This study suggests that CM is an efficacious treatment for reducing stimulant use and is superior during treatment to a CBT approach. CM is useful in engaging substance abusers, retaining them in treatment and helping them achieve abstinence from stimulant use. CBT also reduces drug use from baseline levels and produces comparable outcomes on all measures at follow-up.

No abstract

Quantitative electroencephalographic (qEEG) profiles were studied in cocaine-dependent patients in response to an acute, single-blind, self-administered dose of smoked cocaine base (50 mg) vs placebo. qEEG data were averaged using neurometric analytical methods and the spectral power of each primary bandwidth was computed and topographically imaged. Additional measures included cocaineinduced high, craving, and related subjective ratings, heart rate, blood pressure, and plasma cortisol and homovanillic acid levels. In all, 13 crack cocaine-dependent subjects were tested. Cocaine produced a rapid increase in subjective ratings of cocaine high and good drug effect, and a more persistent increase in cocaine craving and nervousness. Cocaine also produced a rapid rise in heart rate and a prolonged increase in plasma cortisol. Placebo, administered in the context of cocaine cues and dosing expectations, had no cocaine-like subjective or physiological effects. Cocaine produced a rapid increase in absolute theta, alpha, and beta power over the prefrontal cortex (FP1, FP2), lasting up to 25 min after dosing. The increase in theta power was correlated with good drug effect, and the increase in alpha power was correlated with nervousness. Cocaine also produced a similar increase in delta coherence over the prefrontal cortex, which was positively correlated with plasma cortisol, and negatively correlated with nervousness. Placebo resulted in an increase in alpha power over the prefrontal cortex. These data demonstrate the involvement of prefrontal cortex in the qEEG response to acute cocaine. Evidence indicates slow wave qEEG, delta and theta activity, involvement in the rewarding properties of cocaine.

No abstract

36 alcoholic patients, recruited from a treatment program, and 20 non-alcohol abusing control subjects were tested for their reactions to alcohol and non-alcohol cues. The cue exposure paradigm included audio-visual (video), tactile, olfactory, and guided imagery cue components related to alcohol and non-alcohol beverages. Response measures were analyzed for significant difference based on alcohol and non-alcohol cue and patient type. Among the subjective ratings, alcohol cue specific increases in alcohol craving, desire to drink, alcohol-like high, positive drinking expectancies and alcohol-like withdrawal were seen in alcoholic subjects. Among the physiological measures, alcohol cue specific increases in salivation were seen in alcoholic subjects. Changes in heart rate, skin conductance and temperature were not specific to alcohol cues, or to alcoholic patients. The smelling of alcohol had the greatest impact on alcohol craving and skin conductance in alcoholic subjects. These findings demonstrate robust subjective effects, and weak physiological effects, in response to a multidimensional alcohol cue exposure paradigm. The response profile indicates cue reactivity in alcoholics as an appetitive based form of alcohol craving.