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Allen MI, Nader MA. Animal models of cocaine use: importance of social context and co-use. Trends Pharmacol Sci 2025; 46:220-230. [PMID: 39875301 PMCID: PMC11890930 DOI: 10.1016/j.tips.2025.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Revised: 01/09/2025] [Accepted: 01/09/2025] [Indexed: 01/30/2025]
Abstract
Cocaine-use disorders (CUDs) continue to be a major public health problem that requires effective treatments. Despite decades of preclinical research, there are no FDA-approved pharmacotherapies for cocaine use. While there are numerous potential reasons why no efficacious treatments have been identified or approved for cocaine use, we discuss two possible reasons in this review: the low number of studies incorporating social variables and the overlooking of the clinical reality of polysubstance use. These variables impact drug use across the substance-use cycle, including vulnerability, maintenance, and treatment. Recent preclinical and clinical data suggest that cocaine users who engage in polysubstance use should be viewed as a distinct and more prevalent population who require unique behavioral and pharmacological approaches to reduce cocaine use. Therefore, to understand the neurobiology and eventual treatments for CUDs, both variables should be included in animal models.
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Affiliation(s)
- Mia I Allen
- Department of Translational Neuroscience, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1083, USA.
| | - Michael A Nader
- Department of Translational Neuroscience, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1083, USA.
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Psarianos A, Chryssanthopoulos C, Theocharis A, Paparrigopoulos T, Philippou A. Effects of a Two-Month Exercise Training Program on Concurrent Non-Opiate Substance Use in Opioid-Dependent Patients during Substitution Treatment. J Clin Med 2024; 13:941. [PMID: 38398255 PMCID: PMC10888880 DOI: 10.3390/jcm13040941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/14/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND This randomized controlled trial aimed to evaluate the effects of a two-month exercise intervention on the concurrent non-opiate substance use (alcohol, cocaine, cannabis, and benzodiazepines) in opioid users during their medication treatment. METHODS Ninety opioid users (41 females) in methadone and buprenorphine medication treatment were randomly divided into four groups: (a) buprenorphine experimental (BEX; n = 26, aged 41.9 ± 6.1 yrs); (b) buprenorphine control (BCON; n = 25, aged 41.9 ± 5.6 yrs); (c) methadone experimental (MEX; n = 20, aged 46.7 ± 6.6 yrs); and (d) methadone control (MCON; n = 19, aged 46.1 ± 7.5 yrs). The experimental groups (BEX and MEX) followed an aerobic exercise training program on a treadmill for 20 min at 70% HRmax, 3 days/week for 8 weeks. Socio-demographic, anthropometric, and clinical characteristics, as well as non-opioid drug use in days and quantity per week, were assessed before and after the intervention period. RESULTS Following the exercise training, the weekly non-opioid substance consumption (days) decreased (p < 0.05) in both exercise groups and was lower in BEX compared to MEX, while no differences were observed (p > 0.05) between the control groups (BCON vs. MCON) or compared to their baseline levels. Similarly, the daily amount of non-opiate substance intake was reduced (p < 0.05) post-training in BEX and MEX, whereas it did not differ (p > 0.05) in BCON and MCON compared to the baseline. CONCLUSIONS The two-month exercise intervention reduced the non-opioid drug use in both the methadone and buprenorphine substitution groups compared to the controls, suggesting that aerobic exercise training may be an effective strategy for treating patients with OUDs.
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Affiliation(s)
- Alexandros Psarianos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.P.); (T.P.)
- Greek Organization Against Drugs (OΚAΝA), 10433 Athens, Greece;
| | - Costas Chryssanthopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | | | - Thomas Paparrigopoulos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.P.); (T.P.)
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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van Amsterdam J, van den Brink W. Combined use of cocaine and alcohol: A violent cocktail? A systematic review. J Forensic Leg Med 2023; 100:102597. [PMID: 37832170 DOI: 10.1016/j.jflm.2023.102597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/04/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023]
Abstract
It is generally believed that the use of alcohol and cocaine alone and especially in combination elicits aggression and violent behaviour. Though there is overwhelming proof that heavy alcohol use is associated with violence, this is not the case for cocaine. Still, in the popular press and by spokesmen of the police, cocaine use is seen as a cause of violent incidents. In the current systematic review, available data from human studies on the relation between cocaine and violent behaviour is presented. In particular, we present scientific data on the acute induction of violence by cocaine alone, as well as, that by the combination of cocaine and alcohol known to be frequently used simultaneously. RESULTS: show that there is only weak scientific evidence for the acute induction of violent behaviour by cocaine, either when used alone or in combination with alcohol. Based on these data we were also able to refute misconceptions about the relation between cocaine and violence published in the popular press and governmental reports, because it appeared that there was hardly any empirical support for this widely shared opinion. Probably, contextual factors, including cocaine use disorder and personality disorder, may better explain the assumed association between cocaine and violence.
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Affiliation(s)
- Jan van Amsterdam
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Neuroscience, Research Program Compulsivity, Impulsivity & Attention, Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, the Netherlands.
| | - Wim van den Brink
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Neuroscience, Research Program Compulsivity, Impulsivity & Attention, Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, the Netherlands
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Patterns of Prescription Medicine, Illicit Drugs, and Alcohol Misuse among High-Risk Population: A Factor Analysis to Delineate Profiles of Polydrug Users. Healthcare (Basel) 2022; 10:healthcare10040710. [PMID: 35455887 PMCID: PMC9031601 DOI: 10.3390/healthcare10040710] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 01/29/2023] Open
Abstract
Polydrug use is a serious health and social problem worldwide. Treatment remains a challenge because it requires planning based on estimates of the nature and extent of drug consumption and the characteristics of the population in need. To this end, 103 subjects, who voluntarily asked to begin rehabilitation treatment, were monitored through hair analysis to investigate the nature and extent of their polydrug use. A factor analysis was carried out to delineate polydrug user profiles based on the following variables: age, sex, type of illicit drug use, type of prescription drug misuse, and amount of alcohol consumption. Twenty-three percent of subjects tested positive to more than one illicit drug (mainly cocaine), 44% to unprescribed drugs (mainly benzodiazepines), and 66% were hard drinkers. The profiles of drug users outlined included “single drug cocaine user”, and “single drug opiate user”. Moreover, a particularly problematic profile of cocaine users, common between genders and age groups, who combine high levels of alcohol and unprescribed benzodiazepines and opiates, emerged (“hard polydrug abusers”). From a treatment policy perspective, these findings support the importance of preventive analysis before rehabilitation treatment begins in order to identify different patterns of drug abusers to implement personalized multidisciplinary measures.
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Caballero CG, Jorge ÓQ, Landeira AC. Alleged drug-facilitated sexual assault in a Spanish population sample. Forensic Chem 2017. [DOI: 10.1016/j.forc.2017.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pereira RB, Andrade PB, Valentão P. A Comprehensive View of the Neurotoxicity Mechanisms of Cocaine and Ethanol. Neurotox Res 2015; 28:253-67. [PMID: 26105693 DOI: 10.1007/s12640-015-9536-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 06/09/2015] [Accepted: 06/16/2015] [Indexed: 01/17/2023]
Abstract
Substance use disorder is an emerging problem concerning to human health, causing severe side effects, including neurotoxicity. The use of illegal drugs and the misuse of prescription or over-the-counter drugs are growing in this century, being one of the major public health problems. Ethanol and cocaine are one of the most frequently used drugs and, according to the National Institute on Drug Abuse, their concurrent consumption is one of the major causes for emergency hospital room visits. These molecules act in the brain through different mechanisms, altering the nervous system function. Researchers have focused the attention not just in the mechanism of action of these drugs, but also in the mechanism by which they damage the nervous tissue (neurotoxicity). Therefore, the goal of the present review is to provide a global perspective about the mechanisms of the neurotoxicity of cocaine and ethanol.
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Affiliation(s)
- Renato B Pereira
- REQUIMTE/LAQV, Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, nº 228, 4050-313, Porto, Portugal
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Graziani M, Nencini P, Nisticò R. Genders and the concurrent use of cocaine and alcohol: Pharmacological aspects. Pharmacol Res 2014; 87:60-70. [PMID: 24972039 DOI: 10.1016/j.phrs.2014.06.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/13/2014] [Accepted: 06/16/2014] [Indexed: 12/19/2022]
Abstract
AIMS Gender-related differences in the pharmacological effects of addictive drug are an emerging issue. This review examines gender differences in both pharmacokinetic and pharmacodynamic aspects of alcohol and cocaine intake since they cause complex pharmacological interactions, not least the formation of the active metabolite cocaethylene. METHODS The MEDLINE database was searched from 1990 to 2014 in order to find articles related to gender differences in alcohol, cocaine and cocaethylene pharmacokinetics and pharmacodynamics. RESULTS Besides the well known gender differences in alcohol pharmacokinetics, women appear more susceptible to alcohol-mediated brain damage and seem to suffer more than men the acute effects of alcohol on hepatic and gonadal hormones. No significant gender differences have been found in the pharmacokinetics of cocaine taken alone; yet, in women pharmacological sensitivity to the drug seems to vary in relation to menstrual cycle; moreover, progesterone attenuates subjective effects of cocaine in women. Higher ratings at a subjective measure of mental/physical well-being have been observed in women when given cocaine and alcohol, alone or in combination. Finally, among subjects dependent on both alcohol and cocaine, men only benefit from naltrexone, whereas women used more cocaine during the trial and were less compliant to therapy than men. CONCLUSIONS The observed subtle gender differences in the pharmacokinetics and pharmacodynamics of both alcohol and cocaine may have no subtle influence on the natural history of the co-abuse of the two drugs by women.
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Affiliation(s)
- Manuela Graziani
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy; Drug Addiction and Clinical Pharmacology Unit, University Hospital Umberto I, Sapienza University of Rome, Rome, Italy.
| | - Paolo Nencini
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy; Drug Addiction and Clinical Pharmacology Unit, University Hospital Umberto I, Sapienza University of Rome, Rome, Italy
| | - Robert Nisticò
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy; IRCSS Santa Lucia Foundation, Rome, Italy
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Chi FW, Weisner C, Grella CE, Hser YI, Moore C, Mertens J. Does age at first treatment episode make a difference in outcomes over 11 years? J Subst Abuse Treat 2014; 46:482-90. [PMID: 24462221 PMCID: PMC3940137 DOI: 10.1016/j.jsat.2013.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 11/26/2013] [Accepted: 12/09/2013] [Indexed: 12/29/2022]
Abstract
This study examines the associations between age at first substance use treatment entry and trajectory of outcomes over 11 years. We found significant differences in individual and treatment characteristics between adult intakes first treated during young adulthood (25 years or younger) and those first treated at an older age. Compared to their first treated older age counterparts matched on demographics and dependence type, those who entered first treatment during young adulthood had on average an earlier onset for substance use but a shorter duration between first substance use and first treatment entry; they also had worse alcohol and other drug outcomes 11 years post treatment entry. While subsequent substance use treatment and 12-step meeting attendance are important for both age groups in maintaining positive outcomes, relationships varied by age group. Findings underline the importance of different continuing care management strategies for those entering first treatment at different developmental stages.
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Affiliation(s)
- Felicia W Chi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612.
| | - Constance Weisner
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612; Department of Psychiatry, University of California San Francisco, San Francisco, CA 94143
| | - Christine E Grella
- UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90025
| | - Yih-Ing Hser
- UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90025
| | - Charles Moore
- Kaiser Permanente Chemical Dependency Recovery Program, Sacramento, CA 95821-6237
| | - Jennifer Mertens
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612
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