutamate transporters, a protein present around these connections that remove glutamate, are almost 40 percent less functional after chronic cocaine usage,” Mohan said. “This damage is long lasting, and there is no way for the brain to regulate itself.

Thus, the brain structure in this context actually changes in cocaine addicts.” Mohan and Pendyam, in collaboration with MU professor Satish Nair, professor of electrical and computer engineering, and Peter Kalivas, professor and chair of the neuroscience department at the Medical University of South Carolina, found that the parameters of the brain that activate the pleasure center’s connections beyond those that have been discovered must undergo alteration in order for addicts to recover.

This novel prediction by the computer model was confirmed based on experimental studies done on animal models by Kalivas’ laboratory. “The long-term objective of our research is to find out how some rehabilitative drugs work by devising a model of the fundamental workings of an addict’s brain,” said Mohan, who will attend Washington University in St. Louis for his postdoctoral fellowship.

“Using a systems approach helped us to find key information about the addict’s brain that had been missed in the past two decades of cocaine addiction research.” Moham and Pendyam’s research has been published inNeuroscience and as a book chapter in New Research on Neuronal Network from Nova Publishers.

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Chronic Cocaine Use Triggers Changes in Brain’s Neuron Structure

Posted by Sun on May 10, 2012

ScienceDaily (May 9, 2012) — Chronic exposure to cocaine reduces the expression of a protein known to regulate brain plasticity, according to new, in vivo research on the molecular basis of cocaine addiction. That reduction drives structural changes in the brain, which produce greater sensitivity to the rewarding effects of cocaine.

The finding suggests a potential new target for development of a treatment for cocaine addiction. It was published last month in Nature Neuroscience by researchers at the University at Buffalo and Mount Sinai School of Medicine.

“We found that chronic cocaine exposure in mice led to a decrease in this protein’s signaling,” says David Dietz, PhD, assistant professor of pharmacology and toxicology in the School of Medicine and Biomedical Sciences, who did the work while at Mt. Sinai. “The reduction of the expression of the protein, called Rac1, then set in motion a cascade of events involved in structural plasticity of the brain — the shape and growth of neuronal processes in the brain. Among the most important of these events is the large increase in the number of physical protrusions or spines that grow out from the neurons in the reward center of the brain.

“This suggests that Rac1 may control how exposure to drugs of abuse, like cocaine, may rewire the brain in a way that makes an individual more susceptible to the addicted state,” says Dietz.

The presence of the spines demonstrates the spike in the reward effect that the individual obtains from exposure to cocaine. By changing the level of expression of Rac1, Dietz and his colleagues were able to control whether or not the mice became addicted, by preventing enhancement of the brain’s reward center due to cocaine exposure.

To do the experiment, Dietz and his colleagues used a novel tool, which allowed for light activation to control Rac1 expression, the first time that a light-activated protein has been used to modulate brain plasticity.

“We can now understand how proteins function in a very temporal pattern, so we could look at how regulating genes at a specific time point could affect behavior, such as drug addiction, or a disease state,” says Dietz.

In his UB lab, Dietz is continuing his research on the relationship between behavior and brain plasticity, looking, for example, at how plasticity might determine how much of a drug an animal takes and how persistent the animal is in trying to get the drug.

The research was funded by the National Institute on Drug Abuse and the National Institute of Mental Health.

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Lady Gaga: ‘Cocaine was my friend when I was lonely’

Posted by Sun on May 8, 2012

Lady Gaga has revealed that she used to take cocaine to help her cope with her loneliness and that the drug used to be her “friend”.

The ‘Born This Way’ star has discussed her drug habits in the past, and last Julydenounced cocaine as “the devil”. But according to Rolling Stone, the singer revealed on US TV show The Conversation With Amanda de Cadenet that she had previously used the narcotic to try and fill the “void” inside her.

Gaga, who claimed she was “very depressed” when she was 19, revealed: “I would go back to my apartment every day and I would just sit there. It was quiet and it was lonely. It was still. It was just my piano and myself. I had a television and I would leave it on all the time just to feel somebody was hanging out with me.”

Speaking about how her isolation led her to develop a cocaine habit, she added:

It was like the drug was my friend. I never did it with other people. It’s such a terrible way to fill that void, because it just adds to that void, because it’s not real.

However, the singer said she had eventually realised she was on a destructive path and was killing her creativity. “I sort of fucking woke up one day and was like, ‘You’re an asshole. You’re not an artist,'” she said. “If you were a real fucking artist, you’d be focused on your music. You wouldn’t be spending your money on the white devil.”

….

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

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Cocaine

Posted in Addictions and Habits | Tagged: | 1 Comment »

How the Brain Puts the Brakes On Negative Impact of Cocaine

Posted by Sun on April 29, 2012

ScienceDaily (Jan. 11, 2012) — Research published by Cell Press in the January 12 issue of the journal Neuron provides fascinating insight into a newly discovered brain mechanism that limits the rewarding impact of cocaine. The study describes protective delayed mechanism that turns off the genes that support the development of addiction-related behaviors. The findings may lead to a better understanding of vulnerability to addiction and as well as new strategies for treatment.

Drug addiction is associated with persistent and abnormal changes in the reward circuitry of the brain, and drug-induced changes in gene expression are thought to contribute to addiction behaviors. Recent research with rodent models of addiction has implicated histone deacetylases (HDACs), which are modulators of gene expression, in the regulation of cocaine-induced behaviors. However, how cocaine regulates the function of HDACs and whether this regulation can modify addiction-related behaviors was not known.

“HDAC5 in the nucleus accumbens, a key brain region involved in drug abuse, limits the rewarding impact of cocaine and the long-lasting memory of places where the drug was taken, particularly after prior cocaine exposure,” explains senior study author Dr. Christopher W. Cowan from the University of Texas Southwestern Medical Center. “However, it was not clear whether this was a passive role for HDAC5 or whether drugs of abuse might regulate its function after drug exposure.” In the current study, Dr. Cowan and colleagues explored how cocaine might regulate HDAC5 and the development of drug reward-associated behaviors.

Using a rodent model, the researchers discovered that cocaine triggered a novel signaling pathway that caused HDAC5 to move to the cell nucleus, where gene expression occurs, and they found that this process was essential for HDAC5 to limit the development of cocaine reward-associated behaviors. “Our findings reveal a new molecular mechanism by which cocaine regulates HDAC5 function to antagonize the rewarding impact of cocaine, likely by putting a brake on drug-stimulated genes that would normally support drug-induced behavioral changes,” concludes Dr. Cowan. “Deficits in this process may contribute to the development of maladaptive behaviors associated with addiction following repeated drug use in humans and may help to explain why some people are more vulnerable to addiction than others.”

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Cocaine and the Teen Brain: New Insights Into Addiction

Posted by Sun on March 8, 2012

ScienceDaily (Feb. 21, 2012) — When first exposed to cocaine, the adolescent brain launches a strong defensive reaction designed to minimize the drug’s effects, Yale and other scientists have found. Now two new studies by a Yale team identify key genes that regulate this response and show that interfering with this reaction dramatically increases a mouse’s sensitivity to cocaine.

The findings may help explain why risk of drug abuse and addiction increase so dramatically when cocaine use begins during teenage years.

The results were published in the Feb. 14 and Feb. 21 issues of

theJournal of Neuroscience.

Researchers including those at Yale have shown that vulnerability to cocaine is much higher in adolescence, when the brain is shifting from an explosive and plastic growth phase to more settled and refined neural connections characteristic of adults. Past studies at Yale have shown that the neurons and their synaptic connections in adolescence change shape when first exposed to cocaine through molecular pathway regulated by the gene integrin beta1, which is crucial to the development of the nervous system of vertebrates.

“This suggests that these structural changes observed are probably protective of the neurocircuitry, an effort of the neuron to protect itself when first exposed to cocaine,” said Anthony Koleske, professor of molecular biophysics and biochemistry and of neurobiology and senior author of both papers.

In the latest study, Yale researchers report when they knocked out this pathway, mice needed approximately three times less cocaine to induce behavioral changes than mice with an intact pathway.

The research suggests that the relative strength of the integrin beta1 pathway among individuals may explain why some cocaine users end up addicted to the drug while others escape its worst effects, Koleske theorized.

“If you were to become totally desensitized to cocaine, there is no reason to seek the drug,” he said.

Koleske and Jane R. Taylor, professor of psychiatry and psychology and an author of the Feb. 14 paper, are teaming up with other Yale researchers to look for other genes that may play a role in protecting the brain from effects of cocaine and other drugs of abuse.

Shannon Gourley, now of Emory University who worked with Koleske and Taylor, is lead author on the Feb. 14 paper detailing how the structural response to cocaine protects against cocaine sensitivity. Anastasia Oleveska and Michael S. Warren are other Yale authors on this paper. Warren and William D. Bradley of Yale are co-lead authors of the latest Neuroscience paper describing the role for integrin beta 1 in the control of adolescent synapse and dendrite refinement and stability. Yu-Chih Lin, Mark A. Simpson, Charles A. Greer are other Yale-affiliated authors.

Source: http://www.sciencedaily.com

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

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Cocaine Users Have 45 Percent Increased Risk of Glaucoma

Posted by Sun on October 2, 2011

ScienceDaily (Sep. 30, 2011) — A study of the 5.3 million men and women seen in Department of Veterans Affairs outpatient clinics in a one-year period found that use of cocaine is predictive of open-angle glaucoma, the most common type of glaucoma.

The study revealed that after adjustments for race and age, current and former cocaine users had a 45 percent increased risk of glaucoma. Men with open-angle glaucoma also had significant exposures to amphetamines and marijuana, although less than cocaine.

Patients with open-angle glaucoma and history of exposure to illegal drugs were nearly 20 years younger than glaucoma patients without a drug exposure history (54 years old versus 73 years old).

Study results appear in the September issue of Journal of Glaucoma.

“The association of illegal drug use with open-angle glaucoma requires further study, but if the relationship is confirmed, this understanding could lead to new strategies to prevent vision loss,” said study first author Regenstrief Institute investigator Dustin French, Ph.D., a research scientist with the Center of Excellence on Implementing Evidence-Based Practice, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service in Indianapolis. A health economist who studies health outcomes, he is also an assistant professor of medicine at the Indiana University School of Medicine.

Glaucoma is the second most common cause of blindness in the United States. Although the mechanism of vision loss in glaucoma is not fully understood, most research has focused on an increase in eye pressure gradually injuring the optic nerve. Most individuals who develop open-angle glaucoma have no symptoms until late in the disease process when substantial peripheral vision has been lost.

Dr. French and colleagues found that among the 5.3 million veterans (91 percent of whom were male) who used VA outpatient clinics in fiscal year 2009, nearly 83,000 (about 1.5 percent) had glaucoma. During the same fiscal year, nearly 178,000 (about 3.3 percent) of all those seen in the outpatient clinics had a diagnosis of cocaine abuse or dependency.

Although this study determined significant increased risk for glaucoma in those with a history of drug use, it does not prove a causal relationship. It is unlikely that glaucoma preceded the use of illegal drugs, since substance use typically begins in the teens or twenties.

“The Veterans Health Administration substance use disorder treatment program is the largest and most comprehensive program of its kind in the country,” said Dr. French. He believes that the reliability of the data used in the glaucoma study reflects the overall scope and high quality of the VHA substance use program.

The long-term effects of cocaine use on intraocular pressure, the only modifiable risk factor for glaucoma, requires further study. Should the association of cocaine use and glaucoma be confirmed in other studies, substance abuse would present another modifiable risk factor for this blinding disease.

This study, “Substance Use Disorder and the Risk of Open-Angle Glaucoma” was funded by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service. In addition to Dr. French, co-authors are Curtis E. Margo, M.D., of the University of South Florida College of Medicine and Lynn E. Harman, M.D., of the James Haley VA Hospital in Tampa.

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

Related Articles

Cocaine and the Teen Brain: New Insights Into Addiction

Cocaine – The History and the Risks

Cocaine

Cocaine Abuse

Sigmund Freud’s Cocaine Years

New way to reduce the effects of cocaine

COCAINE HISTORY

Cocaine Detoxification

Current, Not Prior, Depression Predicts Crack Cocaine Use

New Hope for Treatment of Cocaine Addiction

Lady Gaga: ‘Cocaine was my friend when I was lonely’


Source:http://www.sciencedaily.com

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Cocaine – The History and the Risks

Posted by Sun on August 7, 2011

Coca is a plant that the devil invented for the total destruction of the natives.
– Don Diego De Robles, 16th-Century Orthodox Catholic artist.

Cocaine – or Charlie; Coke; Blow; Snow; Flake; C; Candycaine (or cane); Cat’s pee (for crack); Incentive; Bazooka; Bouncing powder; Dama Blanca; Nose Powder; Peruvian Lady; Roxanne – is a powerfully addictive short-acting drug that directly stimulates the brain, the heart, blood vessels and the nervous system.

What is Cocaine?

It’s great for sex but really it’s an a***hole’s drug.
– Sir Elton John.

Coca1 leaves, the source of cocaine, have been chewed and ingested for thousands of years. Human beings are drug users; most drugs are derived from natural substances which, in moderation, have a benign effect. The pure chemical, cocaine hydrochloride, (C17H21NO4), has been an abused substance for over a century. This leads on to the problems that we have with cocaine abuse (as opposed to use) in that we, as a society, have the ‘more, NOW!‘ bug. So rather than chew a coca leaf, we take refined lines of it, at concentrations that are far from natural.

Cocaine is the oldest-known effective local anaesthetic, first used in ophthalmic surgery in 1884 by Karl Koller. It is due to its powerful anaesthetic properties (first noticed by future psychoanalyst Sigmund Freud) that the flesh it directly touches is liable to suffer secondary damage; this is why habitual cocaine ‘snorters’ tend to lose the partition (septum) between their nostrils.

Cocaine is generally sold by drug-dealers as a fine, white, crystalline powder, which has been ‘cut’ (diluted) with innocuous substances such as flour, cornstarch, talcum powder or icing sugar, because they want to make more profit. However, drug dealers sometimes don’t have such innocent ‘mixers’ so the next batch they sell might have been combined with active drugs like procaine (a chemically-related local anaesthetic) or other stimulants such as amphetamines and painkilling drugs like paracetamol and aspirin which are dangerous in large doses.

The possession and distribution of cocaine, a Class A drug in the UK, is illegal and carries consequences such as jail sentences or large fines. People with a drugs conviction may find they have problems with visa applications.

Why do People Take Cocaine?

Cocaine is a stimulant which provides a feeling of alertness, mild euphoria and (usually misplaced) self-confidence. It is a mood-enhancer and heightenssexual interest. Some people think it increases their performance when it is usually their perception which has changed.

Cocaine in Popular Culture

  • Cocaine Decisions – sung by Frank Zappa.
  • Cocaine – written and sung by JJ Cale; also performed by Eric Clapton.
  • Simply Everyone’s Taking Cocaine a poem by Murray Lachlan Young.
  • The Strange Case of Dr Jekyll and Mr Hyde was written by Robert Louis Stephenson while he was on a six-day cocaine binge.
  • [Cocaine is] ‘so transcendentally stimulating and clarifying to the mind that its secondary action is a matter of small moment’ according to Sherlock Holmes (written by Sir Arthur Conan Doyle).

How Cocaine is Used

Cocaine can be:

  • Snorted through the nose.
  • Rubbed onto places like the gums.
  • Injected. Injecting cocaine – or indeed any drug – carries the added risk of infection with hepatitis B and HIV, the virus that causes AIDS, if the user shares a needle with a person already infected with the virus.
  • Or smoked, in a form known as ‘crack’.

Crack Cocaine

Crack cocaine is produced by mixing base cocaine with a solution of baking soda and water and heating until all the water has gone. This produces the distinctive ‘crack’ sound by which it is named. Some crack-partakers describe the buzz they get as a ‘whole-body orgasm’. Crack is very, very addictive; much more so than cocaine. Therefore an intense craving for more soon develops, and heavy users may experience formication (the sensation of insectscrawling beneath the skin). Eventually the brain starts to lose its ability to send out the ‘feelgood’ signals, leading to more hits as the user tries in vain to relive the original high.

How Cocaine was used Historically

In 1886 a ‘valuable brain-tonic and cure for all nervous afflictions’ was introduced. The new beverage ‘offering the virtues of coca without the vices of alcohol’ contained 60mg of cocaine per serving until 1903. It was a popular drink then, and it remains so today, although the drug is now removed from the coca leaves which are still used for flavouring Coca-Cola™.

Cocaine used to be used in cigarettes ‘guaranteed to lift depression’; chocolate; medicines; tonics and toothache cures. Ryno’s Hay Fever and Catarrh Remedy was a best-seller – it was 99% cocaine. The pharmaceutical company which promoted it claimed that it ‘could make the coward brave, the silent eloquent, and render the sufferer insensitive to pain’.

Vin Mariani was a wine with an essential ingredient – cocaine. A variety of assertions were made about its health benefits, including Health, Strength, Energy and VitalityHastens Convalescence especially after Influenza and Fortifies, Strengthens, Stimulates and Refreshes the Body and the Brain. This coca wine was very popular in high quarters: His Holiness Pope Leo XIII honoured Corsican-born pharmacist and businessman Angelo Mariani with a Vatican gold medal as a mark of his gratitude.

The Brompton Cocktail

The Brompton Cocktail2 was an elixir of cocaine, morphine (heroin), alcohol and flavoured syrup which used to be prescribed to patients dying of cancer. Popular in the 1930s, it is now banned. The orgasmic, euphoric exit must have seemed a better way to end a life than an agonisingly painful drawn-out last gasp as well as being beneficial for the attending loved ones around the death bed.

Progression

A ‘drug-user’ does not necessarily utilise one single drug in their lifetime. Some analysing drug use believe in the idea of progression: a susceptible individual starts with one seemingly innocuous drug that many have tried and then left alone, such as cannabis – then ‘progresses’ through harder drugs like cocaine before becoming seriously unstuck with something like heroin. Although most ‘soft’ drug-users do not progress in this way, there is evidence to suggest that many hard drug users followed a progressive line of addiction.

Medical Consequences of Cocaine Abuse

Cardiovascular Effects

A growing number of reports have related cocaine use with the onset of myocardial infarction (heart disease) in young, otherwise healthy, people. Several studies have suggested that cocaine may be cardiotoxic (cause heart muscle damage).

  • Disturbances in heart rhythm (fast or irregular heartbeats).
  • Myocardial infarction.
  • Spasm and narrowing of the arteries that lead to the heart muscle.
  • Aneurysm.
  • Thrombosis (blood clot).
  • High blood pressure.

Respiratory Effects

  • Respiratory failure.
  • ‘Crack lung’ (severe chest pain and breathing problems).

Neurological Effects

  • Haemorrhage.
  • Seizure.
  • Stroke.
  • Headache.
  • Drug-induced psychosis (a condition known as toxic paranoid psychosis).
  • Depression.
  • Hallucinations.

Gastrointestinal Complications

  • Abdominal pain.
  • Constipation.
  • Perforation of the stomach lining.
  • Bloody diarrhoea.
  • Vomiting.

Due to reduced blood flow, ingested cocaine can cause gangrene of the bowel. Loss of appetite leads to malnourishment, which in turn can lead to related disorders such as anorexia nervosa. Cocaine can be detected in urine for five days after ingestion and up to three weeks later in heavy users.

Personality Changes

  • Mood disturbances/swings.
  • Short temper.
  • Anger.
  • Restlessness/tiredness/inability to sleep.
  • Irritability.
  • Anxiety disorders/fear/phobia/panic attacks.
  • Carelessness about personal appearance, bathing and grooming.
  • Change in friends/groups of friends.
  • Frequently in need of money.
  • Loss of interest in work/school, family, pets and hobbies or activities previously enjoyed.
  • Abuse of relationships – for example, stealing from family members to pay for the next ‘hit’.
  • Inability to think clearly3.
  • Losing touch with reality.

Effects During Pregnancy

Cocaine use by expectant mothers can lead to miscarriage, stillbirth, premature labour, low birthweight babies and birth defects. Cocaine increases the risk of placental abruption, which is when the placenta detaches from the inside of the womb; and ante-partum haemorrhage, a life-threatening condition for both mother and child. Cocaine use doubles the risk of premature birth, which can lead to other complications like immature lungs, cerebral palsy, visual and hearing impairments, and slow development of the child.

Babies may even be born addicted to cocaine if the mother continues to take it during late pregnancy. Any drug travels through the bloodstream of a foetus via the mother’s umbilical cord. If a baby has been used to having cocaine course through its body in utero (inside the womb) he or she will go through ‘withdrawal’ once born.

Cosmetic Effects

  • Runny nose/frequent sniffing.
  • Red, bloodshot eyes with dark circles beneath.
  • Weight loss/skeletal look.
  • Septum damage.

Death

Death can result from cocaine abuse4, either through overdose, allergic reaction, or the combination of the effects with other dangerous drugs or substances, such as alcohol. The human liver combines cocaine and alcohol and creates a third substance, cocaethylene, which magnifies cocaine’s euphoric effects. The mixture of cocaine and alcohol is the most common two-drug combination which results in drug-related death.

Fluid in the lungs (pulmonary edema) occurs because extremely intoxicated (drunk or drugged or both) sleeping people often lose the reflexive tendency to clear their throat of mucus, or they may drown in their own vomit. A state of intoxication can be achieved where the abuser endangers his ability to breathe altogether.

For every social drug-related death, there are family and friends left behind to pick up the pieces. If you are an addict, seek help5 to cure your addiction.

Source: http://www.bbc.co.uk/dna/h2g2/A10832384

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

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Cocaine Abuse

Posted by Sun on August 1, 2011

Cocaine Abuse Overview

Cocaine is presently the most abused major stimulant in America. It has recently become the drug most frequently involved in emergency department visits. It is not a new drug of abuse but is now considered the caviar of recreational drugs. Thus, this distinction is reflected in its description-champagne of drugs, gold dust, Cadillac of drugs, status stimulant, yuppie drug, and others. Street names for cocaine also reflect its appearance or method of use (such as flake, snow, toot, blow, nose candy, her, she, lady flake, liquid lady [a mixture of cocaine and alcohol], speedball [cocaine and heroin], crack, rock). And it can also express its method of preparation, such as freebase. It is more popularly known simply as coke.

A common myth is that cocaine is not addictive because it lacks the physicalwithdrawal symptoms seen in alcohol or heroin addiction. Cocaine has powerful psychological addictive properties. As more than one user has reflected, “If it is not addictive, then why can’t I stop?” The trend in drug abuse in the United States is presently multiple or polydrug abuse, and cocaine is no exception. Cocaine is often used with alcohol, sedatives such as Valium, Ativan, or heroin, as an upper/downer combination. The other drug is also used to moderate the side effects of the primary addiction. A common polydrug abuse problem, seen especially in adolescents, is cocaine, alcohol, and marijuana.

Drug abuse, chemical dependency, and addictive behavior spare no one and are spread throughout society. They do not respect age, profession, race, religion, or physical attributes.

  • History: Cocaine is a naturally occurring alkaloid usually extracted from the leaves of the coca shrub, which was originally found in the Andes Mountains of Peru and Bolivia. With its appreciation as a lucrative cash crop, it is now cultivated in Colombia, Argentina, Brazil, Mexico, the West Indies, Ecuador, and Java. Coca leaves were mixed with lime and chewed by the Peruvian Indians as early as the sixth century to allay the effects of cold, hunger, and fatigue. It is still used as such as a gift from the Sun God. In this sense, coca is an important sociocultural tradition for Peruvian and Bolivian Indians and should not to be confused with the cocaine snorting, smoking, and injecting of the Western abuser. Coca was later introduced to Europe, where the alkaloid cocaine was isolated. Its medicinal effects on depression, alcohol andmorphine addiction, fatigue, and as a local anesthetic were discovered. However, these discoveries were not without cost to those who experimented with it. The result was addiction and dependency on the drug.
  • A brain tonic: In 1886, an elixir containing cocaine from the coca leaf andcaffeine from the African kola nut was marketed in Atlanta. It was sold as a brain tonic recommended for headaches, alcoholism, morphine addiction,abdominal pain, and menstrual cramps. This elixir, appropriately named Coca-Cola, rapidly became one of the most popular elixirs in the country. But because of the adverse effects of cocaine, appreciated even then, the Coca-Cola Company agreed to use decocainized coca leaves in 1903. Cocaine came under strict control in the United States in 1914 with the Harrison Narcotic Act. It is listed as a narcotic and dangerous. Though its use is dangerous, it is not a narcotic, but its use is subject to the same penalties as those for opium, morphine, and heroin.
  • Limited medical use: Cocaine has little medical use. Because of its anesthetic effect, it was used for eye surgery. But because of its profound ability to vasoconstrict blood vessels (that is, make veins and arteries narrow, thus stopping bleeding), it can lead to scarring and delayed healing of the cornea. It is still available for use in the nose for surgery, stopping nosebleeds, and as a local anesthetic for cuts in children.
  • Street use: The cocaine destined for street use in the United States is generally isolated and converted to cocaine hydrochloride in South American labs. This cocaine salt, which can be as pure as 95%, is then smuggled into the country. As it passes through many hands from the importer to the user, it is usually diluted (“cut” or “stepped on”) at each stage of distribution to increase each dealer’s profit. The final product can be from 1% to 95% pure. Common additives are sugars, such as mannitol, lactose, or glucose, or even sugar substitutes, and local anesthetics such as tetracaine, procaine, and lidocaine. Quinine, talc, and cornstarch have also been used. Other illicit drugs, such as heroin, codeine, amphetamine, phencyclidine (PCP), LSD, and hashish, can be mixed in as well. Some consumers may unknowingly purchase a supply without any cocaine, but just a cocaine substitute such as caffeine, amphetamine, PCP, procaine, and lidocaine.
    • Population surveys released by the National Institute on Drug Abuseindicate that most cocaine users are older, inner-city crack addicts.
    • However, field reports are identifying new groups of users: teenagers smoking crack with marijuana in some cities, Hispanic crack users in Texas, middle-class suburban users of cocaine hydrochloride, and female crack users in their 30s with no prior drug use history.
  • Methods of abuse: Coke in this hydrochloride salt form may be injected; swallowed; applied to oral, vaginal, or even rectal mucous membranes; or mixed with liquor. Coke is most commonly used by snorting or sniffing.
    • With snorting, the usual ritual is to place a line of coke, about 0.3 cm wide by 2.5 cm long, on a smooth surface. The finely divided powder is then snorted (inhaled quickly) into a nostril through a plastic or glass straw or a rolled currency bill. This ritual is usually repeated within a few minutes using the other nostril.Special spoons and other paraphernalia are available for snorting cocaine.
    • Cocaine is generally not taken by mouth for recreational purposes. Toxic reactions, including death, have occurred in people who swallow the drug to avoid police detection or border authorities. This smuggling attempt is known as body packing. This crystalline white powder can be dissolved in water and used intravenously (“slammed”). In this form, it has a high melting point, so it cannot be smoked and is the most widely used form of the drug.
    • Freebasing involves the conversion of cocaine hydrochloride into cocaine sulfate that is “free” of the additives and nearly 100% pure. It is not water soluble and has a low melting point, so it can be smoked. The freebaser runs the risk of being burned by the conversion process because a highly volatile solvent, such as ether, is being used.
    • Crack is extracted from coke using baking soda and heat-a relatively safe method compared with the ether technique. The waxy base becomes rocks of cocaine, ready to be sold in vials. This rock cocaine is also easy to smoke, the most common form of use in the streets. Cocaine sulfate is also available as coca paste known as basuco, bazooka, piticin, pistol, pitillos, or tocos and is widely smoked in South America. Because the freebase is resistant to destruction by heat, it can be smoked either in cigarettes, including marijuana cigarettes, or in “coke pipes.” Smoking the freebase produces a more powerful effect more rapidly, but it is also more dangerous because the safe dose can easily be exceeded. A user describes the comparison: “Snorting coke is like driving 50 miles per hour. Smoking crack is like driving 150 miles per hour without brakes!”
  • Why cocaine becomes addictive: Research with cocaine has shown that all laboratory animals can become compulsive cocaine users. Animals will work more persistently at pressing a bar for cocaine than for any drug, including opiates. An addicted monkey pressed the bar 12,800 times until it got a single dose of cocaine. If the animal survives, it will return to the task of obtaining more cocaine.
    • The human response is similar to that of the laboratory animal. The cocaine-dependent human prefers it to all other activities and will use the drug until the user or the supply is exhausted. These persons will exhibit behavior entirely different from their previous lifestyle.
    • Cocaine-driven humans will compel themselves to perform unusual acts compared with theirformer standards of conduct. For example, a cocaine user may sell her child to obtain more cocaine. There are many stories of professionals, such as lawyers, physicians, bankers, and athletes, with daily habitscosting hundreds to thousands of dollars, with binges in the $20,000-$50,000 range. The result may be loss of job and profession, loss of family, bankruptcy, and death.
  • Lethal dose: Although this drug has been in use for more than 5000 years, the toxic dose or the amount of cocaine that will cause death or some significant medical consequence is unknown. The average lethal dose by the IV route or by inhalation is about 750-800 mg. This is subject to significant individual variation because deaths have occurred in doctors’ offices with as little as 25 mg applied to the mucous membrane or the snorting of a single line in recreational use where the average dose of 1 line is 20 mg.
  • Effects: The method of use dictates the onset of activity and duration of its effects. If snorted, the effects will peak within 30 minutes with its duration of effect lasting 1-3 hours. If swallowed with alcohol, effects peak in 30 minutes and last about 3 hours. If used intravenously or inhaled/smoked, the effects peak in seconds to 2 minutes but last only 15-30 minutes. The breakdown products of the drug will be excreted and can be detected in the urine for 24-72 hours. For chronic users, it can be detected for up to 2 weeks.

Cocaine Abuse Causes

Addictive disease is believed to be caused by genetic background and environment. Those from high-risk family environments are particularly susceptible to the development of addictive disease, and they need to know this in their pre-adolescent period. However, the presence of an addict in the family does not mean that a person will become an addict.

  • Researchers supported by the National Institute on Drug Abuse have identified a process in the brain that may help explain addiction to cocaine and other drugs of abuse. Their research indicates that repeated exposure to cocaine causes a change in genes that leads to altered levels of a specific brain protein. This protein regulates the action of a normally occurring brain chemical called dopamine. It is a chemical messenger in the brain associated with the cocaine’s pleasurable “rush”-the mechanism of addiction. Certainly, more research is needed to unlock the mysteries of addiction, but this information adds one more link in explaining how the brain adapts in the addiction process.

Cocaine Abuse Symptoms

The effects of cocaine can be divided into what goes on in the central nervous system, in the brain, and in the rest of the body. The effects of the drug vary greatly, depending on the route of administration, amount, purity, and effects of the added ingredients. The effect also varies with the user’s emotional state while taking the drug. This is based on the user’s attitude toward the drug, the physical setting in which the drug is being used, his or her physical condition, and whether or not the person is a regular user. Because cocaine affects every organ system, from the brain to the skin, the following discussion will cover signs (what doctors find by physical examination) and symptoms (what you feel) for major organ systems.

  • Central nervous system and psychiatric effects: Users who have pleasurable experiences report varying degrees of euphoria; increased energy, excitement, and sociability; less hunger and fatigue; a marked feeling of increased physical and mental strength; and decreased sensation of pain. Some will feel a great sense of power and competence that may be associated with the delusion or false sense of grandeur, known as cocainomania. There can be talkativeness, good humor, and laughing. Dilated pupils, nausea, vomiting, headache, or vertigo (the sensation of your surroundings or yourself moving or spinning). With or even without increased amounts of coke, these can progress to excitement, flightiness, emotional instability, restlessness, irritability, apprehension, inability to sit still, teeth grinding, cold sweats, tremors, twitching of small muscles (especially of face, fingers, feet), muscle jerks, hallucinations (cocaine bugs, snow lights, voices and sounds, smells), and cocainepsychosis. Cocaine psychosis resembles paranoid schizophrenia and can bring on paranoia, mania, and psychosis.

Major effects that usually cause a cocaine abuser to go to an emergency department are severe headache, seizures, loss of consciousness that can be caused by not breathing or bleeding in the brain, stroke, hyperthermia(increased body temperature), coma, loss of vital support functions (such aslow blood pressure, slow heart rate, slow respirations, and death).

  • Brain effects: The use of cocaine causes the alteration of responsiveness of the brain to various chemicals. These chemicals or neurotransmitters, such asnorepinephrine, dopamine, serotonin, acetylcholine, and gamma-aminobutyric acid, are responsible for most of the complications of cocaine. Infants of cocaine-smoking parents have been brought to an emergency department because of seizures induced by secondhand cocaine smoking. One study of people who sought care in an emergency department reported that 22% complained of anxiety, 13% dizziness, 10% headache, 9% nausea, 9% psychosis, and 9% confusion.
  • Ear, nose, and throat effects: Because the majority of users sniff or snort cocaine through their nose, there are a variety of nasal and sinus diseases. Many users complain of nasal irritation, nasal crusting, recurrent nosebleeds, nasal stuffiness, facial pain caused by sinusitis, and hoarseness.
    • The mucous membrane of both sides of the septum (the cartilage that separates the nostrils) can be damaged by decreased blood supply, along with drying, crusting, and nose picking. This results in a perforation or hole in the septum with more crusting, foul secretions, nosebleeds, and whistling with nasal breathing, the so-called coke nose.
    • Because nasal obstruction is a common complaint, many users self-treat with over-the-counter nasal decongestants, such as Afrin, which adds to the problem because it also closes or narrows the blood vessels. Many users have also realized that this easily recognized and accepted form of self-medication with a nasal spray is a way to administer cocaine in public. After all, who is going to check that it is not a common nasal spray in the dispenser?
  • Lung effects: The direct effects of smoking cocaine are responsible for most lung and breathing complications. The large surface area of the lungs and its great blood supply cause rapid and profound brain stimulation known as the head rush.
    • Smoking the freebase, crack, or paste is done using a glass pipe, waterpipes, or cigarettes, which are heated by butane lighters or matches. The residue from the tars, matches, cocaine contaminants, and additives, such as marijuana, often cause chronic bronchitis, chronic coughing, and coughing up black, nonbloody phlegm. These conditions can cause shortness of breath and chest pain.
    • Utilizing the technique of deep inhalation and breath holding to maximize the amount of cocaine inhaled and absorbed can cause the lung to collapse. These cocaine users will complain of sharp chest pain, often worse with deep breathing, neck pain, difficult or painful swallowing, and air under the skin in the neck that feels like Rice Krispies under the skin when touched (subcutaneous emphysema). Though unusual, the user’s lungs can fill with fluid (pulmonary edema) causing extreme shortness of breath, sometimes respiratory failure, and death.
    • In one study of the cocaine abusers who came to an emergency department, 40% complained of chest pain-the most common complaint-and 22% complained of shortness of breath or were unable to breathe.
  • Cardiovascular (heart, blood vessels): The major effect of cocaine is to stimulate the sympathetic nervous system. This system is responsible for the “fight or flight response” and is controlled primarily by adrenaline orepinephrine. The effects include increased heart rate, blood vessel narrowing, and high blood pressure. Angina or the chest pain that is felt with decreased blood supply to the heart and heart attack have accounted for more reports in medical journals than any other complication of cocaine intoxication. Chest pain associated with cocaine use is now a common problem in urban emergency departments.
    • Other cardiovascular complications include abnormal heart rhythms or rapid heart rate, cardiomyopathy or disease of the heart muscle, or aortic rupture or dissection where there is weakening of the walls of the aorta. The acute use, despite the amount or route, causes narrowing of the arteries to the heart and vasospasm resulting in decreased blood flow to the heart. This causes angina, which can lead to a heart attack that means death of heart tissue. Chronic use of cocaine, again regardless of the route, leads to accelerated hardening and subsequent narrowing of the coronary arteries. Therefore, angina and heart attacks and cardiac deaths have been found in young users from ages 19-44 years.
    • The overstimulation of the sympathetic system with the rapid heart rate, high blood pressure, and vasospasm also cause the abnormal rhythms. Those rhythms may be ventricular tachycardia and ventricular fibrillationand may cause sudden death. Chest pain has been the most common complaint to the emergency department, up to 40% of people, 21% complain of palpitations or the sensation that their hearts are racing or going fast.
  • Pregnancy effects: Cocaine use during pregnancy can increase the complications of pregnancy and affect the fetus directly. These abusers may also use other drugs, alcohol, and nicotine, which adversely affect the pregnancy. They have an increased rate of miscarriages, placenta abruption in which the placenta separates from the wall of the uterus and results instillbirth. There is increasing information that cocaine may cause birth defects with increased rates of malformation, low birth weights, and behavioral abnormalities.
  • Infections: The infectious complications related to IV use of cocaine are not unique to cocaine. All IV drug users are at risk for infections such as cellulitis(soft tissue infection at the injection site), abscesses at the injection sites,tetanus or lockjaw, lung or brain abscesses, or infection of the heart valves. These are due to nonsterile techniques of IV injections. Contagious viruses such as hepatitis B, hepatitis C, and HIV (AIDS virus) are transmitted by sharing IV needles. The abuser may complain of pain and swelling and redness at the injection site or fever. Abusers may also complain of jaundiceor turning yellow, abdominal pain, nausea, vomiting, loss of appetite, or the multitude of complaints that accompany hepatitis and AIDS.
  • Body packers or stuffers: People smuggle the processed cocaine across international borders. They often swallow drug-filled packets or stuff them into body openings such as the vagina or rectum. The “body packer” or “mule” can carry 50 to 200 tightly wrapped condoms or latex bags filled with high-grade cocaine hydrochloride. If the containers break or leak, the cocaine can be absorbed by the person’s body. Most mules have no symptoms and may be apprehended by an astute official who notices some suspicious behavior. Some will become acutely ill when the packets leak or rupture resulting in massive intoxication, seizures, and death. A similar problem may occur with “body stuffers.” These are cocaine users or traffickers who swallow bags of cocaine when arrested so there is no evidence.

When to Seek Medical Care

If you have a psychiatrist who knows of your drug use, and if your symptoms are psychiatric in nature (such as mania, paranoia, violence,suicidal, major depression, homicidal, or hallucinations), call or have someone call your doctor.

  • Call your doctor if the following conditions develop:
    • If you have foul, itchy, or bloody discharge, or facial pain that seems like sinusitis
    • If your chronic cough is associated with a mild fever, more phlegm production, or foul phlegm
    • If you are pregnant and have premature labor pain, vaginal bleeding, or ankle swelling with high blood pressure.
    • If you notice redness with mild swelling and mild pain at an injection site

Severe headache, generalized seizures, loss of consciousness, signs of a stroke (loss of vision, seeing double, inability to speak or slurred speech, weakness of extremities), or coma are all symptoms that demand emergency care. Call 911 for an ambulance as opposed to bringing someone by car to a hospital emergency department.

Someone with severe depression, violent behavior, paranoia, suicidal, or homicidal behavior should certainly be brought to the hospital, especially if a psychiatrist is easily reached. Police may be needed to subdue the violent, paranoid, suicidal, or homicidal person.

  • Go to an emergency department if the following conditions develop:
    • A brisk nosebleed that cannot be stopped by direct pressure for 10 minutes
    • Facial pain or headache with a fever
    • Severe chest pain, difficulty breathing, shortness of breath, or foul or bloody phlegm with fever
    • High blood pressure, especially with symptoms of headache, chest pain, or shortness of breath
    • Chest pain, usually described as pressure or squeezing in nature, which may be accompanied by difficulty breathing, nausea, vomiting, and sweatiness
    • Vaginal bleeding, premature labor pains, and suspicion of miscarriage
    • Significant swelling, pain, redness, red lines leading from the injection site, and accompanied by fever
    • Severe abdominal pain, persistent vomiting, vomiting blood
    • If you think that one of your packets you have swallowed or stuffed in a body orifice (vagina, rectum) is leaking or has broken

Exams and Tests

Often, the final diagnosis of someone who is abusing cocaine is not made by emergency department evaluation and may require admission to the hospital, further testing, and results of tests, which take time or are not done in a hospital emergency department.

Overall, the doctor will conduct whatever tests are necessary to evaluate the symptoms of someone with cocaine-induced conditions. In addition to a physical exam and medical history, tests may include blood and urine analysis, chest x-ray, CT scans, MRI scans, and spinal tap.

  • Cocaine-induced headache diagnosescan include such conditions as tension headache, stroke (bleed in head), sinusitis,meningitis, or brain abscess.
  • Cocaine-induced seizures might indicate more serious problems such as bleeding in the brain, meningitis, very high blood pressure with organ injury, or low blood pressure, respiratory failure, and heart problems. Infants may experience seizures caused by parents’ smoking cocaine in their presence. It is important to note that this is a form of child abuse.
  • Psychiatric problems caused by cocaine abuse may include cocainomania, anxiety, hallucinations, paranoia, psychoses, violence, major depression, suicidal or homicidal tendencies, or attempted suicide.
  • Nasal and throat complications of cocaine abuse will include diagnoses of nasal itching, post-nasal drip, nosebleed, sinusitis, laryngitis, and perforatednasal septum.
  • Pulmonary diagnoses may include pneumonia, bronchitis, COPD (chronic obstructive pulmonary disease or emphysema), asthma or reactive airway disease, or a collapsed lung.
  • Cardiovascular diagnoses include heart problems such as chest pain, heart attack, abnormal heart rhythms, and various heart conditions that can lead to sudden death.
  • Pregnancy diagnoses may include vaginal bleeding, threatened abortion, incomplete abortion, or spontaneous abortion, or miscarriage. Ultrasound may be used in this diagnosis.
  • Infectious diagnoses may include cellulitis, shooter’s abscess, lung abscess, brain abscess, septic shock, hepatitis, and any of the opportunistic infections associated with AIDS if you are HIV infected.
  • Body packers and stuffers may have various diagnoses depending on whether the packets leak or remain intact. If they leak, the diagnoses may be massive cocaine intoxication with seizures, high temperatures, hypertension, muscle breakdown, kidney failure, and death. If the abuser has no symptoms with normal vital signs and refuses medical care, invasive procedures may not be done until proper legal documentation has been provided.

Cocaine Abuse Treatment

Self-Care at Home

First and foremost, the cocaine abuser must stop using the drug and other drugs that accompany its use. Not many complications of cocaine use can be treated at home. The most common complications are psychiatric in nature.

  • Anxiety, mild agitation, loss of appetite,insomnia, irritability, mild panic attacks, mild depression, and mild headaches could probably be treated at home by stopping the use of the drug and observing the user.
  • Runny noses, nasal congestion, and brief nosebleeds can be also be cared for at home by stopping the drug, increasing the humidity of the air breathed in with vaporizers and humidifiers, and direct nasal pressure for 10 minutes to stop the nosebleed. Apply topical antibiotic such asbacitracin or petroleum jelly to help with the drying and crusting. Avoiding nose picking.
  • The chronic cough or coughing up of black, nonbloody phlegm can be treated again by cessation of cocaine smoking and other drugs such as nicotine or marijuana. Over-the-counter cough medicines containing the ingredientguaifenesin, the active compound in Robitussin, plus increased water drinking may help.
  • IV drug users who do not stop using cocaine may lower their exposure to communicable diseases and infection by not reusing or sharing needles. Cleansing the skin properly prior to the injection also decreases risk of infection.

Medical Treatment

Emergency treatment includes emergency procedures to get the person breathing and stable. These measures will take time-sometimes longer than waiting family and friends expect. The initial contact in a hospital emergency department may be the police, the receptionist/secretary, the social worker, or a nurse. If you accompany a person to the emergency department, give these medical staff as much information as possible that will help in the medical care of the drug user because he or she may not be capable of giving any history at all.

  • After the person is stabilized, the doctor can take a medical history, perform a more detailed physical exam, and begin diagnostic testing.
  • Despite the best of medical efforts, certain medical complications of cocaine use can lead to sudden death. The person may never regain consciousness and die in the emergency department or the intensive care unit from these complications: high body temperature, massive bleeding into the brain usually due to high blood pressure, heart attack, or seizures.
  • The great majority of people who come to the emergency department are alive, awake, and have normal vital signs or vital signs that rapidly become normal. They will usually be sent home in relatively good health after their immediate medical and physical conditions are treated.
    • Certain medical conditions will require hospitalization and referral to specialists. Chest pain is a common problem, and people with this condition will be referred to heart specialists. Other less life-threatening conditions may require antibiotics, IV medications, or prescription medications. Abscesses are often drained in the emergency department.
    • Complications with pregnancy will be monitored and referred to specialists.
    • People with mental conditions will be referred to psychiatrists and drug abuse counselors for follow-up counseling after initial health issues are resolved.
  • The treatment of body packers and body stuffers is rapid removal of the packets before they leak. If access is relatively easy, such as in the vagina and rectum, the packets are carefully removed manually. If the packets are swallowed and the person has no symptoms and the vital signs are normal, whole bowel irrigation may be done. A tube is placed into the stomach, then a nonabsorbable fluid (typically polyethylene glycol) is put in continuously until the packets are recovered or the fluid from the rectum is clear. Activated charcoal may also be used initially to adsorb any drug that may leak during the process. If the person has any symptoms or shows signs the drug is leaking into the body, treatment is immediate removal by surgery plus control of the blood pressure, heart rate, temperature, and seizures. Retrieval of the packets using a fiberoptic scope (endoscopy) is not recommended.

Next Steps

Follow-up

Follow-up should be as planned in the emergency department or as discussed when discharged from the hospital. Because any addiction involves the entire family, the treatment plan should include family. It may consist of follow-ups with a drug counselor, psychiatrist, family doctor, internist, infectious disease specialist, obstetrician, general surgeon, or heart surgeon.

Prevention

Prevention should start early in the preadolescent years for those who are at risk. This would include children in families with a history of any addiction such as alcoholism and drug use. However simplistic the concept, teaching youngsters to say “no” to smoking, alcohol, and drugs is an excellent prevention tool. If we can keep the children and our future generations from the gateway drugs of nicotine, alcohol, and marijuana, then we may be able to prevent the escalation to harder drugs such as cocaine.

Outlook

The prognosis for minor complications of cocaine use is good if further drug use can be stopped completely. This will be a significant challenge to the addicted person and may require professional and support group interaction. The majority of the cocaine abusers who come to the hospital for medical care will usually do well and are often sent home. They may be seen or referred to chemical dependency counselors for follow-up as outpatients.

Source: http://www.emedicinehealth.com

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

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Posted in Addictions and Habits | Tagged: | Leave a Comment »

Sigmund Freud’s Cocaine Years

Posted by Sun on August 1, 2011

By SHERWIN NULAND   Published: July 21, 2011

On April 21, 1884, a 28-year-old researcher in the field now called neuroscience sat down at the cluttered desk of his cramped room in Vienna General Hospital and composed a letter to his fiancée, Martha Bernays, telling her of his recent studies: “I have been reading about cocaine, the effective ingredient of coca leaves,” Sigmund Freud wrote, “which some Indian tribes chew in order to make themselves resistant to privation and fatigue.”

Less than a month later, Freud was writing to Bernays about the many self-experiments in which he had swallowed various quantities of the drug, finding it useful in relieving brief episodes of depression and anxiety. Later, he described how “a small dose lifted me to the heights in a wonderful fashion. I am just now busy collecting the literature” — in German, French and English — “for a song of praise to this magical substance.”

That song of praise was “Über Coca,” a monograph published in July 1884 in a highly regarded journal. In his perceptive new book, “An Anatomy of Addiction,” Howard Markel points out that this landmark essay — Freud’s first major scientific publication — was in fact a turning point for the young scientist. “The most striking feature of ‘Über Coca’ is how Sigmund incorporates his own feelings, sensations and experiences into his scientific observations,” Markel writes. “When comparing this study with his previous works, a reader cannot help but be struck by the vast transition he makes from recording reproducible, quantitatively measurable, controlled laboratory observations to exploring thoughts and feelings. In essence, ‘Über Coca’ introduces a literary character that would become a standard feature in Sigmund’s work: himself. From this point on, Freud often applies his own (and later his patients’) experiences and thoughts in his writings as he works to create a universal theory of the mind and human nature. It was a method that for its time would prove scientifically daring, at times somewhat incautious, and, in terms of the creation of psychoanalysis, strikingly productive.”

Thus does Markel set the scene for his absorbing and thoroughly documented account of the ways in which cocaine may or may not have influenced Freud’s transformative notions of psychology, and most certainly did shape the pathbreaking American surgeon William Halsted’s vast contributions to the development of surgery.

Though some of Freud’s major biographers — most notably the British historian Peter Swales — remain convinced of the influence of the drug on Freud’s entire edifice of psychoanalytic thought, most agree with Markel’s conclusion that he completely stopped 12 years of what Markel calls “compulsive cocaine abuse” in 1896, just as he was beginning to formulate the concepts that laid the groundwork for his historical legacy. During the period of Freud’s addiction (or, at the very least, abuse), he wrote frequently about cocaine, making plenty of references to its debilitating effect on his clarity of thought. But the drug is rarely mentioned after 1896. That was the year in which two major events occurred in Freud’s life. The first was the publication in a French medical journal of his influential article “The Aetiology of Hysteria,” in which the word “psychoanalysis” is used for the first time; the second was the death of his father. Freud was no doubt influenced by having been close witness a few years earlier to the anguished death of one of his dearest friends, the accomplished young phsyiologist Ernst von Fleischl-Marxow, whose morphine addiction Freud had tried to treat with cocaine, with disastrous results. As Freud wrote almost three decades later, “the study on coca was an ­allotrion” — an idle pursuit that distracts from serious responsibilities — “which I was eager to conclude.”

Markel, a professor of medical history at the University of Michigan who has also done clinical work involving the treatment of addicts of all sorts, has instructive ways of explaining Freud’s method of turning away from what he had by then realized were the deleterious consequences of drug use. “Most recovering addicts,” he writes, “insist that two touchstones of a successful recovery are daily routines and rigorous accountability.” Around 1896, Freud began to follow a constant pattern of awakening before 7 each morning and filling every moment until the very late evening hours with the demands of his ever enlarging practice (he was soon seeing 12 or more patients per day), writing, lecturing, meeting with colleagues and ruminating over the theories he enunciated in such articulate literary style. Markel concludes: “It appears unlikely that Sigmund used cocaine after 1896, during the years when he mapped out and composed his best-known and most influential works, significantly enriched and revised the techniques of psychoanalysis and . . . attempted to ‘explain some of the great riddles of human existence.’ ”

As Markel shows, the addiction of Freud’s contemporary William Halsted played out very differently. Halsted was a consummately brilliant and flashy surgeon who had captained the Yale football team and then gone on to medical training in New York, where he soon established a reputation not only for his operative skills and speed but for the outgoing personality that distinguished him as a bon vivant and hail-fellow-well-met. In 1884, while working mainly at Bellevue Hospital, he and a small group of rising young doctors began to self-experiment with cocaine, in order to develop techniques that would permit surgery on the extremities and other areas whose nerve supply could be blocked by direct injection of the drug. Unaware of its dangerously addictive qualities, each of the young men gradually fell under its diabolical spell.

After several failed attempts to break his habit, including two long hospitalizations, Halsted was invited in 1888 to do laboratory research at the newly established Johns Hopkins Hospital, where his talents brought him an appointment two years later as chief of surgery. But those talents were of a different sort from the ones that had made his reputation in New York. The operating technique of the now reclusive surgeon had become meticulous to the point of painstaking slowness, characterized by minute attention to detail that enabled him to perceive the physiological characteristics of tissues and of wound healing that eluded his speedier, less observant colleagues. Working with single-minded patience, he developed a wide range of unique methods whose therapeutic results, abetted by the punctilious, biologically-based skills that became known as Halstedian technique, were remarkably improved over those reported by hospitals elsewhere. The cocaine habit that had resulted in his many peculiarities and his aversion to colleagues was now, with masterful self-control, being used in the service of his art.

Halsted had emerged from his hospitalizations a man completely changed in virtually every way. He married a favorite scrub nurse, Caroline Hampton. The couple had no children, lived on separate floors of an enormous town house in Baltimore and entertained reluctantly, but only after scrupulous — one might say obsessional — preparation.

Decades after Halsted’s death in 1922, it emerged that he never did break his addiction, though it appears to have been at least partially transferred to morphine, which he used until the end of his life. Markel describes the “remarkably high-performing addict” rushing home most afternoons to administer his dose: “He took out his own morocco case containing a syringe and a soothing dose of morphine. Ever the measured surgeon, he worked hard to calibrate his dosage to calm his jitters and angst but not cloud his senses or interfere with his medical judgment; on not a few occasions, however, he miscalculated and sailed off to narcotized oblivion, abandoning his responsibilities.”

Freud and Halsted never met. But Markel’s alternating chapters bring them together in a vivid narrative of two of the most remarkable of the many contributors to our understanding of human biology and function. He has written a tour de force of scientific and social history, one that helps illuminate a unique period in the long story of medical discovery — and the not insignificant cohort of experimenters who have fallen victim to their own research.

Source: http://topics.nytimes.com

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New way to reduce the effects of cocaine

Posted by Sun on July 25, 2011

Branwen Morgan                                                                                                                                                                  Monday, 25 July 2011
ABC

A new target for the treatment of drug addiction has been identified by US and Chinese scientists. Research led by Dr Zheng-Xiong Xi of the National Institute on Drug Abuse in the USA has found that activation of receptors in the brains of mice can counteract the behavioural and rewarding effects of cocaine.

There are two major cannabinoid receptor types: CB1 and CB2. CB1 receptors, which are found in large numbers in the brain activated by drugs such as marijuana. They are known to stimulate the brain’s reward system, which is why they have been the focus of addiction research. CB2 receptors are primarily located on the body’s immune cells. They are also known to be involved in pain perception.Until recently, it was thought that CB2 receptors were not present in the brain or that, if they were, it was in such low density that they were not involved in drug addiction. “Due to the limitations of the technology we weren’t able to detect low levels of CB2 receptors,” says Xi. But, six years ago, CB2 receptors were found to be present and active in the brainstem. They were subsequently detected in neurons in the brain. “This prompted us to re-examine the role of CB2 receptors in drug reward and addiction,” says Xi.”Our research suggests that, even though the levels of CB2 receptors [in the brain] are very low, they are critically involved in cocaine’s actions.” The results are published online today in Nature Neuroscience.

Rewarding behaviour

In their study, Xi and colleagues trained mice to self-administer cocaine intravenously. The researchers found that activating CB2 receptors with two different ‘agonists’ reduced drug-induced behaviour such as hyperactivity. In addition, the CB2 receptor agonists reduced the bouts and amount of drug intake in normal (wild type) mice and mice who lacked the CB1 receptors, but not those that lacked CB2 receptors. Further experiments showed the observed effects were mediated by the brain’s CB2 receptors and that the rewarding effects of cocaine were blocked. “Taken all together, the present findings, for the first time suggest that brain CB2 receptors functionally modulate the acute rewarding and locomotor-stimulating effects of cocaine in mice,” says Xi.

Battling addiction

Xi adds that several pharmaceutical companies already have CB2 agonists in preclinical trials, but that they have been developed to treat pain. “Our findings open a new field; CB2 agonists have a very high potential for treating addiction,” he says. Dr Nadia Solowij of the University of Wollongong agrees and speculates that the study will also have relevance for other drug addictions including opiates. “They found minimal side-effects by specifically targeting these cannabinoid receptors and they showed specific effects on the dopamine [reward] system,” she says. However, Solowij adds that the addiction and reward systems involve interactions between many different receptor and neurochemical systems in the brain and that more research is needed to fully understand the changes that result from CB2 activation. Xi acknowledges that “these are very early initial studies,” and adds that they will now test their compounds in other animal species, starting with the rat. He and his colleagues are also focussing on finding the mechanism by which activation of CB2 receptors inhibits dopamine release.

Source: http://www.abc.net.au/science/articles/2011/07/25/3275847.htm

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COCAINE HISTORY

Posted by Sun on July 23, 2011

Cocaine was first synthesized in 1858-1860, by the 1860s it was regarded as a wonder drug that would cure many illnesses. Major dangers of cocaine were known almost from the first uses of the purified drug. Its usein medicine, had been tempered by experience, its use has been largely restricted to producing local anesthesia. Even in this area, the dangers of cocaine led to the early development of safer drugs. In the short time between the isolation of pure cocaine powder from the coca leaf to the beginning of the awareness of it’s dangers, cocaine was used to try to cure almost all the illnesses and maladies that were known to man.One of its first non medical uses was military. In 1883 Theodor Aschenbrandt administered cocaine to members of the Bavarian army. It was found that the drug enhanced their endurance on manoeuvre. His positive findings were published in a German medical journal, which brought the effects of this wonder drug to a wider medical audience, including Sigmund Freud (see below). Cocaine was sold over-the-counter, until 1916, one could buy it at Harrods. It was widely used in tonics, toothache cures and patent medicines; and in chocolate cocaine tablets. Prospective buyers were advised – in the words of pharmaceutical firm Parke-Davis – that cocaine “could make the coward brave, the silent eloquent, and render the sufferer insensitive to pain”. When combined with alcohol, it yielded a further potently reinforcing compound, now known to be cocaethylene. Thus cocaine was a popular ingredient in wines, notably Vin Mariani. Coca wine received endorsement from prime-ministers, royalty and even the Pope.

One medical use that was found early in the history of cocaine, and which the drug is still used for today (rarely), is that of a good surface anesthetic. Beginning in the late 1880s surgical procedures using local anesthetics (numbing a specific area to pain) were starting to be used instead of general anesthesia (rendering a person unconscious). This was due to experiments, using cocaine, that were conducted by William Halstead, one of the four founders of The Johns Hopkins Medical School and often called the Father of American Surgery. Unfortunately William experimented on himself by injecting cocaine, to see if surgery could be performed using cocaine as a local anesthetic. After experimenting for a time, he became addicted, the addiction grew so bad that it put his career on the line. He overcame his addiction to shooting cocaine, but began taking morphine instead, a habit that probably lasted the rest of his life.

Most of us have heard the story of how Coca_Cola at one time contained cocaine, hence the Name “Coca” Cola. Coca-Cola was introduced in 1886 as a valuable brain-tonic and cure for all nervous afflictions. It was promoted as a temperance drink offering the virtues of coca without the vices of alcohol. The new beverage was invigorating and popular. Until 1903, a typical serving contained around 60mg of cocaine. Sold today, it still contains an extract of coca-leaves. Coca Cola imports eight tons from South America each year. Nowadays the leaves are used only for flavoring since the drug has been removed. A coca leaf typically contains between 0.1 and 0.9 percent cocaine. If chewed in such form, it rarely presents the user with any social or medical problems. When the leaves are soaked and mashed, however, cocaine is extracted as a coca-paste. The paste is 60 to 80 per cent pure. It is usually exported in the form of the salt, cocaine hydrochloride. This is the powdered cocaine most common, until recently, in the West. Drug testing for cocaine aims to detect the presence of its major metabolite, the inactive benzoylecgonine. Benzoylecgonine can be detected for up to five days in casual users. In chronic users, urinary detection is possible for as long as three weeks.

Sigmund Freud the father of psychoanalysis, in the early 1880s began to experiment with cocaine. At a time when he was undergoing a low period in his life, he reported that cocaine lifted his spirit, and took his mind off his professional and financial difficulties. He sent cocaine to his fiancee, telling her it would make her strong and give her cheeks a red color. Freud was to play a significant role in the development of the Western cocaine-industry. I take very small doses of it regularly and against depression and against indigestion, and with the most brilliant success, he observed. Drug giants Merck and Parke Davies both paid Freud to endorse their rival brands. He wrote several enthusiastic papers on cocaine, notably Uber coca (1884).

Taken from “On Cocaine” by Sigmund Freud

A few minutes after taking cocaine, one experiences a certain exhilaration and feeling of lightness. One feels a certain furriness on the lips and palate, followed by a feeling of warmth in the same areas; if one now drinks cold water, it feels warm on the lips and cold in the throat. Oneother occasions the predominant feeling is a rather pleasant coolness in the mouth and throat. During this first trial I experienced a short period of toxic effects, which did not recur in subsequent experiments. Breathing became slower and deeper and I felt tired and sleepy; I yawned frequently and felt somewhat dull. After a few minutes the actual cocaine euphoria began, introduced by repeated cooling eructation. Immediately after taking the cocaine I noticed a slight slackening of the pulse and later a moderate increase. I have observed the same physical signs of the effect of cocaine in others, mostly people my own age. The most constant symptom proved to be the repeated cooling eructation. This is often accompanied by a rumbling which must originate from high up in the intestine; two of the people I observed, who said they were able to recognize movements in their stomachs, declared emphatically that they had repeatedly detected such movements.Often, at the outset of the cocaine effect, the subjects alleged that they experienced an intense feeling of heat in the head. I noticed this in myself as well in the course of some later experiments, but on other occasions it was absent. In only two cases did coca give rise to dizziness. On the whole the toxic effects of coca are of short duration, and much less intense than those produced by effective doses of quinine or salicylate of soda; they seem to become even weaker after repeated use of cocaine.

“CRACK” cocaine

Cocaine is a powerfully addictive drug of abuse. Once having tried cocaine, an individual cannot predict or control the extent to which he or she will continue to use the drug.

The major routes of administration of cocaine are sniffing or snorting, injecting, and smoking (including free-base and crack cocaine). Snorting is the process of inhaling cocaine powder through the nose where it is absorbed into the bloodstream through the nasal tissues. Injecting is the act of using a needle to release the drug directly into the bloodstream. Smoking involves inhaling cocaine vapor or smoke into the lungs where absorption into the bloodstream is as rapid as by injection.

“Crack” is the street name given to cocaine that has been processed from cocaine hydrochloride to a free base for smoking. Rather than requiring the more volatile method of processing cocaine using ether, crack cocaine is processed with ammonia or sodium bicarbonate (baking soda) and water and heated to remove the hydrochloride, thus producing a form of cocaine that can be smoked. The term “crack” refers to the crackling sound heard when the mixture is smoked (heated), presumably from the sodium bicarbonate.

There is great risk whether cocaine is ingested by inhalation (snorting), injection, or smoking. It appears that compulsive cocaine use may develop even more rapidly if the substance is smoked rather than snorted. Smoking allows extremely high doses of cocaine to reach the brain very quickly and brings an intense and immediate high.

Source: http://promises.www4.50megs.com/cocaine.html

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

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Cocaine Detoxification

Posted by Sun on July 19, 2011

Cocaine is a highly addictive substance derived from the leaves of coca plants, and it produces euphoric effects that can vary in intensity and duration depending on how the drug is administered. One method of cocaine use involves snorting or injecting the powdered form of the drug. Another method involves smoking the freebase form that has been processed for this purpose, known as crack cocaine.

Regardless of how the drug is administered, the addictive chemicals create changes in the brain and body that will require professional cocaine detoxification to safely remove these chemicals from the body and to control any withdrawal symptoms that occur.

Generally, cocaine detoxification produces only minor withdrawal symptoms, but the �crash� that occurs within the first few days of abstinence can include depression, insomnia, anxiety, and cravings. Within a few weeks after withdrawal these symptoms can intensify and additional symptoms such as excessive appetite, abdominal pains, tremors and muscle pain can occur. In order to control these symptoms, medical cocaine detoxification provides medications such as antidepressants, tranquilizers, bezodiapines or beta-blockers such as propanolol.

Following successful cocaine detoxification, the individual should enroll in a program that addresses the mental aspect of addiction with behavior modification classes, group or individual counseling sessions, family support services and cognitive skills training.

For those who prefer a drug-free approach to treatment, cocaine detoxification can be accomplished with a medically supervised holistic program that provides nutritional guidance, vitamins, exercise and saunas. This is also an effective method of cocaine detoxification, but must also be followed by a rehabilitation program that addresses the psychological aspects of the addiction.

Regardless of which approach to cocaine detoxification you choose, successful recovery is dependent on your commitment to stay in the program as long as necessary to ensure recovery, avoid relapse and to enjoy a future that is free from the negative consequences of addiction.

If you have any questionsplease feel free to ask

Source: http://www.medicaldetox.org/cocaine_detox.php

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

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New Hope for Treatment of Cocaine Addiction

Posted by Sun on July 18, 2011

ScienceDaily (July 15, 2011) — New discoveries by researchers at the University of Wisconsin-Milwaukee (UWM) offer potential for development of a first-ever pharmacological treatment for cocaine addiction.

A common beta blocker, propranolol, currently used to treat people with hypertension and anxiety, has shown to be effective in preventing the brain from retrieving memories associated with cocaine use in animal-addiction models, according to Devin Mueller, UWM assistant professor of psychology and a co-author with James Otis of the research.

This is the first time that a therapeutic treatment has been shown to block the retrieval of memories associated with drug addiction, a major reason many addicts experience relapse, says Mueller.

The research is published in the August issue of the journalNeuropsychopharmacology.

Cocaine is one of the worst drug addictions to kick, with about 80 percent of those trying to quit experiencing a relapse within six months.

“Right now, there are no FDA-approved medications that are known to successfully treat cocaine abuse,” says Mueller, “only those that are used to treat the symptoms of cocaine withdrawal, which are largely ineffective at preventing relapse.”

The effects of propranolol were long-lasting and could be permanent, he says, even without subsequent doses and even in the presence of stimuli known to induce relapse.

Currently, “exposure therapy” is used to help recovering addicts suppress their drug-seeking behavior. In this therapy, the patient is repeatedly exposed to stimuli that provoke cravings but do not satisfy them. Done repeatedly over time, the patient experiences less craving when presented with those stimuli.

The success of exposure therapy, however, is limited. Combining therapy with the use of propranolol, says Mueller, would boost the effectiveness of the treatment.

Propranolol was chosen for the memory study because it has been used before to ease some withdrawal symptoms experienced by recovering cocaine addicts. Those using the drug were able to continue exposure therapy for longer periods than those without the drug.

But Mueller adds that propranolol has never been tested for use with memory extinction before.

In order to develop a drug treatment for overcoming relapse, the next step in the research is to determine where in the brain propranolol acts to mediate the retrieval of cocaine-associated memories.

The study was funded by the National Institute on Drug Abuse, one of the National Institutes of Health, and by the UWM Research Growth Initiative.

Source: http://www.sciencedaily.com/releases/2011/07/110715135335.htm

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

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Current, Not Prior, Depression Predicts Crack Cocaine Use

Posted by Sun on July 17, 2011

ScienceDaily (July 14, 2011) — Even after accounting for current crack use, a new study finds that women in drug court who are experiencing current major depression are more likely to use crack within four months than other women in drug court. The paper’s lead author argues that depression screening and treatment may be important components of drug court services for crack-using women.

Women who are clinically depressed at the time they enter drug court have a substantially higher risk of using crack cocaine within four months, according to a new study. Because current but not past depression was associated with a higher risk of use, the study published in the journal Addictionsuggests that addressing depression could reduce the number of women who fail to beat crack addiction in drug court.

“We found that current major depression increased the risk of crack use, but depression in the past year that had gotten better did not,” said Jennifer Johnson, assistant professor (research) of psychiatry and human behavior in the Warren Alpert Medical School of Brown University and lead author of the study. “This suggests that if the depression remits, the risk of crack use goes down. Screening for depression and effective depression treatment may be important components of drug court services.”

Addiction and depression are closely associated, said Johnson, who is also affiliated with Brown’s Center for Alcohol and Addiction Studies. It isn’t always clear how the two affect each other, especially at an urgent moment such as entry into the court system. Johnson set out to untangle the two by analyzing data gathered by researchers at Washington University in St. Louis as part of an HIV prevention study.

Among the 261 women in the study, 16 percent had a current major depressive episode and 40 percent had experienced a major depressive episode in their lifetime. Among the women currently depressed, 46 percent used crack during the next four months. Among women who weren’t currently depressed, only 25 percent used crack in the next four months.

At the beginning of the study, the analysis statistically adjusted for whether women were using crack, which is highly addictive, and took the timing of the women’s depression into account, said Johnson, who is also affiliated with the Center for Prisoner Health and Human Rights, a collaboration of Brown University and The Miriam Hospital.

Women who had been depressed at some time in the past, even in the last year, did not have an increased risk of crack use compared to women who had never been depressed, Johnson found. Women who were currently depressed, however, were significantly more likely to use crack than women who were never depressed. Furthermore, currently depressed women had nearly four times the odds of using crack during follow-up compared to women who had been depressed at some point in their past. The odds were nearly six times greater compared to women who were depressed within the last year, but not currently.

“It doesn’t matter if they’ve been depressed in the past,” she said, “only how they’re doing right now.”

The data hint that depression may have contributed to crack use in this population, Johnson said.

“It is well known that crack use can cause depression and depression can contribute to crack use,” Johnson said. “However, in this study baseline depression [at the beginning of the study] was not associated with baseline crack use, but was associated with future crack use, suggesting that depression may have led to crack use and not vice versa.”

If women in drug court can be successfully screened and treated for depression, Johnson said, the resulting reduction in crack use predicted by the analysis might benefit not only the women but also the community.

“The public ends up paying the cost of drug court and incarceration,” she said. “Depression treatment isn’t that expensive.”

Source: http://www.sciencedaily.com/releases/2011/07/110714120849.htm

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

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Cocaine

Posted by Sun on July 15, 2011

Brief Description: Cocaine is a powerfully addictive central nervous system stimulant that is snorted, injected, orsmoked. Crack is cocaine hydrochloride powder that has been processed

to form a rock crystal that is then usually smoked.

Street Names: Coke, snow, flake, blow

Effects: Cocaine usually makes the user feel euphoric and energetic, but also increases body temperature, blood pressure, and heart rate. Users risk heart attacks, respiratory failure, strokes, seizures, abdominal pain, and nausea. In rare cases, sudden death can occur on the first use of cocaine or unexpectedly afterwards.

If you have any questions, please feel free to ask


Sources: http://www.nida.nih.gov

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

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