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Curr Opin Psychiatry 2021 07;34(4):344-350

Department of Family and Community Medicine, University of California, San Francisco, California, USA.

Purpose Of Review: This review provides an update on recently published literature on the rise of illicit fentanyls, risks for overdose, combinations with other substances, e.g. stimulants, consequences, and treatment. Read More

MMW Fortschr Med 2021 04;163(8)

Praxis für Allgemeinmedizin - Sportmedizin, Im Ingelstück 31, 36088, Hünfeld, Deutschland.

BMC Public Health 2021 04 23;21(1):781. Epub 2021 Apr 23.

Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil, Rua Major Maragliano, 241, SP, 04017030, São Paulo, Brazil.

Background: Crack-cocaine dependence is a serious public health issue, related to several psychiatric and psychosocial problems. Crack-cocaine users are usually embedded in a context of great social vulnerability, often associated with violence, poverty, family conflict and easy and early access to alcohol, tobacco and other drugs.

Methods: This cross-sectional study enrolled a consecutive sample of 577 patients admitted to 20 therapeutic communities located in Southern Brazil, between September 2012 and September 2013. Read More

Eur J Ophthalmol 2021 Apr;31(1_suppl):11-15

Department of Ophthalmology, King's College Hospital, London, UK.

Aim: To report a case of ocular cicatricial pemphigoid caused by levamisole-adulterated cocaine.

Methods: Case report.

Results: A 54-year-old woman with multi-systemic levamisole-induced vasculitis which triggered bilateral cicatrizing conjunctivitis refractory to conventional immunosuppressants due to continued cocaine misuse. Read More

Int J Environ Res Public Health 2021 03 20;18(6). Epub 2021 Mar 20.

Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy.

Cocaine abuse is associated with severe local effects on mucosal and osteocartilaginous structures, with a centrifugal spreading pattern from the nose, a condition known as cocaine-induced midline destructive lesions (CIMDL). When the soft or hard palate is affected, a perforation may occur, with subsequent oro-nasal reflux and hypernasal speech. Both diagnosis and therapy (surgical or prosthetic) constitute a serious challenge for the physician. Read More

Cochrane Database Syst Rev 2021 03 16;3:CD012823. Epub 2021 Mar 16.

Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.

Background: Parental substance use is a substantial public health and safeguarding concern. There have been a number of trials of interventions relating to substance-using parents that have sought to address this risk factor, with potential outcomes for parent and child.

Objectives: To assess the effectiveness of psychosocial interventions in reducing parental substance use (alcohol and/or illicit drugs, excluding tobacco). Read More

Eur Radiol 2021 May 8;31(5):2754-2755. Epub 2021 Mar 8.

Department of Radiology, UMC Utrecht, Heidelberglaan 100, P.O. Box 85500, 3584, CX, Utrecht, The Netherlands.

J Stroke Cerebrovasc Dis 2021 May 5;30(5):105675. Epub 2021 Mar 5.

University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA, USA. Electronic address:

Objectives: Cocaine use has been linked to stroke in several studies. However, few studies have considered the influence of cocaine use on stroke mechanisms such as small vessel disease (SVD). We conducted a study to assess associations between the toxicology-confirmed use of multiple drugs, including cocaine, and a marker of SVD, white matter hyperintensities (WMH). Read More

Brain Sci 2021 Feb 20;11(2). Epub 2021 Feb 20.

TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellón, Spain.

Cocaine addiction is frequently associated with different psychiatric disorders, especially schizophrenia and antisocial personality disorder. A small number of studies have used prepulse inhibition (PPI) as a discriminating factor between these disorders. This work evaluated PPI and the phenotype of patients with cocaine-related disorder (CRD) who presented a dual diagnosis of schizophrenia or antisocial personality disorder. Read More

Drug Alcohol Depend 2021 04 16;221:108585. Epub 2021 Feb 16.

School of Life Sciences, Arizona State University, Tempe, AZ, USA. Electronic address:

Background: MicroRNAs (miRNAs) are "master post-transcriptional regulators" of gene expression. Here we investigate miRNAs involved in the incentive motivation for cocaine elicited by exposure to cocaine-associated cues.

Methods: We conducted NanoString nCounter analyses of microRNA expression in the nucleus accumbens shell of male rats that had been tested for cue reactivity in a previous study. Read More

An Bras Dermatol 2021 Mar-Apr;96(2):188-195. Epub 2021 Feb 6.

Service of Dermatology, Department of Internal Medicine, Faculty of Medicine, University of Antioquia and San Vicente Fundación Hospital, Medellín, Colombia.

Pyoderma gangrenosum associated to the use of cocaine/levamisole is a rare condition associated to their consumption. Cocaine use is frequent in Colombia, and the substance is contaminated with levamisole, an anthelmintic that increases the psychotropic effects and enhances its side effects. We present three clinical cases of patients with ulcerated lesions, in which the diagnosis was pyoderma gangrenosum secondary to the use of cocaine contaminated with levamisole. Read More

Biochem J 2021 02;478(4):749-764

Institute for Drug Research (IDR), School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel.

The incidence of cocaine abuse is increasing especially in the U.K. where the rates are among the highest in Europe. Read More

Psychiatry Res Neuroimaging 2021 04 23;310:111232. Epub 2020 Nov 23.

Department of Neuroscience, Pontifical Catholic University of Rio Grande do Sul, 90619900, Porto Alegre, Brasil.

Crack-cocaine offers a higher risk of abuse than intranasal and intravenous use of cocaine. Yet, current treatments remain disappointing and our understanding of the mechanism of crack-cocaine neurotoxicity is still incomplete. Magnetic resonance images studies on brain changes of crack-cocaine addicts show divergent data. Read More

Drug Alcohol Depend 2021 04 8;221:108554. Epub 2021 Feb 8.

Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, USA.

Background: The absence of an FDA-approved medication for the treatment of cocaine use disorder (CUD) may, in part, reflect the varying conditions present when the decision to use cocaine is made, with one medication unlikely to work under all conditions. The objective of this double-blind, placebo-controlled, human laboratory study was to test the effects of modafinil, a medication with mixed efficacy for the treatment of CUD, using a novel self-administration procedure designed to model distinct clinical scenarios.

Methods: During modafinil maintenance (0, 300 mg/day), participants chose to self-administer up to 7 doses of smoked cocaine (25 mg) under 9 conditions: immediately after exposure to: (a) cues associated with cocaine and a non-contingent cocaine administration, i. Read More

Biol Psychiatry 2021 05 19;89(10):970-979. Epub 2020 Dec 19.

Departments of Psychiatry, Psychology, and Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.

Background: The balance between goal-directed behavior and habits has been hypothesized to be biased toward the latter in individuals with cocaine use disorder (CUD), suggesting possible neurochemical changes in the putamen, which may contribute to their compulsive behavior.

Methods: We assessed habitual behavior in 48 patients with CUD and 42 healthy control participants using a contingency degradation paradigm and the Creature of Habit Scale. In a subgroup of this sample (CUD: n = 21; control participants: n = 22), we also measured glutamate and glutamine concentrations in the left putamen using ultra-high-field (7T) magnetic resonance spectroscopy. Read More

BMJ Case Rep 2021 Feb 10;14(2). Epub 2021 Feb 10.

General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Cocaine, an alkaloid, is an addictive drug and its abuse as a recreational drug is on the increasing side with its associated complications. Gastrointestinal complications, after cocaine abuse, are less known and need to be addressed since the abuse is on the rise and the existing evidence is scarce. We report a case of a 22-year-old male patient who presented with abdominal pain following a cocaine injection. Read More

Psychopharmacology (Berl) 2021 Jun 8;238(6):1513-1529. Epub 2021 Feb 8.

Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.

Rationale: Given that many patients being treated for opioid-use disorder continue to use drugs, identifying clusters of patients who share similar patterns of use might provide insight into the disorder, the processes that affect it, and ways that treatment can be personalized.

Objectives And Methods: We applied hierarchical clustering to identify patterns of opioid and cocaine use in 309 participants being treated with methadone or buprenorphine (in a buprenorphine-naloxone formulation) for up to 16 weeks. A smartphone app was used to assess stress and craving at three random times per day over the course of the study. Read More

JAMA Netw Open 2021 02 1;4(2):e2036512. Epub 2021 Feb 1.

Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Affairs Medical Center, Bedford, Massachusetts.

Importance: Substance use disorders are a major source of morbidity and mortality in the United States. National data comparing the prevalence of substance use disorder diagnoses (SUDDs) among transgender and cisgender individuals are lacking in the United States.

Objectives: To investigate the prevalence of SUDDs among transgender and cisgender adults and to identify within-group and between-group differences by age, gender, and geographic location. Read More

Addiction 2021 04 3;116(4):715-717. Epub 2021 Feb 3.

Division on Substance Use Disorders, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.

Environ Sci Pollut Res Int 2021 Mar 3;28(12):14285-14292. Epub 2021 Feb 3.

Department of Biosciences, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil.

Crack-cocaine is a cocaine by-product widely consumed by general population in developing countries. The drug is low cost and is associated with more intense effects when compared to other illicit drugs. Genotoxicity, oxidative stress, and inflammatory response are considered crucial events in carcinogenesis, since they actively participate in the multistep process. Read More

Neuropsychopharmacology 2021 04 29;46(5):970-981. Epub 2021 Jan 29.

Department of Pharmacology, Ningbo University School of Medicine, 818 Fenghua Rd., WangChanglai A403, Ningbo, Zhejiang, 315211, China.

Impaired glutamate homeostasis is a key characteristic of the neurobiology of drug addiction in rodent models and contributes to the vulnerability to relapse to drug seeking. Although disrupted astrocytic and presynaptic regulation of glutamate release has been considered to constitute with impaired glutamate homeostasis in rodent model of drug relapse, the involvement of endocannabinoids (eCBs) in this neurobiological process has remained largely unknown. Here, using cocaine self-administration in rats, we investigated the role of endocannabinoids in impaired glutamate homeostasis in the core of nucleus accumbens (NAcore), which was indicated by augmentation of spontaneous synaptic glutamate release, downregulation of metabotropic glutamate receptor 2/3 (mGluR2/3), and mGluR5-mediated astrocytic glutamate release. Read More

Addict Behav 2021 05 15;116:106834. Epub 2021 Jan 15.

Department of Clinical and Experimental Psychology. University of Huelva, Huelva, Spain; Research Center for Natural Resources, Health and the Environment. University of Huelva, Huelva, Spain. Electronic address:

The visual probe paradigm allows for evaluating attentional bias (AB), distinguishing between approach vs avoidance patterns of attention and assessing two different processes when the exposure time to images is manipulated: initial orienting and maintenance of attention. The present study aimed to analyze the predictive capacity of these two processes for substance use disorder severity and therapeutic outcomes of patients with cocaine use disorder in treatment. The sample consisted of 70 outpatients who were starting treatment at a public service. Read More

Eur J Pharmacol 2021 Apr 24;896:173911. Epub 2021 Jan 24.

Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang, 050017, China; Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Medicinal University, 050017, China. Electronic address:

Substance-related and addictive disorders (SRADs) are characterized by compulsive drug use and recurrent relapse. The persistence of pathological drug-related memories indisputably contributes to a high propensity to relapse. Hence, strategies to disrupt reconsolidation of drug reward memory are currently being pursued as potential anti-relapse interventions. Read More

Psychiatry Res Neuroimaging 2021 03 11;309:111235. Epub 2020 Dec 11.

University of Ontario Institute of Technology, Faculty of Social Science and Humanities, 2000 Simcoe Street North, Oshawa, ON L1H 7K4, Canada. Electronic address:

Abnormalities in the spectral power of offenders' neural oscillations have been noted within select Resting-State Networks (RSNs); however, no study has yet evaluated the influence of cocaine dependence, drug use severity, and psychopathic traits on these abnormalities. To this end, the present study compared rest-related power spectral characteristics between two groups of offenders (with and without a DSM-IV-TR cocaine-dependence diagnosis) and a non-offender control group. Results indicated that both offender groups presented with lower low frequency power ratio (LFPR) scores (i. Read More

Psychopharmacology (Berl) 2021 Apr 16;238(4):1121-1131. Epub 2021 Jan 16.

Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, 37232, USA.

Rationale: Cannabinoid type 1 receptors (CB1Rs) are widely expressed within the brain's reward circuits and are implicated in regulating drug induced behavioral adaptations. Understanding how CB1R signaling in discrete circuits and cell types contributes to drug-related behavior provides further insight into the pathology of substance use disorders.

Objective And Methods: We sought to determine how cell type-specific expression of CB1Rs within striatal circuits contributes to cocaine-induced behavioral plasticity, hypothesizing that CB1R function in distinct striatal neuron populations would differentially impact behavioral outcomes. Read More

Drug Alcohol Depend 2021 03 8;220:108514. Epub 2021 Jan 8.

Department of Psychiatry, Yale University, New Haven, CT, United States; Connecticut Mental Health Center, New Haven, CT, United States.

Background: Positron emission tomography (PET) work with the dopamine D3 receptor (DR) preferring ligand [C]PHNO in obese individuals has demonstrated higher binding and positive correlations with body mass index (BMI) in otherwise healthy individuals. These findings implicated brain reward areas including the substantia nigra/ventral tegmental area (SN/VTA) and pallidum. In cocaine use disorder (CUD), similar SN/VTA binding profiles have been found compared to healthy control subjects. Read More

J Neurosci 2021 03 12;41(9):1996-2011. Epub 2021 Jan 12.

Department of Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania 15260

Cocaine experience generates AMPA receptor (AMPAR)-silent synapses in the nucleus accumbens (NAc), which are thought to be new synaptic contacts enriched in GluN2B-containing NMDA receptors (NMDARs). After drug withdrawal, some of these synapses mature by recruiting AMPARs, strengthening the newly established synaptic transmission. Silent synapse generation and maturation are two consecutive cellular steps through which NAc circuits are profoundly remodeled to promote cue-induced cocaine seeking after drug withdrawal. Read More

BMJ Case Rep 2021 Jan 12;14(1). Epub 2021 Jan 12.

Department of Histopathology, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, UK.

Cocaine use causes profound vasoconstriction leading to various systemic complications. Gastrointestinal complications such as mesenteric ischaemia are difficult to recognise and may result in serious consequences if not treated promptly. We report on the case of a 47-year-old man presenting with mesenteric ischaemia on a background of acute on chronic cocaine consumption, where diagnosis was not evident until second presentation. Read More

Am J Emerg Med 2021 04 5;42:20-22. Epub 2021 Jan 5.

Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH, United States of America.

J Biol Regul Homeost Agents 2020 Nov-Dec;34(6 Suppl. 3):59-68

Dental School, Vita-Salute San Raffaele University, Milan, Italy.

Cocaine is one of the most popular illicit drugs in Europe and cocaine-induced midline destructive lesions (CIMDL) represent a rare but destructive consequence of its intranasal use. The extent of lesions can vary remarkably and may include palate perforations with consequent oronasal reflux and hypernasal speech. The therapeutic options encompass surgery, with local and distant flaps, and prosthetic rehabilitation with palatal obturators. Read More