Author: Gary Jackson
addicted brain: differences between heroin and cocaine? Brain
Table 1 summarises a few of the physical and chemical properties of cocaine [26,27]. John has travelled extensively around the world, culminating in 19 years’ experience looking at different models. He is the European pioneer of NAD+ (Nicotinamide Adenine Dinucleotide) treatment to Europe in 2010; and recently back from the USA bringing state of the art Virtual Reality Relapse Prevention and stress reduction therapy.
- Cocaine abuse remains a significant public health problem with serious socio-economic consequences worldwide [4].
- Professional rehabilitation centres offer a diverse range of treatment options for cocaine and heroin addiction to benefit everyone.
- Cocaine is a potent stimulant drug that works by inhibiting the reuptake of neurotransmitters such as dopamine, norepinephrine, and serotonin in the brain.
- Furthermore, this same study demonstrated that cocaine concentrations between 0.1 and 2.5 mM induced an increase in apoptotic cells, and necrotic cells appeared following 5 mM cocaine exposure.
- However, notwithstanding our own earlier work, no studies have investigated if long-term patterns of cocaine or meth use are similar to that of heroin.
- Coca chewing, as an alternative method to consume cocaine, greatly favours sublingual absorption.
Treatment options may include therapy, support groups, and in some cases, medication-assisted therapy to manage withdrawal symptoms and cravings. A severe cocaine intoxication can result in a fatal outcome if not given the necessary medical treatment [157]. Given the ever-present risk of cardiorespiratory arrest, monitoring vital signs is extremely important, and cardiorespiratory resuscitation should be performed as soon as necessary. If this fails, the administration of vasopressin is recommended (this therapeutic option has demonstrated greater effectiveness than epinephrine, the first-line drug for cardiac resuscitation) [158,159].
Cocaine Addiction: Have Scientists Finally Found a Cure?
The intranasal route determines a longer effect, ranging between 15 and 30 min [53]. One can conjecture how treatment provided earlier after onset and for longer durations might alter drug-use trajectories over the life course. Sampson and Laub’s age-graded theory of informal social control and its impact on crime trajectories has only recently been applied to the relationship between drug use and criminal desistance (Schroeder, Giordano, & Cernkovich, 2007), but it seems reasonable to expect that course of crime and drug use are altered by similar life events.
- Relapse research has examined the course of use by discrete drug types, notably heroin and cocaine, and findings have generally shown that severe or dependent users tend to persist in their drug use, often for substantial periods of their lifespan.
- We are inclusive and open-minded treatment providers who keep our clients at the forefront of our treatments and methods.
- At Nova Recovery, our mission is to guide individuals on their journey to addiction recovery.
The effectiveness of these treatments was evaluated in preliminary clinical trials. In the Netherlands, 73 patients with treatment-refractory heroin and cocaine dependence reported fewer days of cocaine use (45 days) after 12 weeks of oral administration of sustained-release dexamphetamine (60 mg/day) compared with placebo-treated patients (61 days) [165]. Regarding the use of glutamatergic/GABAergic medications, 170 cocaine- and alcohol-dependent individuals treated with topiramate (300 mg/day for 13 weeks) were significantly more likely to achieve abstinence from cocaine during the last 3 weeks of treatment [166]. Modafinil has also shown promising results in treating moderate CUD, as it can weaken cocaine-induced euphoria in humans; however, it is not effective in reducing cocaine intake if the subjects have an alcohol dependence in conjunction with CUD [167]. As previously mentioned, the form of cocaine the user choses (cocaine salt or the free base), the route of administration and patterns of use vary. By virtue of its hydrophilicity, cocaine hydrochloride is generally consumed by ‘snorting’ [53,54].
The addicted brain: differences between heroin and cocaine?
The hallmark hepatic lesion following cocaine use is hepatocellular necrosis, which was also demonstrated in animal studies [83,122]. Other pathological characteristics of cocaine-induced hepatic injury include increased infiltration with fatty acids, increased blood aspartate aminotransferase levels and pernicious conjugates of reactive cocaine metabolites with cellular macromolecules [83]. When cocaine is consumed, an exacerbated dopaminergic activity along the mesocorticolimbic pathways occurs. Neurons from these pathways are located in the ventral tegmental area and project to other brain locations, including the nucleus accumbens [78]. This could explain why the drug has such an addictive potential, since it is well acknowledged that the nucleus accumbens may have an important role in the rewarding and addictive properties of cocaine and other drugs [79].
However, few studies have sufficiently lengthy observation periods to adequately characterize the phenomena involved in the long-term processes of dependence, recovery, and relapse and even fewer have investigated differences in these processes by drug type. A vast majority of cocaine users co-consume it with alcohol, and report that this combination extends the duration of the stimulation and counterbalances the dysphoria subsequent to cocaine use [24]. Generally, ethanol potentiates both the morbidity and mortality of cocaine [150,151]. The use of cocaine in combination with alcohol is cardiotoxic [100] and leads to the formation of CE, a pharmacologically active metabolite, as previously mentioned. CE appears to be more selective for DAT than cocaine itself; CE is also capable of inducing an increase in blood pressure and heart rate, and it seems to enhance the effects cocaine has at the level of the CNS [152]; CE also possesses a longer half-life compared to cocaine and is capable of inhibiting the conversion of cocaine into BE.
What Drugs Cause the Most Insane Behavior?
Most primary heroin users in the sample were male (89%), Hispanic (53%) or white (36%), starting their heroin use at about 19 and regular use at about 20, got arrested first at 16, initiated drug treatment at 26, and spent almost 3 years in prison/jail and only 5 months in treatment during the first 10 years of their addiction careers. Compared to users of heroin and cocaine, primary meth users were more likely to be women (46%) and to be white (54%); meth users initiated both meth use and crime at around age 19, were first treated at age 28, and spent about 5 months in treatment and less than a year in prison during the first 10 years after initiating use of meth. About 40% of people were injectors and the percentage of injectors was highest among heroin users (more than 90%), followed by meth (44%) and cocaine users (27%) (data not shown). To assess differences by drug type in changes within individual trajectories, we calculated the number and duration of episodes of no use, low use, high use, and incarceration at the aggregate level (Table 2) and at the individual level (Table 3). The aggregate transition patterns are organized by the beginning and ending status (characterized by level of drug use or incarceration) of each episode. As shown in Table 2, heroin users experienced the greatest number of episode transitions (5711 episodes by 629 individuals, or on average 9 episodes per person), and 37% of their episodes began with use-at-a-high-level (12 or more days per month; 13.4 months per episode), and 36% began with incarceration (10.3 months per episode).
- A severe cocaine intoxication can result in a fatal outcome if not given the necessary medical treatment [157].
- While quitting drug use can be facilitated by treatment and/or self-help participation, few people had these experiences in the 10 years following first use.
- The average half-life of cocaine is between 40 and 90 min, which may vary depending on the route of administration (shorter for intravenous route, longer for insufflation).
- As such, samples suspected to contain cocaine should be adjusted to pH 5 with acetic acid and refrigerated at 4 °C or frozen to increase stability of the drug, although some degradation occurs along the time, even at −20 °C.
- Cocaine is metabolised (mostly hepatically) into two main metabolites, ecgonine methyl ester and benzoylecgonine.
Not only do benzodiazepines exert anxiolytic action, but they also attenuate toxic effects at the cardiovascular and cerebral level, by reducing both blood pressure and cardiac output, which makes them a key first approach in treating cocaine acute intoxications [96,160]. Of note, when the subject rejects benzodiazepines’ oral administration, the intramuscular or intravenous routes are recommended [89,160]. Cocaine promotes vasoconstriction, through indirect agonism of α-/β-adrenergic receptors, blockade of voltage-gated sodium channels, and increases in endothelin-1 and decrease of nitric oxide.