Cocaine Addiction

by Platt, Jerome J.

• ISBN13: 9780674001787
• ISBN10: 0674001788
• Format: Paperback
• Copyright: 2000-05-05
• Publisher: Harvard Univ Pr

Summary

It inspired written testimonials from William McKinley, Thomas Edison, and Sarah Bernhardt; merited a medal from Pope Leo XIII; produced "exhilaration and lasting euphoria" in Sigmund Freud. Once the stimulant of choice of the enlightened and the elite, cocaine has become, a century later, a plague, ravaging the lives of millions. This book is the first to draw together all the facts about this pervasive drug--from its natural occurrence in a tea-like native South American plant to its devastating appearance as crack in the inner cities of the United States. Drawing on the latest work in medicine, psychiatry, neuroscience, pharmacology, epidemiology, social work, and sociology, the volume is a highly accessible reference on the history and use of cocaine, its physical and psychological effects, and the etiology and epidemiology of cocaine addiction. It also provides a critical evaluation of the pharmaceutical agents and psychosocial interventions that have been used to treat this addiction. Author Jerome J. Platt answers such basic questions as: What is cocaine? What forms does it come in? How is it administered? What does it do? What are the medical complications of cocaine addiction? What are the treatments, and how successful are they? Uniquely comprehensive, Cocaine Addiction makes all the latest information on this urgent subject readily available to medical professionals and practitioners, social workers and scholars, and anyone who cares to know more about this perennially troubling drug.

Table of Contents

Preface	xiii
I History, Use, and Pharmacology
The Problem of Cocaine Abuse and Addiction	3	(19)
A Brief History of Erythroxylon coca	3	(8)
Cocaine Use and Users in the United States: An Overview	11	(4)
The Cost of Cocaine Abuse	15	(4)
Entering Treatment	19	(1)
Conclusion	19	(3)
Administration, Action, and Pharmacology of Cocaine	22	(39)
What Is Cocaine?	23	(1)
Forms of Cocaine	24	(1)
Administration and Actions	25	(9)
Purity of Illicit Cocaine	34	(1)
Latency and Duration of Action	35	(2)
The Neurobiology of Cocaine	37	(8)
Use of Cocaine with Other Drugs	45	(11)
Conclusions	56	(5)
II Behavioral Aspects
The Subjective Experience, Course, and Parameters of Cocaine Abuse	61	(36)
Subjective and Related Effects	61	(9)
Is Cocaine Addicting?	70	(3)
The Course of Addiction	73	(9)
Tolerance	82	(2)
Symptoms of Abstinence	84	(7)
Theoretical Explanations of Cocaine Abuse	91	(3)
Conclusions	94	(3)
Characteristics and Behavioral Patterns of Cocaine Abusers	97	(20)
Personal Characteristics	97	(7)
Variables Contributing to the Development of Cocaine Abuse	104	(4)
Cocaine Abuse and Crime	108	(4)
Usefulness of Self-Reports of Cocaine Abuse	112	(1)
Conclusions	113	(4)
III Psychopathological and Medical Aspects
Cocaine Abuse, Psychopathology, and Personality Disorders	117	(33)
Psychopathology	117	(4)
Clinical (AXIS I) Disorders	121	(6)
Personality (AXIS II) Disorders	127	(2)
Psychopathology in Cocaine Abusers Versus Abusers of Other Drugs	129	(3)
Cocaine and Other Substance Abuse in Psychiatric Patients	132	(4)
Direct Psychiatric Complications of Cocaine Abuse	136	(4)
Effects of Cocaine Abuse on Memory and Cognition	140	(6)
Conclusions	146	(4)
Medical and Related Consequences of Cocaine Abuse	150	(38)
Presentation of Cocaine-Related Medical Problems	151	(7)
Specific Systematic Complications	158	(8)
Respiratory System	166	(2)
Gastrointestinal System	168	(1)
Genitourinary System	169	(1)
Obstetrical and Neonatal Complications	170	(7)
Immune System	177	(1)
Acute Complications	178	(1)
Complications of Injection Use of Drugs	179	(1)
Chronic Complications	179	(3)
Cocaine-Related Mortality	182	(3)
Conclusions	185	(3)
Cocaine Abuse and Sexual Behavior	188	(19)
Sexual Functioning	188	(2)
Compulsive Sexuality and the Treatment Process	190	(1)
Cocaine and the Spread of Sexually Transmitted Diseases	190	(12)
Conclusions	202	(5)
IV Treatment
Major Nonpharmacological Treatment Modalities	207	(49)
The Goals of Treatment	207	(2)
The Treatment Process	209	(4)
Treatment Settings and Modalities	213	(12)
Psychotherapy	225	(4)
Behavioral Interventions	229	(9)
Cognitive-behavioral Interventions	238	(2)
Other Interventions	240	(3)
Problematic Behaviors during Treatment	243	(1)
Treatment Problems of Special Populations	244	(7)
Conclusions	251	(5)
Pharmacological Interventions in Cocaine Abuse Treatment	256	(53)
Strategies Underlying Pharmacological Treatment	256	(2)
Agents Addressing Dopamine Depletion	258	(14)
Agents Addressing Attention Deficit Disorders	272	(1)
Agents Addressing Cocaine Withdrawal and Craving	273	(7)
Cocaine Antagonists (Agents Blocking Euphoria)	280	(2)
Agents Producing Aversive Reactions When Taken with Cocaine	282	(1)
Other Pharmacological Agents	282	(8)
Antiseizure Medications	290	(2)
Other Agents	292	(2)
Management of Conditions Associated with Cocaine Abuse	294	(5)
Combined Psychotherapy and Pharmacotherapy	299	(4)
NIDA Medications Development Program	303	(1)
Conclusions	304	(5)
Improving Treatment Outcome and Preventing Relapse	309	(23)
Evaluation of Treatment	309	(9)
Recommendations Regarding Treatment and Research	318	(2)
Relapse and Relapse Prevention	320	(9)
Conclusions	329	(3)
Conclusions and Recommendations	332	(17)
Treatment: What Works?	332	(2)
Special Treatment Issues	334	(1)
Research Issues	335	(3)
Societal Forces Resulting in Cocaine Use	338	(1)
Legalization	339	(4)
Treatment Policy	343	(2)
A Final Note	345	(4)
Notes	349	(10)
References	359	(74)
Index	433