Addiction, Author Interviews, Cocaine, Pain Research / 18.08.2021 Interview with: Youngeun Armbuster Geisinger Commonwealth School of Medicine Scranton, Pennsylvania What is the background for this study? Response: Cocaine is classified by the U.S. Drug Enforcement Administration (DEA) as a Schedule II drug that can be used as an anesthetic in various types of surgery by otorhinolaryngologists, as well as in diagnosing Horner syndrome. Although controlled doses of cocaine used in topical anesthetics does not cause myocardial infarction as can occur with recreational dosages, intranasal administration of cocaine is absorbed systemically and it results in vasoconstriction of the coronary arteries via stimulation of adrenergic receptors. These potential adverse effects may disincentivize health care providers from medical cocaine use. Our objective was to quantify the trends in licit cocaine distribution in the United States using DEA data and to determine the usage of medical cocaine in Medicaid and Medicare, as well as based on electronic medical records [1]. (more…)
Addiction, Author Interviews, Cocaine, Diabetes, Methamphetamine / 07.08.2021 Interview with: Joy M. Schmitz, Ph.D. Professor of Psychiatry Faillace Chair McGovern Medical School The University of Texas Health Science Center at Houston Director, Center for Neurobehavioral Research on Addiction (CNRA)   Scott D. Lane Ph.D. McGovern Medical School Vice Chair For Research Director Of Neurobehavioral Laboratory Center For Neurobehavioral Research On Addiction Director Of Research University of Texas Health Science Center at Houston Houston, TX What is the background for this study? Response: Addiction science has made considerable progress in understanding how cocaine and other addictive drugs impair the brain. Over time, cocaine can disrupt brain regions that help us think, plan, solve problems, and exert self-control. These disruptions in brain structure can be seen in neuroimaging studies that reveal impairment in the nerve fibers or white matter (WM) tracts in the central and front parts of the brain. We conducted two systematic meta-analytic reviews of the literature to document the robustness of evidence showing alterations in WM integrity of chronic stimulant users relative to healthy control subjects who did not use cocaine or other drugs of abuse (Beard et al., 2019; Suchting et al., 2020). Importantly, WM impairments negatively predict treatment outcome, meaning individuals with greater levels of WM impairment are less likely to benefit from treatment and more likely to experience deficits in attention, working memory, and impulse control. We reasoned that pharmacological interventions shown to protect WM integrity may help improve cognition and treatment outcomes in patients recovering from cocaine addiction. Pioglitazone, an approved medication for type 2 diabetes, has been shown to reduce inflammation and mediate protection after traumatic brain injury. The therapeutic potential of pioglitazone has prompted investigation of its role in neurodegenerative conditions, such as dementia, Alzheimer’s disease, and stroke. Similar to these brain diseases and injuries, pioglitazone might effectively protect the brain from the inflammatory damage created by cocaine use.  (more…)
Addiction, Alcohol, Author Interviews, Cannabis, Cocaine, Methamphetamine, Opiods / 21.08.2019 Interview with: Greg Midgette, PhD Assistant Professor Department of Criminology and Criminal Justice University of Maryland What is the background for this study? Response: This report estimates marijuana, cocaine, heroin, and methamphetamine use in the U.S. between 2006 and 2016 on three dimensions: the number of past-month chronic users per year, where "chronic" has previously been defined as consuming the drug at least four days in the past month, expenditure per drug among those users, and consumption of each drug. These measures are meant to aid the public and policy makers' understanding of changes in drug use, outcomes, and policies.   (more…)
Addiction, Author Interviews, Cocaine, Opiods, Primary Care / 03.01.2019 Interview with: Sarah M. Bagley MD, MSc Assistant Professor of Medicine and Pediatrics Director, CATALYST Clinic Boston University School of Medicine/Boston Medical Center Boston, MA What is the background for this study? What are the main findings? Response: Urine drug testing is a routine part of the management of primary care patients with opioid use disorder treated with medications such as buprenorphine. In addition, most providers also ask patients about recent drug use. The point of this study was to see the agreement between the urine drug testing and what patients told a nurse and whether that changed the longer a patient was in treatment. We found that truthful disclosure of opioid and cocaine use increased with time in treatment and that urine drug tests are a useful tool to monitor patients.  (more…)
Addiction, Author Interviews, Cocaine / 08.08.2018 Interview with: Ana-Clara Bobadilla, Ph.D. Postdoctoral scholar in the laboratory of Peter Kalivas, Ph.D MUSC What is the background for this study? What are the main findings?  Response: The Brain-derived neurotrophic factor (BDNF) is a growth factor that has well-described effects in the survival, growth and differentiation of neurons during development of the central nervous system, but it also maintains a role during adulthood in learning, memory and various disorders such as addiction. Several clinical studies show increased BDNF levels in the serum of cocaine- or alcohol-dependent patients compared to controls (D’Sa et al., 2011; D’Sa et al., 2012). In preclinical research, a wealth of studies shows that chronic exposure to drugs of abuse impacts BDNF expression in different parts of the brain, including the main regions comprised in the reward circuitry, the cortex and the nucleus accumbens (for a comprehensive review, see Li & Wolf, 2015). Conversely, altering BDNF expression or transmission has profound effects on the response of the brain to drugs (see McGinty et al., 2010). Importantly, BDNF effects are often region-specific, meaning that an increase in BDNF expression in one region can decrease the effects of drug exposure in the brain while the same increase in another region can have opposite effects (Li et al., 2013). Because BDNF transmission can modify the expression of a wide range of genes leading to long-term modifications, numerous studies administer BDNF early in the drug exposure protocol and focus on the long-term changes induced by the growth factor. In this study, we microinjected BDNF directly in the nucleus accumbens minutes before measuring cocaine craving in a well-known rodent model of relapse. We found that BDNF induces a robust decrease in craving that lasts for at least 3 days post-treatment. The inhibitory effect of BDNF is not seen when animals are tested for sucrose, a very strong reward for rats, suggesting that this effect is specific to cocaine. Moreover, cocaine craving is only decreased when BDNF is microinjected before the craving test, but has no effect when injected a day before the craving test or in the home cage, indicating a time-specificity in addition to the region-specificity previously described.  (more…)
Author Interviews, Cocaine, Gastrointestinal Disease, PLoS, Surgical Research, Vanderbilt, Weight Research / 27.07.2018 Interview with: Aurelio Galli, Ph.D. Professor of Molecular Physiology & Biophysics and Psychiatry & Behavioral Science Associate Director for Research Strategy Vanderbilt Brain Institute What is the background for this study? What are the main findings? Response: The study builds on evidence that bile acids influence the brain’s reward system. Bile acids are normally released from the gall bladder into the upper part of the small intestine, where they emulsify fats for absorption, before being recycled further down the small intestine. In bile diversion surgery, an experimental treatment for weight loss, bile is released at the end of the small intestine, increasing the amount of bile acids that enter the general circulation. Mice treated with this surgery have less appetite for high-fat foods, which suggests that bile acids affect brain reward pathways. We demonstrated that mice receiving the surgery also showed less preference for the cocaine-associated chamber, indicating that cocaine was probably less rewarding. (more…)
Addiction, Author Interviews, Cocaine, Genetic Research / 17.07.2018 Interview with: “Cocaine concealed in washing powder” by The National Crime Agency is licensed under CC BY 2.0 What is the background for this study? What are the main findings?  Response: Drug addiction is a chronically relapsing neuropsychiatric disease that affects 15.5 million people in Europe at a cost of 65.7 billion euros per year. All addictive drugs have in common to cause an artificial increase in the release of a neurotransmitter called dopamine, a very basic effect that can be found in all studied animal species from the fly to the man. The release of dopamine takes place in a region of the brain called the ventral striatum, or Nucleus Accumbens (NAc), which is directly involved in reward and reinforcement processes. An excess of dopamine release by the dopaminergic neurons projecting to the NAc from the Ventral Tegmental Area (VTA) triggers long-term changes in the brain, which can lead to addiction. Cocaine is a prototypical addictive drug, since it is heavely abused in Western societies and extensively studied in animal models as well as humans. We discovered that mice lacking the Maged1 gene showed a marked decrease in cocaine-elicited release of dopamine in the NAc and were entirely unresponsive to cocaine at behavioral level. In fact, they did not show any behavioral reaction normally observed after cocaine treatment, such as cocaine-elicited hyperlocomotion, sensitization (an increased effect of the drug following repeated administrations) or addictive behaviors, such as increased preference for places where the animal expects to obtain a cocaine reward or cocaine self-administration. In a subsequent set of experiments, the researchers tried to identify what brain regions are responsible for Maged1 influence on cocaine effects and found that Maged1 expression is specifically required in the prefrontal cortex, and not in the neurons producing dopamine in the VTA, for the development of cocaine sensitization and dopamine release.  (more…)
Author Interviews, Cocaine / 27.12.2017

“cocaine photo” by Imagens Evangélicas is licensed under CC BY Interview with: Mary Kay Lobo, PhD Associate Professor University of Maryland School of Medicine Department of Anatomy and Neurobiology Baltimore, MD 21201 What is the background for this study? What are the main findings? Response: Altered energy balance has been studied in drug abuse but the fundamental source of energy, mitochondria, has not been well examined.  In this study we found that a molecular regulator of mitochondrial fission (division) is increased in the nucleus accumbens, a major brain reward region, of rodents exposed to repeated cocaine and postmortem samples of cocaine dependent individuals.  We further found that mitochondrial fission is increased in a nucleus accumbens neuron subtype in rodents that self-administer cocaine. Pharmacological blockade of mitochondrial fission can prevent physiological responses to cocaine in this neuron subtype while reducing cocaine-mediated behaviors.  Finally, genetic reduction of mitochondrial fission in this neuron subtype in the nucleus accumbens can reduce drug (cocaine) seeking in rodents previously exposed to cocaine. In contrast, increasing mitochondrial fission, in this neuron subtype, enhances cocaine seeking behavior. (more…)
Annals Internal Medicine, Author Interviews, Cocaine, Kaiser Permanente, NIH, Race/Ethnic Diversity / 05.12.2017 Interview with: “Cocaine” by Nightlife Of Revelry is licensed under CC BY 2.0Dr. Dave Thomas PhD Health Scientist Administrator National Institute on Drug Abuse What is the background for this study? What are the main findings? Response: At the National Institute on Drug Abuse, we support research on all forms of drug use, and are aware that cocaine misuse is on the rise.  We are aware that various forms of drug use can have greater prevalence by race, sex, age and other population characteristics. The main finding of this paper is that cocaine overdose rates are on the rise and that that the group hit hardest is the non-Hispanic black population. (more…)
Addiction, Author Interviews, CDC, Cocaine / 20.10.2017 Interview with: “Pills” by Kurtis Garbutt is licensed under CC BY 2.0Christopher M. Jones, PharmD Office of the Assistant Secretary for Planning and Evaluation Office of the Secretary U.S. Department of Health and Human Services What is the background for this study? What are the main findings? Response: Drug overdoses are the leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Although prescription drugs, in particular opioid pain relievers, were primarily responsible for the rapid expansion of this large and growing public health crisis, illicit drugs (heroin, illicit fentanyl, cocaine, and methamphetamines) now are contributing substantially to the problem. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies. We found that the prevalence of self-reported past-month use of illicit drugs increased significantly across urban status (large metropolitan, small metropolitan, and nonmetropolitan) between 2003-2005 and 2012-2014. Prevalence was higher for males than females, however, in the large metropolitan group, the percentage increase in prevalence from 2003–2005 to 2012–2014 was greater for females (23.4%) than for males (21.6%). There were notable differences by age. During 2012–2014, respondents aged 18–25 years had the highest prevalence of past-month use of illicit drugs for all urban levels. For respondents in this age group, the prevalence increased slightly from 2003–2005 to 2012–2014 in large metropolitan areas while the prevalence remained stable among small metropolitan area respondents and nonmetropolitan area respondents. Past-month use of illicit drugs declined over the study period for the youngest respondents (aged 12–17 years), with the largest decline among small metropolitan area youth. (more…)
Author Interviews, Cocaine, McGill / 24.05.2017 Interview with: Marco Leyton, Ph.D. Professor, Department of Psychiatry McGill University What is the background for this study? What are the main findings? Response: Drug-related cues are potent triggers for eliciting conscious and unconscious desire for the drug. In people with severe substance use disorders, these cues also activate dopamine release in the dorsal striatum, a brain region thought to be involved in hard-to-break habits and compulsions. In the present study we found evidence that drug cues also activate this same dopamine response in non-dependent ‘recreational’ cocaine users. (more…)
Author Interviews, Cocaine / 01.09.2016 Interview with: Dr Stefania Fasano Cardiff University What is the background for this study? Response: Exposure to drugs of abuse such as cocaine produces intense and long-lasting memories that are critical in the transition from recreational drug-taking to uncontrolled drug use. In the brain, addictive drugs usurp cellular circuits and signalling molecules involved in normal memory processes; hence, these drug-related memories resist extinction and contribute to high rates of relapse. Despite almost five decades of experimental research, there are currently no approved medications for cocaine dependence. (more…)
Addiction, Author Interviews, Cocaine, Science / 20.06.2016 Interview with: Dr Karen Ersche PhD University of Cambridge Department of Psychiatry Brain Mapping Unit Herchel Smith Building Cambridge UK What is the background for this study? Dr. Ersche: Cocaine addiction is a major public health problem that is associated with significant harm - not just for the individual, but also for their families and for society as a whole. Without medically proven pharmacological treatments, therapeutic interventions mainly rely on psychosocial approaches, but behaviour in people with cocaine addiction remains extremely difficult to change. The impetus for this study was to find out why people with cocaine addiction are so resistant to change. One possibility would be that they have a strong tendency to develop habits, which means that they show patterns of behaviour that are not under direct voluntary control. (more…)
Addiction, Author Interviews, Cocaine, Methamphetamine, Opiods, University of Pittsburgh / 25.04.2016 Interview with: Jeanine Buchanich, Ph.D. Deputy director of the Graduate School of Public Health’s Center for Occupational Biostatistics and Epidemiology Research assistant professor in Pitt Public Health’s Department of Biostatistics University of Pittsburgh What is the background for this study? What are the main findings? Dr. Buchanich: Using the Mortality and Population Data System, a unique repository and retrieval system for detailed death data from the National Center for Health Statistics, housed at the University of Pittsburgh Graduate School of Public Health, my team examined overdose deaths in the U.S. from 1979 to 2014. We started with 1979 because changes in reporting cause of death make it impossible to make comparisons with previous years. 2014 is the most recent year for which data are available. The counties with the largest increases in overdose death rates were clustered in southern Michigan; eastern Ohio and western Pennsylvania; eastern Pennsylvania, New Jersey and much of southeastern New York; and coastal New England. Counties in the Midwest, California and Texas have seen little to no increase in overdose death rates. We cross-referenced the mortality data with counties in the High Intensity Drug Trafficking Areas program, which was created by Congress in 1988 to provide 31 high drug-trafficking areas of the U.S. with coordinated law enforcement resources dedicated to reducing trafficking and production. High Intensity Drug Trafficking Areas with high overdose death rates were mostly concentrated in Appalachia and the Southwest U.S., whereas such areas with lower death rates were near the borders in California, Texas and southern Florida. (more…)
Addiction, Author Interviews, Cocaine, Lancet / 30.03.2016 Interview with: Mascha Nuijten MSc Researcher/ PhD candidate Brijder Research (PARC) The Hague The Netherlands What is the background for this study? What are the main findings? Response: Crack-cocaine dependence is a complex disorder, for which no proven effective pharmacotherapy is yet available. Prior to our study, sustained-release dexamfetamine was found to be a promising treatment for cocaine dependence in several studies, but no studies so far had shown a convincing benefit in terms of substantial cocaine use reductions. Therefore, we investigated the efficacy of sustained-release (SR) dexamphetamine in a robust dose of 60 mg/day in chronic crack-cocaine dependent patients. We found that the number of days of cocaine use decreased with almost 40% in the dexamfetamine group, compared with 9% in the matched placebo group. In addition, the number of cocaine self-administrations on days that patients used crack-cocaine decreased with 43% in the dexamfetamine group and with 7% in the placebo group. Thus, SR dexamfetamine both contributed to cocaine abstinence and to cocaine use reductions. (more…)
Author Interviews, Cocaine, Heart Disease / 17.12.2014 Interview with: Luis F. Callado M.D., Ph.D. Department of Pharmacology University of the Basque Country CIBERSAM Medical Research: What is the background for this study? What are the main findings? Dr. Callado: Cocaine is the most commonly used illicit stimulant drug in Europe. The use of cocaine has become a major issue for drug policy, with also important health implications, including potentially lethal cardiovascular complications. In this way, several case series have suggested a relationship between cocaine use and cardiovascular diseases in young adults. Furthermore, cocaine use has been also associated with sudden and unexpected death. Our results demonstrate that the recent use of cocaine is the main risk factor for sudden cardiovascular death in persons between 15 and 49 years old. Thus, persons that consumed cocaine recently presented a 4 times higher risk for sudden cardiovascular death than those who did not use cocaine. The morphological substrate of sudden cardiovascular death associated to cocaine use is a structural pathology not diagnosed in life. Usually, sudden death is the first manifestation of the disease. (more…)
Addiction, Author Interviews, Cocaine / 25.09.2013 Interview with: Krishna Patel, M.S. Clinical Data Analyst Hartford Hospital|Institute of Living Olin Neuropsychiatry Research Center Hartford, CT-06106 What are the main findings of the study? Answer:  We looked at brain response to a monetary incentive delay (MID) task in current and former cocaine users compared to healthy controls using functional MRI. The task measures aspects of sensitivity to rewards and punishments. Current cocaine users showed abnormal under-activation in reward circuitry compared to healthy controls. In some of those regions former cocaine users (who had an average of 4years of abstinence from cocaine) also showed abnormalities. These former users also showed over-activation in the ventral tegmental area of the midbrain, (an important region containing dopamine cell bodies) compared to both healthy controls and current cocaine users. Current and former cocaine users also scored higher on specific impulsivity measures, compared to healthy controls. (more…)