Cocaine opioids

Protease inhibitors Histamine2 receptor antagonists Other Isoniazid Cocaine Opioids Verapamil... 

The non-precipitated withdrawal procedure represents a first screen for possible induction of drug dependence and has been shown to be sensitive to withdrawal effects with a variety of dependence-inducing agents including amphetamines, cocaine, opioids and benzodiazepines. It therefore possesses face validity. On the other hand, it is remarkably difficult, under the conditions of the protocol described, to show signs of withdrawal after treatment with agents such as nicotine... 

Key words Gene, Alcohol, Cocaine, Opioid, Addiction, Dependence, Abuse, Drug, Therapy, Polymorphism... 

The DRD2 and ANKK1 genes are located approximately 10,000 nucleotides apart on chromosome llq22-23. Variants in both genes have been found to be associated with several psychiatric diseases such as schizophrenia, as well as with substance abuse disorders, including alcohol, heroin, nicotine, cocaine, opioid, gambling, methamphetamine, and polysubstance addiction [30-37]. 

Drugs of abuse Ethanol, cannabinoids, cocaine, opioids, smoking ... 

The activation of the mesohmbic DA neurons is a common feamre of drugs of abuse (i.e., cocaine, opioids, amphetamine), and it appears that cannabinoids indirectly activate the same dopaminergic pathways. 

Consequently, we undertook a study of morphine (both in the basic (M) and N-protonated forms (MH)), heroin (H) and cocaine (C) (protonated species), with particular emphasis on the cocaine-opioid interactions. Raman spectra of both the free samples and the C H and C M (1 1, w w) mixtures (with morphine either in the unprotonated or N-protonated forms) were obtained and analyzed in the light of the results obtained from quantum mechanical calculations, in view of understanding those interactions at a molecular level. 

Glassification of Substance-Related Disorders. The DSM-IV classification system (1) divides substance-related disorders into two categories (/) substance use disorders, ie, abuse and dependence and (2) substance-induced disorders, intoxication, withdrawal, delirium, persisting dementia, persisting amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction, and sleep disorder. The different classes of substances addressed herein are alcohol, amphetamines, caffeine, caimabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics, polysubstance, and others. On the basis of their significant socioeconomic impact, alcohol, nicotine, cocaine, and opioids have been selected for discussion herein. 

Lthanol (or alcohol) is a two-carbon molecule that, in contrast to many other drugs of abuse, such as opioids, cocaine, and nicotine, does not bind to specific brain receptors. Nonetheless, alcohol affects a variety of neurotransmitter systems, including virtually all of the major systems that have been associated with psychiatric symptoms (Kranzier 1995). Alcohol affects these neurotransmitter systems indirectly by modifying the composition and functioning of... 

A 2.5-yeat follow-up study of opioid addicts in methadone maintenance treatment found that prevalence of cocaine use only shghtly declined and that... 

Childress AR, McLellan AT, Ehrman R, et al Classically conditioned responses in opioid and cocaine dependence a role in relapse NIDA Res Monogr 84 23 3, 1988... 

Seecof R, Tennant FS Subjective perceptions to the intravenous rush of heroin and cocaine in opioid addicts. Am J Drug Alcohol Abuse 12 79—87, 1987 Sees KL, Delucci KL, Masson C, et al Methadone maintenance vs. 180-day psycho-socially enriched detoxification for treatment of opioid dependence a randomized controlled trial. JAMA 283 1303-1310, 2000 Sells SB Treatment effectiveness, in Handbook on Drug Abuse. Edited by Dupont RE, Goldstein A, O Donnell J. Washington, DC, U.S. Government Printing Office, 1979, pp 105-118... 

There is some evidence of a synergistic effect on reinforcement with concurrent administration of benzodiazepines and opioids (Walker and Ettenberg 2003). Cocaine abusers are less likely than opioid abusers to abuse benzodiazepines, preferring alcohol and opioids as secondary drugs of abuse. The most common pattern of benzodiazepine misuse in these individuals is intermittent use of therapeutic or supratherapeutic doses to counter unwanted effects of cocaine. 

A meta-analysis of placebo-controlled studies by Levin and Lehman (1991) showed that desipramine produced greater cocaine abstinence than placebo. Although a more recent review did not concur (Lima et al. 2001), secondary analyses of studies with imipramine, desipramine, and bupropion suggested that depressed cocaine abusers are more likely to show significant reductions in cocaine abuse than nondepressed cocaine abusers (Margolin et al. 1995 Nunes et al. 1991 Ziedonis and Kosten 1991). Furthermore, recent work with desipramine supported its efficacy in opioid-dependent patients, particularly in combination with contingency management therapies (Kosten et al. 2004 Oliveto et al. 1999). 

Oliveto AH, Feingold A, Schottenfeld R, et al Desipramine in opioid-dependent cocaine abusers maintained on buprenorphine vs methadone. Arch Gen Psychiatry 56 812-820, 1999... 

Schmitz JM, Averill P, Stotts AL, et al Fluoxetine treatment of cocaine-dependent patients with major depressive disorder. Drug Alcohol Depend 63 207-214,2001 Schottenfeld RS, Pakes JR, Oliveto A, et al Buprenorphine vs methadone maintenance treatment for concurrent opioid dependence and cocaine abuse. Arch Gen Psychiatry 54 713-720, 1997... 

A number of psychosocial treatments for alcohol and other substance use disorders exist and are widely used. In this chapter, we discuss six of these psychotherapies as they are applied to alcohol, cocaine, and opioid dependence brief interventions, motivational enhancement therapy, cognitive-behavioral therapy, behavioral treatments (including contingency management and community reinforcement approaches), behavioral marital therapy, and 12-step facilitation. We also describe studies that examined the efficacy of a medication in combination with one or more of the six psychotherapies. In the second section of the chapter, we highlight research that directly studied the interaction between psychosocial and pharmacological treatments. 

In other substance use disorders, the use of 12-step interventions is also popular, and participation in 12-step groups is correlated with better outcomes in cocaine abusers (e.g., McKay et al. 1994). However, a smdy of 128 cocaine abusers found that cognitive-behavioral therapy was more efficacious than 12-step facilitation in engendering cocaine abstinence (Maude-Griffm et al. 1998). Thus, the relative efficacy of 12-step approaches for drug use disorders requires further investigation. No known studies have systematically evaluated the efficacy of 12-step treatments in opioid-dependent patients, either alone or in conjunction with pharmacotherapies. 

Several CM studies have explored interactions between medication and psychosocial treatments for substance use disorders. In a 12-week randomized, double-blind study of buprenorphine-maintained opioid- and cocaine-dependent patients, Kosten et al. (2003a) found that desipramine and CM together led to greater abstinence from cocaine and heroin and more consecutive weeks of abstinence than either treatment individually or placebo. A later... 

Finally, in a recent study, Schottenfeld and colleagues (2005) conducted a 24-week, double-blind medication trial in which 162 opioid- and cocaine-... 

Many studies have examined the efficacy of a variety of psychosocial treatments for alcohol, cocaine, and opioid use disorders, alone and in conjunction with pharmacotherapy. However, only a handful of studies have explored how these two treatment approaches may interact. More research is needed to further explore the ways in which psychosocial interventions may be used in conjunction with pharmacotherapy to optimize outcomes for both treatments. Providing encouragement for abstinence, greater treatment retention, medication adherence, and coping with medication side effects are some potential applications of psychosocial therapies. 

Carroll KM, Sinha R, Nich C, er al Conringency management to enhance naltrexone treatment of opioid dependence a randomized clinical trial of reinforcement magnitude. Exp Clin Psychopharmacol 10 5d—63, 2002 Carroll KM, Fenron LR, Ball SA, er al Efficacy of disulfiram and cognitive behavior rherapy in cocaine-dependenr ourparienrs. Arch Gen Psychiatry 61 264—272, 2004... 

Schottenfeld RS, Chawarski MC, Pakes JR, et al Methadone versus buprenorphine with contingency management or performance feedback for cocaine and opioid dependence. Am J Psychiatry 162 340-349, 2003 Smith JE, Meyers RJ, Delaney HD Community reinforcement approach with homeless alcohol-dependent individuals. J Consult Clin Psychol 66 341-348, 1998... 

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