Cocaine Addiction

Jerome J. Platt is Professor of Psychiatry and Director of the Division of Addiction Research and Treatment, Allegheny University of the Health Sciences, MCP / Hahnemann School of Medicine, and Director of the newly established Institute for Addictive Disorders at Allegheny University of the Health Sciences.

• Preface I HISTORY, USE, AND PHARMACOLOGY 1. The Problem of Cocaine Abuse and Addiction A Brief History ofErythroxylon coca Cocaine Use and Users in the United States: An Overview The Cost of Cocaine Abuse Entering Treatment Conclusions 2. Administration, Action, and Pharmacology of Cocaine What Is Cocaine? Forms of Cocaine Administration and Actions Purity of Illicit Cocaine Latency and Duration of Action The Neurobiology of Cocaine Use of Cocaine with Other Drugs Conclusions II BEHAVIORAL ASPECTS 3. The Subjective Experience, Course, and Parameters of Cocaine Abuse Subjective and Related Effects Is Cocaine Addicting? The Course of Addiction Tolerance Symptoms of Abstinence Theoretical Explanations of Cocaine Abuse Conclusions 4. Characteristics and Behavioral Patterns of Cocaine Abusers Personal Characteristics Variables Contributing to the Development of Cocaine Abuse Cocaine Abuse and Crime Usefulness of Self-Reports of Cocaine Abuse Conclusions III PSYCHOPATHOLOGICAL AND MEDICAL ASPECTS 5. Cocaine Abuse, Psychopathology, and Personality Disorders Psychopathology Clinical (AXIS I) Disorders Personality (AXIS II) Disorders Psychopathology in Cocaine Abusers versus Abusers of Other Drugs Cocaine and Other Substance Abuse in Psychiatric Patients Direct Psychiatric Complications of Cocaine Abuse Effects of Cocaine Abuse on Memory and Cognition Conclusions 6. Medical and Related Consequences of Cocaine Abuse Presentation of Cocaine-Related Medical Problems Specific Systematic Complications Respiratory System Gastrointestinal System Genitourinary System Obstetrical and Neonatal Complications Immune System Acute Complications Complications of Injection Use of Drugs Chronic Complications Cocaine-Related Mortality Conclusions 7. Cocaine Abuse and Sexual Behavior Sexual Functioning Compulsive Sexuality and the Treatment Process Cocaine and the Spread of Sexually Transmitted Diseases Conclusions IV TREATMENT 8. Major Nonpharmacological Treatment Modalities The Goals of Treatment The Treatment Process Treatment Settings and Modalities Psychotherapy Behavioral Interventions Cognitive-Behavioral Interventions Other Interventions Problematic Behaviors during Treatment Treatment Problems of Special Populations Conclusions 9. Pharmacological Interventions in Cocaine Abuse Treatment Strategies Underlying Pharmacological Treatment Agents Addressing Dopamine Depletion Agents Addressing Attention Deficit Disorders Agents Addressing Cocaine Withdrawal and Craving Cocaine Antagonists (Agents Blocking Euphoria) Agents Producing Aversive Reactions When Taken with Cocaine Other Pharmacological Agents Antiseizure Medications Other Agents Management of Conditions Associated with Cocaine Abuse Combined Psychotherapy and Pharmacotherapy NIDA Medications Development Program Conclusions 10. Improving Treatment Outcome and Preventing Relapse Evaluation of Treatment Recommendations Regarding Treatment and Research Relapse and Relapse Prevention Conclusions 11. Conclusions and Recommendations Treatment: What Works? Special Treatment Issues Research Issues Societal Forces Resulting in Cocaine Use Legalization Treatment Policy A Final Note Notes References Index

Dr. Platt has written a comprehensive review of the English-language literature on cocaine abuse...His scholarship is impressive; he has reviewed more than 1,000 articles covering cocaine's history, use, pharmacology, behavioral effects, psychopathological and medical aspects, and treatment of abuse...Dr. Platt is an able writer and a talented summarizer.