NCJ Number
192862
Journal
Journal of Addictive Diseases Volume: 20 Issue: 3 Dated: 2001 Pages: 105-119
Date Published
2001
Length
15 pages
Annotation
This article reviews the role of the hypothalamic-pituitary-adrenal (HPA) axis in cocaine use within the context of two approaches to developing pharmacological treatments for drug dependence in humans.
Abstract
The two approaches are (1) reducing the reinforcing effects of cocaine and (2) reducing a cocaine addict’s susceptibility to stress-induced relapse. The review suggests that HPA-axis-suppressing medications such as ketoconazole and metyrapone are unlikely to block cocaine’s reinforcing effects completely, but they may be useful in reducing the frequency of use by increasing the addicted individual’s resistance to stress-induced relapse. Therefore, it is essential that studies of these medications include efficacy assessments regarding response to cocaine cues or stress, in addition to measures of cocaine’s subjective effects. In addition, medications that diminish the reinforcing effects of cocaine without diminishing responsiveness to cocaine cues, stress, or both will probably lead to an increase in cocaine use and thus exacerbate rather than ameliorate the problem. The analysis concludes that future research should target the factors that lead to the re-initiation of cocaine use instead of trying to block the high of individuals who will probably find some means of obtaining their desired effect. Figure and 49 references (Author abstract modified)