How Addictive is Cocaine


Animal laboratory studies have demonstrated how addictive cocaine can be. Animals will work much more persistently for a cocaine bar than any other drug, even opiates. Addicted humans eventually prefer taking cocaine to any other activity - their lifestyles may alter completely as the addiction takes hold more firmly. There have been cases of mothers selling their child, professionals spending thousands of dollars with binges costing from $20,000 to $50,000. Some may lose their jobs, families, become bankrupt, and even die.

Brain alterations - scientists at the University of Cambridge, England, identified abnormal brain structure in the frontal lobe of the brain of cocaine users that are associated with their cocaine-using behaviour. They scanned the brains of 120 individuals, half of whom were addicted to cocaine. They found that the cocaine users had widespread loss of grey matter that was directly linked to how long they had been using cocaine - the longer the abuse, the greater the loss. They also found that those with the most reduction in volume had the greatest cocaine compulsivity.

They also found that the basal ganglia, the brain reward system where cocaine exerts its actions, was much larger among those dependent on cocaine. However, there was no association between the size of the enlargement and how long the person had been doing cocaine. The scientists believe that the enlargement may have occurred before cocaine usage, meaning that there are people who are more vulnerable to the effects of cocaine.

Dr Karen Ersche, of the Behavioural and Clinical Neuroscience Institute at the University of Cambridge, said:

"This research gives us important insight into why some people are more vulnerable to drug addiction. Not only is this important for the future development of more effective therapeutic interventions for people who have become dependent on drugs, it will also inform improved strategies to prevent drug addiction in the first place."

Dr Ersche explained that cocaine changes the way an individual thinks and feels. Those addicted to it feel an uncontrollable, overwhelming need for the drug, even in the face of very unpleasant consequences.

Dr Ersche said:

"People with cocaine dependence describe their out-of-control drug use as a 'compulsion' to use cocaine. Our current work has laid the foundation for a better understanding of cocaine dependence and why this compulsion occurs.

Our findings are important because they show a clear relationship between the brain, the duration of cocaine use and some of the common attention problems that people with cocaine dependence report. These data show that cocaine dependence is a disorder of the brain, which is very relevant information for the treatment of people who are trying to beat their addiction."

Whether cocaine dependence is an inherited trait is unknown, Dr. Ersche says. This is something she and her team are currently investigating. Cocaine is highly addictive, however, a considerable number of people who take it never develop an addiction.

Exposure during teenage years - exposure to cocaine during adolescent years raises the "reinforcing effects" that make people vulnerable to developing an addiction, researchers from the University of Valencia, Spain found. The same was found with ecstasy. Adolescents who take cocaine often take ecstasy simultaneously - known as polyconsumption. According to studies carried out in Spain, 44% of cocaine users also take ecstasy, a practice that started off during adolescence.

Cocaine affects an epigenetic process - researchers at NIDA (National Institute on Drug Abuse, USA) identified a key epigenetic mechanism in the brain that helps explain cocaine's addictiveness. Cocaine affected an epigenetic process - a process that can influence gene expression without altering a gene's sequence - called histome methylation. These epigenetic alterations in the brain's pleasure circuits, which appear to be the first affected by long-term cocaine exposure, are thought to contribute to an acquired preference for cocaine.

NIDA Director Dr. Nora D. Volkow, said:

"This fundamental discovery advances our understanding of how cocaine addiction works. Although more research will be required, these findings have identified a key new player in the molecular cascade triggered by repeated cocaine exposure, and thus a potential novel target for the development of addiction medications."

The scientists found that one mechanism by which cocaine changes the reward pathway is by repressing a histome demethylating enzyme called G9A - this enzyme plays a vital role in epigenetic control of gene expression.

The researchers found that animals exposed to long-term cocaine displayed dramatic changes in gene expression, as well as a powerful preference for cocaine. By repressing G9a, they were able to block the gene expression changes and reduce addiction to cocaine.

Team leader, Dr. Eric J. Nestler, director of the Brain Institute at Mount Sinai School of Medicine, said:

"The more complete picture that we have today of the genetic and epigenetic processes triggered by chronic cocaine give us a better understanding of the broader principles governing biochemical regulation in the brain which will help us identify not only additional pathways involved but potentially new therapeutic approaches."

The Lancet data suggests cocaine is ranked both the 2nd most addictive and the 2nd most harmful of 20 popular recreational drugs, just behind heroin.

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