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N Engl J Med 2019 02;380(8):772-779

From the Department of Medicine, Boston Medical Center (A.Y.W.), the Department of Medicine, Boston University School of Medicine (A.Y.W.), the Departments of Medicine (S.E.W.) and Pathology (G.E.), Massachusetts General Hospital, and the Departments of Medicine (S.E.W.) and Pathology (G.E.), Harvard Medical School - all in Boston.

Rev Med Chil 2018 Sep;146(9):1070-1073

Clínica Universidad de los Andes, Santiago, Chile.

Vasculitic midline destructive lesions can be a complication of cocaine use. We report a 44-year-old man who presented with a two months history of left facial pain associated with ipsilateral facial paralysis and a cheek phlegmon. Magnetic resonance imaging showed broad soft tissue destruction linked to important cranial nerve involvement. Read More

Eur J Med Chem 2019 Mar 9;165:250-257. Epub 2019 Jan 9.

Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, 32610, USA; Department of Medicinal Chemistry, School of Pharmacy, The University of Mississippi, University, Mississippi, 38677, USA. Electronic address:

Sigma receptors (σRs) are considered to be a significant and valid target for developing new medications to address several diseases. Their potential involvement in numerous central nervous system disorders, neuropathic pain, addiction, and cancer has been extensively reported. In particular, the σR has been identified as potential target for the development of pharmaceutical agents intended to treat the negative effects associated with drugs of abuse. Read More

Neuroimage Clin 2019 4;21:101652. Epub 2019 Jan 4.

Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland. Electronic address:

Background: Cocaine use has been consistently associated with decreased gray matter volumes in the prefrontal cortex. However, it is unclear if such neuroanatomical abnormalities depict either pre-existing vulnerability markers or drug-induced consequences. Thus, this longitudinal MRI study investigated neuroplasticity and cognitive changes in relation to altered cocaine intake. Read More

Trials 2018 Dec 29;19(1):713. Epub 2018 Dec 29.

Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320b, 4052, Basel, Switzerland.

Background: Numerous studies suggest that exercise may be an effective adjunct treatment for substance use disorders. It has been suggested that exercise-induced improvements in inhibitory control may reduce craving for the substance of abuse. However, this potential mechanism has seldom been researched. Read More

JAAPA 2019 Jan;32(1):23-27

At the John S. Dunn Burn Center at Memorial Hermann Hospital, part of the University of Texas Health Science Center at Houston, Tex., Tonya C. George is an assistant professor of surgery, Daniel J. Freet is an assistant professor, James M. Cross is a professor of surgery, and Todd F. Huzar is an associate professor of surgery. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Levamisole is a veterinary antihelminthic, chemotherapeutic agent, and immunomodulator that also is used as an adulterant and cutting agent in cocaine distribution. This drug may potentiate the sympathomimetic actions of cocaine and can cause neutropenia, agranulocytosis, purpuric retiform lesions, and skin necrosis. This article describes two cases of suspected levamisole-induced vasculitis. Read More

Cochrane Database Syst Rev 2018 12 5;12:CD009269. Epub 2018 Dec 5.

BC Centre on Substance Use, BC Centre for Excellence in HIV/AIDS, 611 Powell Street, Vancouver, BC, Canada, V6A 1H2.

Background: Problem alcohol use is common among people who use illicit drugs (PWID) and is associated with adverse health outcomes. It is also an important factor contributing to a poor prognosis among drug users with hepatitis C virus (HCV) as it impacts on progression to hepatic cirrhosis or opioid overdose in PWID.

Objectives: To assess the effectiveness of psychosocial interventions to reduce alcohol consumption in PWID (users of opioids and stimulants). Read More

Psychiatry Res 2019 01 24;271:226-229. Epub 2018 Nov 24.

Department of Ophthalmology, Hospital do Servidor Público Estadual Francisco Morato de Oliveira, São Paulo, Brazil.

Cocaine is a well-known factor of tissue ischemia and may be related to thinning of the inner retinal layers. The present study aimed to evaluate and determine whether cocaine users show retinal nerve fiber layer (RNFL) thinning by means of spectral-domain optical coherence tomography. A group of 17 cocaine users and 18 non-users were recruited for complete ophthalmologic examination. Read More

Psychopharmacology (Berl) 2019 Jan 28;236(1):517-529. Epub 2018 Nov 28.

Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA.

Rationale: A challenge in treating substance use disorder is that successful treatment often does not persist, resulting in relapse and continued drug seeking. One approach to persistently weaken drug-seeking behaviors is to pair exposure to drug-associated cues or behaviors with delivery of a compound that may strengthen the inhibition of the association between drug cues and behavior.

Objectives: We evaluated whether a selective histone deacetylase 3 (HDAC3) inhibitor could promote extinction and weaken contextual control of operant drug seeking after intravenous cocaine self-administration. Read More

Drug Alcohol Depend 2019 01 15;194:310-317. Epub 2018 Nov 15.

Department of Psychiatry and Behavioral Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road, Houston, TX, United States; Department of Psychology, University of Illinois at Chicago, Behavioral Sciences Building, 1007 W. Harrison St., Chicago, IL, United States. Electronic address:

Background: Depressive symptoms may contribute to cocaine use. However, tests of the relationship between depression and severity of cocaine use have produced mixed results, possibly due to heterogeneity in individual symptoms of depression. Our goal was to establish which symptoms of depression are most strongly related to frequency of cocaine use (one aspect of severity) in a large sample of current cocaine users. Read More

Psychol Addict Behav 2018 Nov;32(7):812-820

Hospital das Clínicas, Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo.

Studies have evidenced more severe health consequences in individuals who smoked crack cocaine as compared to intranasal cocaine users. Differential neurocognitive deficits between the crack and intranasal cocaine-addicted patients, associated with prefrontal cortex functions, have never been tested using complex cognitive tasks in humans. In this study, we examined possible distinct neurocognitive deficits in 43 crack-addicted patients (CrD) compared with 36 intranasal cocaine-addicted patients (CD) and 32 controls. Read More

Psychopharmacology (Berl) 2018 Dec 13;235(12):3509-3523. Epub 2018 Nov 13.

Department of Drug Addiction Pharmacology, Institute of Pharmacology Polish Academy of Sciences, 12 Smetna Street, PL-31-343, Kraków, Poland.

Rationale And Objectives: Many studies indicated that adenosine via its A receptors influences the behavioral effects of cocaine by modulating dopamine neurotransmission. The hypothesis was tested that A receptors in the nucleus accumbens (NAc) or the prefrontral cortex (PFc) may modulate cocaine reward and/or cocaine seeking behavior in rats.

Methods: The effects of local bilateral microinjections of the selective A receptor agonist CGS 21680 or the A receptor antagonists KW 6002 and SCH 58261 were investigated on cocaine self-administration on reinstatement of cocaine seeking. Read More

Psychopharmacology (Berl) 2019 Jan 8;236(1):531-543. Epub 2018 Nov 8.

Department of Psychiatry, Yale University, New Haven, CT, USA.

Rationale: Environmental stimuli, or cues, associated with the use of drugs such as cocaine are one of the primary drivers of relapse. Thus, identifying mechanisms to reduce the motivational properties of drug cues is an important research goal.

Objectives: The purpose of this study was to identify cellular signaling events in the nucleus accumbens (NAc) that are induced when a cocaine cue memory is either extinguished through repeated cue presentation in the absence of drug, or when the memory is reactivated and reconsolidated by a brief cue re-exposure. Read More

PLoS One 2018 8;13(11):e0207231. Epub 2018 Nov 8.

Department of Psychiatry and Behavioral Science, University of Texas Health Science Center at Houston, Houston, TX, United States of America.

Treatments for Cocaine Use Disorder (CUD) are variably effective, and there are no FDA-approved medications. One approach to developing new treatments for CUD may be to investigate and target poor prognostic signs. One such sign is anhedonia (i. Read More

Drug Alcohol Depend 2019 01 24;194:32-39. Epub 2018 Oct 24.

Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2812 Erwin Rd, Durham, NC, 27710, United States; Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, United States.

Background: Cocaine addiction is related to impulsive decision making that is mediated by brain circuitry involved in reward processing and executive functions, such as cognitive control and attentional salience. Resting-state functional connectivity between reward and executive control circuitry is altered among cocaine users, with concomitant deficits in impulsivity and learning. Prior research has examined how select brain regions interact to influence impulsive decision making for drug users; however, research examining interactions between large-scale brain networks and impulsive behavior is limited. Read More

Trends Pharmacol Sci 2018 12 29;39(12):1008-1020. Epub 2018 Oct 29.

Department of Neuroscience, Karolinska Institutet, Solnavägen 9, Stockholm, Sweden. Electronic address:

The concept of allosteric receptor-receptor interactions in G protein-coupled receptor homo- and heteroreceptor complexes in which they physically interact provides a new dimension to molecular integration in the brain. The receptor-receptor interactions dynamically change recognition, pharmacology, signaling, and trafficking of the participating receptors. Among the receptor complexes, disruption of the A2A receptor-dopamine D2 receptor (A2AR-D2R) complex by an A2AR agonist has been shown to fully block the inhibition of cocaine self-administration. Read More

N Engl J Med 2018 11;379(18):1782

Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

QJM 2019 Feb;112(2):125-126

Division of Pulmonary Medicine, St. Agnes Hospital, Baltimore, MD, USA.

EBioMedicine 2018 Nov 28;37:489-498. Epub 2018 Oct 28.

Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.

Background: Enhanced drug-related reward sensitivity accompanied by impaired sensitivity to non-drug related rewards in the mesolimbic dopamine system are thought to underlie the broad motivational deficits and dysfunctional decision-making frequently observed in cocaine use disorder (CUD). Effective approaches to modify this imbalance and reinstate non-drug reward responsiveness are urgently needed. Here, we examined whether cocaine users (CU) can use mental imagery of non-drug rewards to self-regulate the ventral tegmental area and substantia nigra (VTA/SN). Read More

Tex Heart Inst J 2018 08 1;45(4):273-274. Epub 2018 Aug 1.

Cutis 2018 Sep;102(3):169;170;175;176

Department of Dermatology, Vanderbilt University, Nashville, Tennessee, USA.

Reports of levamisole-induced vasculopathy (LIV) secondary to use of levamisole-contaminated cocaine largely have been limited to the skin. We report the case of a 35-year-old woman with painful purpuric lesions affecting the cheeks, nose, ears, arms, and legs of several days' duration. She recently had used crack cocaine. Read More

J Anal Toxicol 2018 Oct;42(8):518-524

Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA.

Cocaine continues to be one of the most widespread abused illicit drugs in the USA. Rapid methods are needed for the identification and quantitation of cocaine and its metabolites, benzoylecgonine (BE), ecgonine methyl ester (EME) and cocaethylene (CE), in biological specimens by clinical and forensic toxicology laboratories. Presented is a differential ion mobility spectrometry-tandem mass spectrometry (DMS-MS-MS) method for the analysis of cocaine and its major metabolites in human serum that requires minimal sample preparation and no column chromatography. Read More

J Anal Toxicol 2018 Oct;42(8):512-517

Aegis Sciences Corporation, 501 Great Circle Road, Nashville, TN, USA.

Cocaine (COC) is widely abused and associated with significant adverse effects. Forensic and clinical laboratories often test for COC intake through detection of the primary metabolite, benzoylecgonine (BZE) in urine. Testing for BZE alone may result in false-negative determinations in situations where COC is recently administered or metabolism is impaired. Read More

Transl Psychiatry 2018 10 27;8(1):235. Epub 2018 Oct 27.

Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, Experimental and Clinical Pharmacopsychology, University of Zurich, Zurich, Switzerland.

Currently, levamisole is the most common cocaine adulterant worldwide and it is known to induce a variety of adverse side effects. Animal studies and human case reports suggest potential neurotoxicity of the compound but neither neuroanatomical nor cognitive effects of levamisole have been systematically investigated in cocaine users so far. We examined cognitive performance and cortical structural differences between chronic cocaine users with low and high recent exposure to levamisole objectively determined by quantitative toxicological hair analyses. Read More

Cien Saude Colet 2018 Oct;23(10):3453-3462

Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.

The abuse of psychoactive drugs is a health problem throughout the entire world, as its magnitude pervades childhood and adult life. The objective of this article is to understand the feelings and perceptions of family members regarding the support network, care and treatment of their offspring who use crack and associated drugs, in the context of a reference center for treatment. In line with methodological approach, qualitative research was used, with data collected and analyzed under the light of Phenomenology. Read More

Psychol Addict Behav 2018 Nov 22;32(7):800-811. Epub 2018 Oct 22.

Bronx-Lebanon Hospital Center.

Cognitive impairments are associated with poor outcomes when treating cocaine dependent patients, but behavioral interventions to mitigate this impact have not been developed. In this Stage 1A/1B treatment development study, several compensatory strategies (e.g. Read More

Drug Alcohol Depend 2018 12 11;193:21-28. Epub 2018 Oct 11.

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

Background And Aims: Stress can be validly assessed "live" or by a summary evaluation of the very recent past. Using smartphone-based ecological momentary assessment (EMA) combined with end-of-day (EOD) entries, we assessed the association between daily hassles, stressful events and use of opioids and cocaine, in opioid- and cocaine-using men and women.

Methods: For up to 16 weeks, 161 outpatients in opioid-agonist treatment who reported cigarette smoking carried smartphones on which they reported stressful events (SEs) and drug use (DU) and completed an EOD questionnaire to report hassles encountered throughout the day, current perceived stress, cigarettes/day, and current mood. Read More

Integr Zool 2018 Nov;13(6):795-803

Department of Biomedical Sciences and Program in Neuroscience, Florida State University, Tallahassee, Florida, USA.

DNA methylation has been identified as a powerful and activity-dependent regulator of changes in the brain that may underlie neuroadaptations in response to various types of stimuli, including exposure to drugs of abuse. Indeed, the medial prefrontal cortex (mPFC) projections to the nucleus accumbens (NAc) are critically important for reinstated cocaine-seeking in a rodent model of cocaine relapse. This circuitry undergoes several epigenetic modifications following cocaine exposure, including changes in DNA methylation that are associated with drug-seeking behavior. Read More

Molecules 2018 Oct 11;23(10). Epub 2018 Oct 11.

Department of Medicinal Chemistry, University of Kansas, Lawrence, KS 6604, USA.

The acute activation of kappa opioid receptors (KOPr) produces antinociceptive and anti-cocaine effects, however, their side-effects have limited further clinical development. Mesyl Sal B is a potent and selective KOPr analogue of Salvinorin A (Sal A), a psychoactive natural product isolated from the plant . We assessed the antinociceptive, anti-cocaine, and side-effects of Mesyl Sal B. Read More

Behav Brain Res 2019 02 5;359:589-596. Epub 2018 Oct 5.

Department of Psychology, United States; Neuroscience Program, Temple University, United States. Electronic address:

Childhood and adolescent adversity are associated with a wide range of psychiatric disorders, including an increased risk for substance abuse. Despite this, the mechanisms underlying the ability of chronic stress during adolescence to alter reward signaling remains largely unexplored. Understanding how adolescent stress increases addiction-like phenotypes could inform the development of targeted interventions both before and after drug use. Read More

Psychopharmacology (Berl) 2018 Dec 6;235(12):3391-3400. Epub 2018 Oct 6.

Department of Psychology, University of Kentucky, BBSRB, Room 443, Lexington, KY, 40536, USA.

Background: An important factor that can lead to drug relapse is to re-associate with drug-using social peers, but there is little literature on the effect of social peers on relapse in animal models.

Methods: The current study used a dual-compartment operant conditioning apparatus that allowed adult male rats to respond for cocaine in the presence of a conspecific. In experiment 1, rats were trained to self-administer cocaine in the presence of a social peer that was separated by a wire screen partition and then that peer was used as a reinstatement cue following a period of extinction. Read More

Transl Psychiatry 2018 10 5;8(1):209. Epub 2018 Oct 5.

Psychology Department, University of Florida, Gainesville, FL, 32611, USA.

PTSD is highly comorbid with cocaine use disorder (CUD), and cocaine users with PTSD + CUD are more resistant to treatment. Here we sought to develop a rat model of PTSD + CUD in order to identify the neurobiological changes underlying such comorbidity and screen potential medications for reducing cocaine seeking in the PTSD population. We utilized a predator scent stress model of PTSD, wherein rats received a single exposure to the fox pheromone 2,5-dihydro-2,4,5-trimethylthiazoline (TMT). Read More

Drug Alcohol Depend 2018 11 25;192:245-249. Epub 2018 Sep 25.

Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, United States; Boston University School of Public Health, Boston, MA, United States.

Background: Urine drug tests (UDTs) are recommended to monitor patients treated for opioid use disorder in primary care. The aims are to (1) estimate the frequency of self-report and UDT results of opioid and cocaine use and (2) evaluate the association between treatment time with non-disclosure of opioid or cocaine use and having a positive UDT.

Methods: We conducted a retrospective review of patients enrolled in a primary care-based buprenorphine program between January 2011-April 2013. Read More

eNeuro 2018 Sep-Oct;5(5). Epub 2018 Oct 2.

Functional Connectivity of Chronic Cocaine Use Reveals Progressive Neuroadaptations in Neocortical, Striatal, and Limbic Networks by, Caitlin A. Orsini, Luis M. Colon-Perez, Sara C. Read More

Eur Addict Res 2018 2;24(5):226-233. Epub 2018 Oct 2.

Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands.

Substance use disorders (SUD) and personality disorders co-occur frequently. This relationship might be understood by studying schema modes (a key concept in Schema therapy), which explain the dysfunctions characterizing personality disorder patients. In the present study, we compared the schema modes and personality disorder symptoms between alcohol-dependent patients, cocaine-dependent patients and healthy controls. Read More

Drug Alcohol Depend 2018 11 25;192:239-244. Epub 2018 Sep 25.

Department of Psychology, University of Florida, 945 Center Dr., Gainesville, FL, 32611, United States.

Background: Cocaine use disorder is characterized by compulsive drug-seeking that persists long into abstinence. Work using rodent models of cocaine addiction has found evidence for reversal learning deficits 21 days after non-contingent cocaine administration and 60 days after self-administration. Here we sought to determine if a deficit in reversal learning is present 3-4 weeks after cessation of cocaine self-administration, when relapse to cocaine-seeking is robust. Read More

Neuropharmacology 2018 12 28;143:163-175. Epub 2018 Sep 28.

Neurobiology of Behaviour Research Group (GReNeC - NeuroBio), Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; Neuroscience Research Programme. IMIM-Hospital Del Mar Research Institute, Barcelona, Spain. Electronic address:

Cannabinoid derivatives have shown promising results for treating neuropsychiatric disorders, including drug addiction. Recent studies on the therapeutic effects of Cannabidiol (CBD) on drug abuse showed mixed results, especially with psychostimulant substances such as cocaine. To determine whether CBD can attenuate cocaine reinforcement, we assessed behavioural responses induced by cocaine in mice, using the behavioural sensitization, conditioned place preference and intravenous self-administration paradigms. Read More

Neuropharmacology 2018 12 27;143:299-305. Epub 2018 Sep 27.

Department of Psychological & Brain Sciences, University of California, Santa Barbara, CA, USA; Neuroscience Research Institute, University of California, Santa Barbara, CA, USA; Department of Molecular Cellular Developmental Biology, University of California, Santa Barbara, CA, USA; Institute for Collaborative Biotechnology, University of California, Santa Barbara, CA, USA.

Repeated cocaine administration induces many long-term structural and molecular changes in the dorsal medial prefrontal cortex (dmPFC) and are known to underlie aspects of cocaine-seeking behavior. DNA methylation is a key long-lasting epigenetic determinant of gene expression and is implicated in neuroplasticity, however, the extent to which this epigenetic modification is involved in the neuroplasticity associated with drug addiction has received limited attention. Here, we examine the relation between DNA methylation and gene expression within the dorsal medial prefrontal cortex (dmPFC) following limited cocaine self-administration (1 h/day), prolonged cocaine self-administration (6 h/day), and saline self-administration (1 h/day). Read More

J Consult Clin Psychol 2018 Oct;86(10):799-809

Department of Psychiatry, Division of Substance Abuse, Yale University School of Medicine.

Objective: Contingency management (CM) interventions that reinforce attendance have rarely been evaluated in terms of reducing drug use. Using a sequential randomized design, this study examined the efficacy of three attendance CM conditions compared to usual care (UC) on drug use outcomes. It evaluated whether the duration (6 vs. Read More

Drug Alcohol Depend 2018 11 16;192:137-145. Epub 2018 Sep 16.

Department of Psychiatry, Yale University School of Medicine, 300 George St, #901, New Haven, CT 06511, USA; Connecticut Mental Health Center, 34 Park St, New Haven, CT 06519, USA; Department of Neuroscience, Yale University School of Medicine, 200 S Frontage Rd, New Haven, CT 06510, USA; Interdepartmental Neuroscience Program, Yale University School of Medicine, SHM L-200, P.O. Box 208074, New Haven CT 06520-8074, USA.

Background: Many studies have investigated how cognitive control may be compromised in cocaine addiction. Here, we extend this literature by employing spatial Independent Component Analysis (ICA) to describe circuit dysfunction in relation to impairment in response inhibition in cocaine addiction.

Methods: Fifty-five cocaine-dependent (CD) and 55 age- and sex-matched non-drug-using healthy control individuals (HC) participated in the study. Read More

Drug Alcohol Depend 2018 11 22;192:80-87. Epub 2018 Aug 22.

Department of Anthropology, Case Western Reserve University, 11220 Bellflower Rd., Cleveland, OH 44106, USA. Electronic address:

Background: Since 2000, heroin use patterns have shifted within the United States. How this change may relate to polydrug use among local heroin users is unknown. Although polydrug use has been studied, user perceptions of drug use in terms of health risks, arrest risk, availability, cost, liking, and dependence have not been considered. Read More

J Cardiovasc Med (Hagerstown) 2018 Nov;19(11):671-673

Cardiovascular Department, IRCCS MultiMedica Hospital.

Proc Natl Acad Sci U S A 2018 10 18;115(40):E9479-E9488. Epub 2018 Sep 18.

Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029;

GABAR-dependent activation of G protein-gated inwardly rectifying potassium channels (GIRK or K3) provides a well-known source of inhibition in the brain, but the details on how this important inhibitory pathway affects neural circuits are lacking. We used sorting nexin 27 (SNX27), an endosomal adaptor protein that associates with GIRK2c and GIRK3 subunits, to probe the role of GIRK channels in reward circuits. A conditional knockout of SNX27 in both substantia nigra pars compacta and ventral tegmental area (VTA) dopamine neurons leads to markedly smaller GABAR- and dopamine DR-activated GIRK currents, as well as to suprasensitivity to cocaine-induced locomotor sensitization. Read More

J Clin Ethics 2018 ;29(3):185-190

Department of Neurology and Department of Neurosurgery, New York University Langone Medical Center, New York, New York, USA.

Tissue plasminogen activator (tPA) is administered to patients with suspected ischemic stroke to improve blood flow to the brain In rare cases, patients present with complaints of stroke symptoms that appear to be non-organic due to malingering, factitious disorder, or conversion disorder (psychogenic stroke mimics). Deciding whether or not to administer tPA to these patients can be challenging. The risk of hemorrhage after administration of tPA is low, but not zero. Read More

Drug Alcohol Depend 2018 11 1;192:16-28. Epub 2018 Sep 1.

Department of Psychology, University of Florida, 945 Center Dr., P.O. Box 112250, Gainesville, FL 32611, USA; Center for Addiction Research and Education, Gainesville, FL 32611, USA. Electronic address:

Background: Polysubstance use (PSU) is prevalent among individuals with substance use disorders, but the vast majority of preclinical substance use research has focused on individual substances in isolation. Cocaine has been prevalent in the repertoire of persons who use more than one illicit substance.

Methods: We conducted a meta-analysis combining results from literature searches and secondary data analyses to estimate the prevalence of simultaneous and concurrent cocaine + alcohol and cocaine + cannabis use among cocaine users. Read More

Int Rev Neurobiol 2018;140:131-169. Epub 2018 Aug 20.

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

Cocaine use disorders are strongly influenced by the social conditions prior, during, and after exposure to cocaine. In this chapter, we discuss how social factors such as early life stress, social rank stress, and environmental stress impact vulnerability and resilience to cocaine. The discussion of each animal model begins with a brief review of examples from the human literature, which provide the psychosocial background these models attempt to capture. Read More

BMC Emerg Med 2018 09 4;18(1):29. Epub 2018 Sep 4.

Emergency Department, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.

Background: Smuggling of illegal drugs by hiding them inside one's own body, also called body packing, is a worldwide phenomenon. Cocaine is the most frequently transported drug. Body packing is a potentially lethal practice. Read More

Transl Psychiatry 2018 08 30;8(1):173. Epub 2018 Aug 30.

Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain.

Cocaine is one of the most used psychostimulant drugs worldwide. MicroRNAs are post-transcriptional regulators of gene expression that are highly expressed in brain, and several studies have shown that cocaine can alter their expression. In a previous study, we identified several protein-coding genes that are differentially expressed in a dopaminergic neuron-like model after an acute exposure to cocaine. Read More

Braz J Psychiatry 2018 Oct-Dec;40(4):459

Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.