Treatment Outcome Predictors for Cocaine Dependence

Abstract

Over the past decade, a large number of potential medications have been examined in clinical trials for cocaine dependence. Unfortunately, no effective pharmacotherapies for cocaine dependence have been found to date. Although effective treatments for cocaine dependence are still being investigated, a few variables have been found to significantly predict cocaine treatment response. These variables include cocaine use variables, such as days of cocaine use in the month before treatment, baseline urine cocaine results, and cocaine withdrawal symptoms. Comorbid depression and alcohol use have also been shown to be risk factors for relapse. Among personality variables, impulsivity and similar personality traits may predict treatment response. Initial promising findings with genetic polymorphism, brain activation, and stress response have also been found and need to be replicated in future studies.

The Neuropsychology of Cocaine Addiction: Recent Cocaine Use Masks Impairment

“…The main goal aim of the current study was to test the reliability of our previous results in a larger sample of individuals with cocaine use disorders (CUD). In addition, we aimed to test the effects of four factors that commonly vary within cocaine-addicted groups, namely urine status for cocaine, history of cigarette smoking and alcohol consumption, and dysphoric symptoms (Budney et al, 1993;Rusted et al, 1994Rusted et al, , 1995Di Sclafani et al, 2002;Richter et al, 2002;Poling et al, 2007). These factors may influence NP performance in drug abusers and possibly account for the inconsistencies in this literature.…”

The Relationship between Drug User Stigma and Depression among Inner-City Drug Users in Baltimore, MD

“…Other studies have also found that depression predicts relapse. [7][8][9][10][11] Drug treatment among cocaine users may lead to a reduction in depressive symptoms. 12 A less-studied consequence of drug use is that of stigma.…”

Exercise during early, but not late abstinence, attenuates subsequent relapse vulnerability in a rat model

“…33 The rats assigned to an exercise group were given access to a running wheel for 2 h per day with sessions beginning between 0900 and 1100 h. We have previously shown that this wheel-running session length (2 h per day) effectively blocks the development of the incubation effect when available throughout abstinence. [15][16][17] The sessions were conducted daily during early (days 1-7), late (days [8][9][10][11][12][13][14] or throughout abstinence (days [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The rats in the sedentary group were also given access to a wheel for 2 h per day throughout abstinence; however, the wheel was locked at all times (as a control for environmental enrichment).…”

“…We also compared the effects of early or late exercise to the effects of access to a locked or unlocked wheel throughout abstinence (days [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. On the basis of the neurobiological data, 29,33,38 we predicted that exercise during early abstinence would cause a greater decrease in cocaine seeking as compared with exercise during late abstinence.…”

“…Exercise has been shown to reduce symptoms of depression and measures of anxiety, and to enhance cognition, 6,7 factors known to contribute to drug relapse. 8,9 Recent reports analyzing exercisebased programs piloted at drug abuse treatment facilities have also shown that engaging in a consistent exercise regimen reduces withdrawal symptoms, increases the likelihood of remaining abstinent and decreases craving. [10][11][12][13] In animals, several studies have shown that wheel and treadmill running reduce the reinforcing effects of cocaine, as well as cocaine seeking when the exercise option is contemporaneously available.…”