Cocaine: history, use, abuse

A critical review of front-loading: A maladaptive drinking pattern driven by alcohol's rewarding effects

Front-loading is a drinking pattern in which alcohol intake is skewed toward the onset of reward access. This phenomenon has been reported across several different alcohol self-administration protocols in a wide variety of species, including humans. The hypothesis of the current review is that front-loading emerges in response to the rewarding effects of alcohol and can be used to measure the motivation to consume alcohol. Alternative or additional hypotheses that we consider and contrast with the main hypothesis are that: (1) front-loading is directed at overcoming behavioral and/or metabolic tolerance and (2) front-loading is driven by negative reinforcement. Evidence for each of these explanations is reviewed. We also consider how front-loading has been evaluated statistically in previous research and make recommendations for defining this intake pattern in future studies. Because front-loading may predict long-term maladaptive alcohol drinking patterns leading to the development of alcohol use disorder (AUD), several future directions are proposed to elucidate the relationship between front-loading and AUD.

Cocaine: from a controlled drug by the DEA to an approved drug by the FDA

Abstract:

NumbrinoTM, a nasal anesthetic solution based on cocaine hydrochloride, was recently approved by the FDA for diagnostic procedures and surgery – now, what will be the role of the controlling agencies and the legislation of producing countries to face the imminent medicinal use of cocaine? Would chemistry be the protagonist in proposing alternative approaches to help and overcome this issue? The debate is open with this commentary

The Use of Drosophila to Understand Psychostimulant Responses

The addictive properties of psychostimulants such as cocaine, amphetamine, methamphetamine, and methylphenidate are based on their ability to increase dopaminergic neurotransmission in the reward system. While cocaine and methamphetamine are predominately used recreationally, amphetamine and methylphenidate also work as effective therapeutics to treat symptoms of disorders including attention deficit and hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Although both the addictive properties of psychostimulant drugs and their therapeutic efficacy are influenced by genetic variation, very few genes that regulate these processes in humans have been identified. This is largely due to population heterogeneity which entails a requirement for large samples. Drosophila melanogaster exhibits similar psychostimulant responses to humans, a high degree of gene conservation, and allow performance of behavioral assays in a large population. Additionally, amphetamine and methylphenidate reduce impairments in fly models of ADHD-like behavior. Therefore, Drosophila represents an ideal translational model organism to tackle the genetic components underlying the effects of psychostimulants. Here, we break down the many assays that reliably quantify the effects of cocaine, amphetamine, methamphetamine, and methylphenidate in Drosophila. We also discuss how Drosophila is an efficient and cost-effective model organism for identifying novel candidate genes and molecular mechanisms involved in the behavioral responses to psychostimulant drugs.

Application of Microextraction-Based Techniques for Screening-Controlled Drugs in Forensic Context-A Review

The analysis of controlled drugs in forensic matrices, i.e., urine, blood, plasma, saliva, and hair, is one of the current hot topics in the clinical and toxicological context. The use of microextraction-based approaches has gained considerable notoriety, mainly due to the great simplicity, cost-benefit, and environmental sustainability. For this reason, the application of these innovative techniques has become more relevant than ever in programs for monitoring priority substances such as the main illicit drugs, e.g., opioids, stimulants, cannabinoids, hallucinogens, dissociative drugs, and related compounds. The present contribution aims to make a comprehensive review on the state-of-the art advantages and future trends on the application of microextraction-based techniques for screening-controlled drugs in the forensic context.

Neurotoxicology Syndromes Associated with Drugs of Abuse

Substance use disorders-and their associated neurologic complications-are frequently encountered by neurologists as well as emergency room physicians, internists, psychiatrists, and medical intensivists. Prominent neurologic sequelae of drug abuse, such as seizure and stroke, are common and often result in patients receiving medical attention. However, less overt neurologic manifestations, such as dysautonomia and perceptual disturbances, may be initially misattributed to primary medical or psychiatric illness, respectively. This article focuses on the epidemiology, pharmacology, and complications associated with commonly used recreational drugs, including opioids, alcohol, marijuana, cocaine, and hallucinogens.

Potential of an Interactive Drug Prevention Mobile Phone App (Once Upon a High): Questionnaire Study Among Students

BACKGROUND

In recent years, drug prevention networks and drug education programs have started using Web-based or mobile phone apps as novel prevention tools, testing their efficacy compared with face-to-face prevention.

OBJECTIVE

The aim of this study was to assess the potential of an interactive app called Once Upon a High (VoltEgySzer).

METHODS

The app approaches drug prevention from 6 different aspects, and it addresses youngsters with 6 different modules: (1) interactive comics/cartoons, telling stories of recovery; (2) quiz game; (3) roleplay game; (4) introduction of psychoactive drugs; (5) information on the somatic and psychological effects of psychoactive substances; (6) list of available treatment units, rehabs, and self-support groups in Hungary. Students of 2 vocational schools and 2 high schools filled out a questionnaire at a baseline (T0) and a 2-month follow-up (T1) data collection session. Students of 1 vocational school and 1 high school downloaded the Once Upon a High app (app group), whereas students from the other vocational school and high school did not (nonapp group). The time points of T0 and T1 questionnaires contained demographic variables, items with regard to substance use characteristics for both legal and illegal substances, including novel psychoactive substance, exercise habits, knowledge about psychoactive substances, attitudes toward substance users and validated instruments measuring the severity of tobacco (Fagerström Test for Nicotine Dependence), alcohol (Alcohol Use Disorder Identification Test), cannabis (Cannabis Abuse Screening Test), and synthetic cannabinoid consumption. Beliefs about substance use (Beliefs About Substance Abuse) and perceived self-efficacy (General Perceived Self-Efficacy) were also measured. At T1, members of the app group provided additional evaluation of the app.

RESULTS

There were 386 students who participated in the T0 session. After dropout, 246 students took part in T1 data collection procedure. Alcohol was the most frequently consumed psychoactive substance (334/364, 91.8% lifetime use), followed by tobacco (252/386, 65.3%, lifetime use) and cannabis (43/323, 13.3% lifetime use). Decreased self-efficacy (beta=-.29, P=.04) and increased daily physical exercise frequencies (beta=.04, P<.001) predicted higher frequencies of past month energy drink consumption, whereas elevated past month alcohol consumption was mainly predicted by a decrease in negative attitudes toward substance users (beta=-.13, P=.04) in the regression models. Once Upon a High was found to be effective only in reducing energy drink consumption (beta=-1.13, P=.04) after controlling for design effect, whereas perceived utility of the app showed correlation with a decreasing alcohol use (rS(44)=.32, P=.03). The roleplay module of the app was found to be the most preferred aspect of the app by the respondents.

CONCLUSIONS

The Once Upon a High app can be a useful tool to assist preventive intervention programs by increasing knowledge and self-efficacy; however, its efficacy in reducing or preventing substance use needs to be improved and further studied. Additional potential impacts of the app need further testing.

Global cocaine intoxication research trends during 1975-2015: a bibliometric analysis of Web of Science publications

BACKGROUND

Cocaine is subject to recreational abuse as a stimulant and psychoactive agent, which poses a major worldwide health problem. The aim of the present study was to perform a bibliometric analysis of publication related to cocaine intoxication an insight of the research trends at a global level to enable recommendations for future research strategies in this field.

METHODS

Publications about cocaine intoxication were retrieved from the Web of Science (WoS) Core Collection database on December 28, 2016, and analysed regarding the following bibliometric indicators: research trends, document types, languages, countries/territories with their h-index, collaboration patterns, journals with their impact factors (IF), and institutions.

RESULTS

In total, 2,902 scientific publications from 1975 to 2015 were retrieved from the WoS database. The annual number of publications related to cocaine toxicity increased slightly after 1990 and reached a peak of 148 in 1992, with an average of 103 publications per year. The USA outranked other countries/territories with 2,089 publications, of which 1,927 arose exclusively from the USA and 162 involved international collaborations. The h-index for all publications related to cocaine was 212, and the h-index for all publications related to cocaine intoxication was 99. Moreover, the USA had the highest h-index of 95, followed by Spain with h-index of 24, and Canada with h-index of 24. The main research topics were consistently reproductive toxicity, clinical management of acute cocaine exposure, laboratory methods for detection of exposure to cocaine, cocaine metabolism, and cocaine toxicity in animals.

CONCLUSIONS

This is the first bibliometric approach to examining research related to cocaine toxicity and shows that research activity has become more global and extensive since 1990. The USA remains the leading country regarding published literature, the highest h-index, and greatest role in international collaborations.

Use and abuse of alcohol and other drugs during the heroic age of Antarctic exploration

During the heroic age of Antarctic exploration, there was much discussion on the role of alcohol. The explorers expected to be able to consume alcohol, and the expeditions were supported by companies producing alcoholic beverages that used the Antarctic connection in their advertising. On the other side, it was said (incorrectly) than Fridjof Nansen, perhaps the most famous of the Arctic explorers, had taken no alcohol and this was used in the arguments against alcohol by the temperance movement. In general, alcohol consumption was low but it was felt that alcohol played an important role in maintaining the psychological welfare of the participants. A number of them had alcohol problems, and participation in an expedition was thought to be of benefit in that it would remove the temptation to consume alcohol. However, there were episodes of drunkenness on the ships and in the Antarctic. Cocaine was taken as one of a number of tonics but only one explorer is thought to have abused drugs, though another is said to have done so.

Focused local anesthesia and analgesia for head and neck surgery

Facility in the use of head and neck regional blocks will provide excellent perioperative analgesia and patient satisfaction. The scope of ambulatory surgical care for head and neck surgery will undoubtedly increase as expertize in these blocks expand in the face of strict criteria for patient selection. Supplemental sedation will be more precise with the intended result of less hangover and nausea and vomiting.

Rats markedly escalate their intake and show a persistent susceptibility to reinstatement only when cocaine is injected rapidly

When drugs enter the brain rapidly, liability for addiction is increased, but why this is the case is not well understood. Here we examined the influence of varying the speed of intravenous cocaine delivery on self-administration behavior in rats given limited or extended opportunity to take drug. The speed of cocaine delivery had no effect on self-administration behavior when rats were given only 1 h each day to take cocaine. When given sixfold more time to take cocaine, rats that received cocaine rapidly (5-45 s) increased their total intake eightfold. However, rats that received cocaine more slowly (>90 s) did not avail themselves of the opportunity to take much more drug: they increased their intake only twofold. Furthermore, when tested 45 d after the last self-administration session, a drug-priming injection reinstated drug-seeking behavior only in rats that in the past had cocaine injected rapidly (5 s), and this was associated with a persistent suppression in the ability of cocaine to induce immediate early gene expression. Cocaine may be potentially more addictive when it reaches the brain rapidly because (1) this promotes a marked escalation in intake and (2) it renders individuals more susceptible to relapse long after the discontinuation of drug use. This is presumably because the rapid uptake of drug to the brain preferentially promotes persistent changes in brain systems that regulate motivation for drug, and continuing exposure to large amounts of drug produces a vicious cycle of additional maladaptive changes in brain and behavior.

Prevalence and correlates of crack-cocaine injection among young injection drug users in the United States, 1997-1999

OBJECTIVES

We estimated prevalence and identified correlates of crack-cocaine injection among young injection drug users in the United States.

METHODS

We analyzed data from the second Collaborative Injection Drug Users Study (CIDUS II), a 1997-1999 cohort study of 18-30-year-old, street-recruited injection drug users from six US cities.

RESULTS

Crack-cocaine injection was reported by 329 (15%) of 2198 participants. Prevalence varied considerably by site (range, 1.5-28.0%). No participants injected only crack-cocaine. At four sites where crack-cocaine injection prevalence was greater than 10%, recent (past 6 months) crack-cocaine injection was correlated with recent daily injection and sharing of syringes, equipment, and drug solution. Lifetime crack-cocaine injection was correlated with using shooting galleries, initiating others into drug injection, and having serologic evidence of hepatitis B virus and hepatitis C virus infection.

CONCLUSIONS

Crack-cocaine injection may be a marker for high-risk behaviors that can be used to direct efforts to prevent HIV and other blood-borne viral infections.

The effect of controlled drugs on the unborn child and fetus

Illicit substance abuse is more prevalent than thought in women of a child bearing age and its incidence is increasing. Although maternal factors, such as poor socioeconomic status, diet, smoking, alcohol and infection, have detrimental effects on the fetuses of drug-abusing mothers, harm is increased due to the pharmacological activity of the drugs themselves. This article reviews the pharmacophysiological interactions between mother and fetus, describes the general effects of substance abuse during each trimester and details the deleterious effects on the fetus of the more commonly abused controlled drugs.

Selection of 2?-Fluoro-modified RNA Aptamers for Alleviation of Cocaine and MK-801Inhibition of the Nicotinic Acetylcholine Receptor

The nicotinic acetylcholine receptor (nAChR) belongs to a group of five structurally related proteins that regulate signal transmission between approximately 10(12) cells of the mammalian nervous system. Many therapeutic agents and abused drugs inhibit the nAChR, including the anti-convulsant MK-801 and the abused drug cocaine. Many attempts have been made to find compounds that prevent inhibition by cocaine. Use of transient kinetic techniques to investigate the inhibition of the receptor by MK-801 and cocaine led to an inhibition mechanism not previously proposed. The mechanism led to the development of combinatorially synthesized RNA ligands that alleviate inhibition of the receptor. However, these ligands are relatively unstable. Here we determined whether much more stable 2'-fluoro-modified RNA ligands can be prepared and used to study the alleviation of receptor inhibition. Two classes of 2'-fluoro-modified RNA ligands were obtained: One class binds with higher affinity to the cocaine-binding site on the closed-channel form and, as predicted by the mechanism, inhibits the receptor. The second class binds with equal or higher affinity to the cocaine-binding site on the open-channel form and, as predicted by the mechanism, does not inhibit the receptor, and does alleviate cocaine and MK-801 inhibition of the nAChR. The stability of these 2'-fluoro-RNAs expands the utility of these ligands.

Plants and the central nervous system

This review article draws the attention to the many species of plants possessing activity on the central nervous system (CNS). In fact, they cover the whole spectrum of central activity such as psychoanaleptic, psycholeptic and psychodysleptic effects, and several of these plants are currently used in therapeutics to treat human ailments. Among the psychoanaleptic (stimulant) plants, those utilized by human beings to reduce body weight [Ephedra spp. (Ma Huang), Paullinia spp. (guaraná), Catha edulis Forssk. (khat)] and plants used to improve general health conditions (plant adaptogens) were scrutinized. Many species of hallucinogenic (psychodysleptic) plants are used by humans throughout the world to achieve states of mind distortions; among those, a few have been used for therapeutic purposes, such as Cannabis sativa L., Tabernanthe iboga Baill. and the mixture of Psychotria viridis Ruiz and Pav. and Banisteriopsis caapi (Spruce ex Griseb.) C.V. Morton. Plants showing central psycholeptic activities, such as analgesic or anxiolytic actions (Passiflora incarnata L., Valeriana spp. and Piper methysticum G. Forst.), were also analysed.Finally, the use of crude or semipurified extracts of such plants instead of the active substances seemingly responsible for their therapeutic effect is discussed.

The pathophysiology of cocaine abuse

Cocaine is a naturally occurring alkaloid that increases dopamine concentrations in the reward centers of the brain. There has been a marked increase in cocaine abuse over the last two decades. A neuropsychological stimulant, cocaine also reduces somnolence, increases alertness and improves concentration. However, cocaine abuse has many pathophysiological consequences. These fall broadly into four groups: pathology associated with a drug abusing lifestyle, pathology that occurs whilst intoxicated with (but not directly due to) the drug, pathology associated with drug administration and pathology resulting from pharmacological action of the drug. This review provides a detailed description of the physiological, pharmacological, and pathological effects of cocaine, and highlights the forensic and medicolegal implications of cocaine abuse.

Cocaína: lendas, história e abuso

A civilização ocidental tem estado envolvida com múltiplos problemas sociais, sendo o abuso de drogas um deles. A cocaína e os transtornos decorrentes de seu abuso tornaram-se um problema de saúde pública. O presente trabalho tem como objetivo colaborar pelo aprofundamento da investigação histórica desse tema. Há mais de 4500 anos, as folhas de coca são usadas por índios da América do Sul. Com a industrialização no século XIX, a cocaína chegou aos países desenvolvidos da época. Na medicina, essa substância também se mostrou presente, sendo usada, tanto por Freud quanto por outros médicos, na tentativa de curar inúmeras enfermidades. No entanto, a maior disponibilidade e a queda dos preços nos últimos 30 anos possibilitaram que essa droga fosse usada abusivamente por um número crescente de pessoas, trazendo conseqüências assustadoras para a saúde do indivíduo e para a sociedade como um todo.