“…Chronic cocaine use as well as abuse of other substances, including alcohol and nicotine all reflect up-regulation of CRF and NE feed-forward circuitry (Smith & Aston-Jones, 2008) (Marcinkiewcz et al, 2009), as well as elevated noradrenergic transporter binding in the hypothalamus, brainstem, hippocampus, midbrain and limbic forebrain regions and a desensitization of the alpha2-adrenoceptors in the prefrontal cortex (PFC) (Baumann, Milchanowski, & Rothman, 2004; Beveridge, Smith, Nader, & Porrino, 2005; Goldstein & Volkow, 2002; Porrino, Lyons, Smith, Daunais, & Nader, 2004). In addition, anxiety involves up-regulated extra-hypothalamic CRF and NE circuits involving the amygdala, bed nucleus of the stria terminalis (BNST) and down-regulated medial prefrontal circuits, which in turn, result in changes in stress-related pathways involving the hypothalamic paraventricular nucleus and locus coeruleus to construct a powerful ‘feed forward’ loop that contributes to increased anxiety and stress responses (Dunn & Berridge, 1990; Dunn & Swiergiel, 2008a; Dunn et al, 2004; Koob, 2009a) (Kushner, Abrams, & Borchardt, 2000).…”