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Zorrilla EP, Wee S, Zhao Y, Specio S, Boutrel B, Koob GF, Weiss F. Extended access cocaine self-administration differentially activates dorsal raphe and amygdala corticotropin-releasing factor systems in rats. Addict Biol 2012; 17:300-8. [PMID: 21762287 DOI: 10.1111/j.1369-1600.2011.00329.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Cocaine-induced neuroadaptation of stress-related circuitry and increased access to cocaine each putatively contribute to the transition from cocaine use to cocaine dependence. The present study tested the hypothesis that rats receiving extended versus brief daily access to cocaine would exhibit regional differences in levels of the stress-regulatory neuropeptide corticotropin-releasing factor (CRF). A secondary goal was to explore how CRF levels change in relation to the time since cocaine self-administration. Male Wistar rats acquired operant self-administration of cocaine and were assigned to receive daily long access (6 hours/day, LgA, n=20) or short access (1 hour/day, ShA, n=18) to intravenous cocaine self-administration (fixed ratio 1, ~0.50 mg/kg/infusion). After at least 3 weeks, tissue CRF immunoreactivity was measured at one of three timepoints: pre-session, post-session or 3 hours post-session. LgA, but not ShA, rats showed increased total session and first-hour cocaine intake. CRF immunoreactivity increased within the dorsal raphe (DR) and basolateral, but not central, nucleus of the amygdala (BLA, CeA) of ShA rats from pre-session to 3 hours post-session. In LgA rats, CRF immunoreactivity increased from pre-session to 3 hours post-session within the CeA and DR but tended to decrease in the BLA. LgA rats showed higher CRF levels than ShA rats in the DR and, pre-session, in the BLA. Thus, voluntary cocaine intake engages stress-regulatory CRF systems of the DR and amygdala. Increased availability of cocaine promotes greater tissue CRF levels in these extrahypothalamic brain regions, changes associated here with a model of cocaine dependence.
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Affiliation(s)
- Eric P Zorrilla
- Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA.
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Oliveto A, Poling J, Mancino MJ, Williams DK, Thostenson J, Pruzinsky R, Gonsai K, Sofuoglu M, Gonzalez G, Tripathi S, Kosten TR. Sertraline delays relapse in recently abstinent cocaine-dependent patients with depressive symptoms. Addiction 2012; 107:131-41. [PMID: 21707811 PMCID: PMC3237722 DOI: 10.1111/j.1360-0443.2011.03552.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS Whether the selective serotonin re-uptake inhibitor sertraline at 200 mg/day delays relapse in recently abstinent cocaine-dependent individuals. DESIGN The study involved a 12-week, double-blind, placebo-controlled clinical trial with 2-week residential stay followed by 10-week out-patient participation. SETTING Veterans Affairs residential unit and out-patient treatment research program. PARTICIPANTS Cocaine-dependent volunteers (n = 86) with depressive symptoms (Hamilton score > 15), but otherwise no major psychiatric or medical disorder or contraindication to sertraline. MEASUREMENTS Participants were housed on a drug-free residential unit (weeks 1-2) and randomized to receive sertraline or placebo. Participants then participated on an out-patient basis during weeks 3-12 while continuing to receive study medication. Patients participated in a day substance abuse/day treatment program during weeks 1-3 and underwent weekly cognitive behavioral therapy during weeks 4-12. The primary outcome measure was thrice-weekly urine results and the secondary measure was Hamilton Depression scores. FINDINGS Pre-hoc analyses were performed on those who participated beyond week 2. Generally, no group differences in retention or baseline characteristics occurred. Sertraline patients showed a trend towards longer time before their first cocaine-positive urine ('lapse', χ(2) = 3.67, P = 0.056), went significantly longer before having two consecutive urine samples positive for cocaine ('relapse', χ(2) = 4.03, P = 0.04) and showed significantly more days to lapse (26.1 ± 16.7 versus 13.2 ± 10.5; Z = 2.89, P = 0.004) and relapse (21.3 ± 10.8 versus 32.3 ± 14.9; Z = 2.25, P = 0.02). Depression scores decreased over time (F = 43.43, P < 0.0001), but did not differ between groups (F = 0.09, P = 0.77). CONCLUSIONS Sertraline delays time to relapse relative to placebo in cocaine-dependent patients who initially achieve at least 2 weeks of abstinence.
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Affiliation(s)
- Alison Oliveto
- University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
| | - James Poling
- Yale University School of Medicine, New Haven CT and VA CT Healthcare System, West Haven, CT
| | | | | | - Jeff Thostenson
- University of Arkansas for Medical Sciences, Little Rock, AR
| | - Rhonda Pruzinsky
- Yale University School of Medicine, New Haven CT and VA CT Healthcare System, West Haven, CT
| | - Kishorchandra Gonsai
- Yale University School of Medicine, New Haven CT and VA CT Healthcare System, West Haven, CT
| | - Mehmet Sofuoglu
- Yale University School of Medicine, New Haven CT and VA CT Healthcare System, West Haven, CT
| | | | - Shanti Tripathi
- University of Arkansas for Medical Sciences, Little Rock, AR
| | - Thomas R. Kosten
- Baylor College of Medicine and Michael E DeBakey VA Medical Center, Houston, TX
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Ramo DE, Grov C, Delucchi K, Kelly BC, Parsons JT. Cocaine use trajectories of club drug-using young adults recruited using time-space sampling. Addict Behav 2011; 36:1292-300. [PMID: 21907497 PMCID: PMC3184016 DOI: 10.1016/j.addbeh.2011.08.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 08/09/2011] [Accepted: 08/18/2011] [Indexed: 12/31/2022]
Abstract
Cocaine is the most widely used club drug. Yet, little is known about how patterns of cocaine use vary over time among young adults of diverse gender and sexual identities. This study used latent class growth analysis to identify trajectories of cocaine use over a year and explored individual and substance use factors associated with these trajectories. A sample of 400 young adults (mean age=23.9 years) with recent club drug use were recruited from New York City bars and nightclubs using time-space sampling. Participants completed quantitative measures at baseline, 4-, 8- and 12-months follow-up. A 4-class model fit the data best. Patterns were: Consistent use (48%), Inconsistent use (14%), Decreasing Likelihood of use (28%), and Consistent non-use (11%). Those most likely to be in the Consistent use class had the highest frequency of baseline club drug dependence (χ2 (3, 397)=15.1, p<.01), cocaine dependence (χ2 (3, 397) = 18.9, p<.01), recent alcohol use (χ2 (3, 397)=12.48, p<.01), and drug sensation-seeking (χ2 (3, 397)=9.03, p<.01). Those most likely to be in the Consistent Non-use class had the highest frequency of baseline marijuana use (χ2 (3, 397)=2.71, p<.05). Contrary to hypotheses, there were no differences in most-likely trajectory class by gender/sexual-orientation, age, ethnicity, education, employment status, or income. Findings highlight the diversity of cocaine use patterns over time among young adults, and the personal and substance use characteristics that are associated with each.
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Affiliation(s)
- Danielle E. Ramo
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, TRC 0984, San Francisco, CA 94143, USA, 401 Parnassus Avenue, TRC 0984, San Francisco, CA 94143, USA
| | - Christian Grov
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, 2900 Bedford Ave., Brooklyn, NY. 11210
- The Center for HIV/AIDS Educational Studies and Training (CHEST), 250 West 26 Street, #300, New York, NY. 10001
| | - Kevin Delucchi
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, TRC 0984, San Francisco, CA 94143, USA, 401 Parnassus Avenue, TRC 0984, San Francisco, CA 94143, USA
| | - Brian C. Kelly
- The Center for HIV/AIDS Educational Studies and Training (CHEST), 250 West 26 Street, #300, New York, NY. 10001
- Department of Sociology, Purdue University, 700 State Street, West Lafayette, IN 47907, USA
| | - Jeffrey T. Parsons
- The Center for HIV/AIDS Educational Studies and Training (CHEST), 250 West 26 Street, #300, New York, NY. 10001
- Department of Psychology, Hunter College of the City University of New York, 695 Park Avenue, New York, New York, 10065, USA
- Social-Personality Doctoral Subprogram, Graduate Center of the City University of New York, 695 Park Avenue, New York, NY 10065, USA
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Horta RL, Horta BL, Rosset AP, Horta CL. Perfil dos usuários de crack que buscam atendimento em Centros de Atenção Psicossocial. CAD SAUDE PUBLICA 2011; 27:2263-70. [DOI: 10.1590/s0102-311x2011001100019] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2011] [Accepted: 08/22/2011] [Indexed: 11/21/2022] Open
Abstract
O artigo descreve o perfil de 95 usuários de crack acolhidos em três Centros de Atenção Psicossocial (CAPS) da Região Metropolitana de Porto Alegre, no Sul do Brasil, entre agosto de 2009 e março de 2010. Todos os usuários de crack que buscaram atendimento no período foram entrevistados. Utilizou-se questionários desenvolvidos pela equipe, mais o Self-Reporting Questionnaire (SRQ-20) e inventários de critérios de dependência e abuso (SAMHSA). Houve predomínio de pacientes homens, adultos jovens, com escolaridade fundamental, sem ocupação regular, mas com renda individual informada, em uso frequente e pesado há mais de um ano, e a maioria preenchia critérios para dependência e abuso do crack e tinha escores elevados de SRQ-20. Os resultados evidenciam que os CAPS são buscados por usuários de crack em sofrimento, que deve ser valorizado, mas também a existência de algum tipo de seleção na oferta destes serviços, caracterizada pelas especificidades de renda, escolaridade e grupo primário de apoio aos entrevistados.
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Affiliation(s)
- Rogério Lessa Horta
- Universidade do Vale do Rio dos Sinos, Brasil; Clínica de Psiquiatria e Psicoterapia, Brasil
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Weiss F. Advances in Animal Models of Relapse for Addiction Research. ADVANCES IN THE NEUROSCIENCE OF ADDICTION 2010. [DOI: 10.1201/9781420007350-c1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Palamar JJ, Mukherjee PP, Halkitis PN. A longitudinal investigation of powder cocaine use among club-drug using gay and bisexual men. J Stud Alcohol Drugs 2009; 69:806-13. [PMID: 18925338 DOI: 10.15288/jsad.2008.69.806] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Few studies have analyzed the use of powder cocaine over time and its relation to psychosocial states. The purpose of the present analysis was to examine trajectories of powder cocaine use among club-drug using gay and bisexual men in New York City. METHOD A purposive sample of 355 powder cocaine using men was surveyed four times over a period of 12 months. We analyzed natural trajectories of cocaine use and examined use in relation to demographic and psychosocial variables. Hierarchical linear modeling was used to examine associations of use at baseline and over time. RESULTS Frequency of use at baseline was negatively related to sexual sensation seeking and positively related to triggers of unpleasant emotions, physical discomfort, and the desire for pleasant times with others. Men who reported using cocaine to avoid physical discomfort or to enhance pleasant times with others were also more likely to decrease their frequency of use during the year long investigation. CONCLUSIONS The antecedents that explained cocaine use in this sample indicate the need for treatment and prevention programs that consider the interplay between emotions and behaviors related to use of this drug.
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Affiliation(s)
- Joseph J Palamar
- Center for Health, Identity, Behavior and Prevention Studies, The Steinhardt School of Culture, Education, and Human Development, New York University, 726 Broadway, Suite 525, New York, New York 10003, USA.
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Conner KR, Pinquart M, Holbrook AP. Meta-analysis of depression and substance use and impairment among cocaine users. Drug Alcohol Depend 2008; 98:13-23. [PMID: 18585871 PMCID: PMC2570759 DOI: 10.1016/j.drugalcdep.2008.05.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Revised: 04/29/2008] [Accepted: 05/03/2008] [Indexed: 11/29/2022]
Abstract
BACKGROUND The study evaluated, among cocaine users, the hypothesized positive association of depression and concurrent cocaine use and impairment, alcohol use and impairment, and general drug use and impairment. The hypothesis that gender would moderate these associations, with women showing a stronger correlation between depression and measures of substance use and impairment, was also tested. Also examined was the association of depression with future cocaine use and impairment and substance use treatment participation. METHODS Empirical reports on adult cocaine users published in English in peer-reviewed journals since 1986 that contained data on depression and substance use outcome(s) were obtained using a systematic search. Studies that placed restrictions on range of depression scores to select the sample, experiments that administered cocaine to subjects, and trials of antidepressant medications were excluded. The search yielded 60 studies for the analysis including 53 reports that collected data from clinical venues and seven that were community-based. RESULTS As hypothesized, the analyses showed that depression is associated with concurrent cocaine-, alcohol-, and general drug use and impairment. Effect sizes were small. Hypothesized moderating effects of gender were not supported. Depression was not associated, at a statistically significant level, with treatment participation or future cocaine use and impairment. CONCLUSIONS Depression is consistently but modestly associated with measures of cocaine-, alcohol-, and general drug use and impairment among cocaine users. Associations of depression with treatment participation and with future cocaine use and impairment are not immediately evident, although limitations of data warrant cautious interpretation.
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Affiliation(s)
- Kenneth R. Conner
- University of Rochester Medical Center, Department of Psychiatry, 300 Crittenden Boulevard, Rochester, NY 14642 and Center of Excellence, Veterans Administration, 400 Fort Hill Avenue, Canandaigua, NY 14424
| | | | - Amanda P. Holbrook
- Rochester Institute of Technology, One Lomb Memorial Drive, Rochester, NY 14623
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Herbeck DM, Hser YI, Lu AT, Stark ME, Paredes A. A 12-year follow-up study of psychiatric symptomatology among cocaine-dependent men. Addict Behav 2006; 31:1974-87. [PMID: 16503094 DOI: 10.1016/j.addbeh.2006.01.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2005] [Accepted: 01/19/2006] [Indexed: 11/15/2022]
Abstract
This prospective longitudinal study examines patterns of psychiatric symptomatology among men admitted to treatment for cocaine dependence in 1988-1989. Study participants were interviewed at treatment intake, and at 1 year, 2 years and 12 years after treatment. The Hopkins Symptom Checklist-58 (SCL) and Natural History Interview were administered at the 4 time points. Of the 266 study participants interviewed at the 12-year follow-up, 138 (52%) had been cocaine abstinent for 5 years or more. Repeated measures ANOVA assessed changes in SCL scores over time for cocaine-abstinent and non-abstinent men. Both groups had similarly high mean SCL scores at treatment intake, and reductions in symptom severity 1 year after treatment. By 12-year follow-up, the abstinent group reported significantly lower SCL scores than the non-abstinent group on 4 of the 5 symptom measures. Additionally, cocaine-abstinent men reported lower rates of depressive and psychotic disorders, and lower use of psychopharmacologic and inpatient treatment than non-abstinent men. These findings suggest that severe psychiatric symptomatology persists among individuals unable to achieve a stable recovery from cocaine dependence.
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Orsi MM, Oliveira MDS. Avaliando a motivação para mudança em dependentes de cocaína. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2006. [DOI: 10.1590/s0103-166x2006000100001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo desta pesquisa foi estudar a motivação para a mudança em indivíduos internados por dependência de cocaína através de um delineamento transversal e correlacional. A amostra era composta por 70 indivíduos de ambos os sexos, idade média de 28,67 anos. Foram utilizados os seguintes instrumentos: Escala de Intensidade de Dependência de Cocaína, Beck Depression Inventory, Beck Anxiety Inventory da University of Rhode Island Change Assessment. A intensidade da dependência de cocaína foi avaliada como leve para 15,7% da amostra, moderada para 54,3% e grave para 30%. A média dos escores do Beck Anxiety Inventory foi 11,39 pontos e do Beck Depression Inventory 17,31 pontos. As médias dos escores nas subescalas da University of Rhode Island Change Assessment foram: 17,03 na pré-contemplação, 35,63 na contemplação, 35,10 na ação e 38,33 na manutenção. Encontrou-se uma correlação significativa entre os sintomas de depressão e a ansiedade e a gravidade da dependência, sugerindo que os indivíduos com grau de dependência mais elevado possuíam maior intensidade de sintomas de depressão e ansiedade.
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Relationship of Aggression, Sensation Seeking, and Impulsivity, With Severity of Cocaine Use. ADDICTIVE DISORDERS & THEIR TREATMENT 2003. [DOI: 10.1097/00132576-200302040-00002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gerra G, Baldaro B, Zaimovic A, Moi G, Bussandri M, Raggi MA, Brambilla F. Neuroendocrine responses to experimentally-induced emotions among abstinent opioid-dependent subjects. Drug Alcohol Depend 2003; 71:25-35. [PMID: 12821203 DOI: 10.1016/s0376-8716(03)00065-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The present study investigated neuroendocrine and cardiovascular changes during experimentally-induced affective states in abstinent heroin-dependent subjects and healthy controls. The procedure for eliciting emotions in all subjects used pleasant and unpleasant stimuli that did not differ in subjective arousal properties. We investigated whether the valence of the stimuli differentially affected neuroendocrine responses by comparing neutral, pleasant and unpleasant pictures on heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), methyl-OH-phenyl-glycol (MHPG), norepinephrine (NE), epinephrine (EPI), adrenocorticotrophic hormone (ACTH) and cortisol (CORT) plasma levels. Twelve abstinent heroin-dependent subjects, in comparison with 12 control subjects, were submitted to three experimental sessions, each on one of three experimental days a week apart, in counterbalanced order: day 1=unpleasant pictures, day 2=pleasant pictures, day 3=neutral pictures. In the rating of subjective arousal pleasant and unpleasant stimuli received the same high score in comparison with neutral stimuli; a different cardiovascular and neuroendocrine pattern was obtained in healthy subjects: unpleasant stimuli elicited increases in HR, SBP, MHPG, NE, ACTH, CORT, whereas neutral and pleasant stimuli did not induce any significant response in hormonal levels. In contrast, in heroin addicts, despite increased perceptions of unpleasantness, HR, SBP, MHPG and NE levels did not increase after disliked stimuli; these subjects also reported increased arousal during exposure to neutral stimuli. In comparison with controls, addicted individuals showed higher CORT and ACTH basal levels, and a consequent lack of response to unpleasant stimuli. The results indicate that neuroendocrine and cardiovascular systems respond selectively to affective, motivationally relevant stimuli, and that substance use disorders may be associated with dysregulation of emotion-processing mechanisms.
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Affiliation(s)
- G Gerra
- Centro Studi Farmacotossicodipendenze, Ser.T., Az. U.S.L., Via Spalato 2, 43100 Parma, Italy.
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O'Leary TA, Rohsenow DJ, Martin R, Colby SM, Eaton CA, Monti PM. The relationship between anxiety levels and outcome of cocaine abuse treatment. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2000; 26:179-94. [PMID: 10852355 DOI: 10.1081/ada-100100599] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Although a number of studies have examined the comorbidity of anxiety disorders and substance use disorders, much less is known about the impact of anxiety symptoms on substance use and on substance abuse treatment outcome. In the current study, we examined how self-reported anxiety levels, as measured by the Spielberger State-Trait Anxiety Inventory, were related to cocaine use variables and patterns following substance abuse treatment. There were 108 patients in substance abuse treatment who met DSM-III-R diagnostic criteria for cocaine abuse or dependence who completed an assessment battery at pretreatment, posttreatment, and 3-month follow-up. State anxiety scores significantly declined from pre- to posttreatment and remained stable into the 3-month follow-up period regardless of relapse status. Trait anxiety was correlated positively with negative consequences due to cocaine use and negatively correlated with days in treatment. State and trait anxiety both were correlated positively with the Alcohol Composite Index of the Addiction Severity Index (ASI). These findings suggest that elevated anxiety scores at pretreatment subside with time, do not require clinical management of associated anxiety symptoms, and may be a temporary by-product of experiencing negative consequences due to recent cocaine use.
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Affiliation(s)
- T A O'Leary
- Brown University Center for Alcohol and Addiction Studies, Providence, Rhode Island, USA
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