Center for Addiction

Marriage and relationship closeness as predictors of cocaine and heroin use.

Addict Behav. 2008 Nov 1;

Authors: Heinz AJ, Wu J, Witkiewitz K, Epstein DH, Preston KL

Marriage has been cited as a protective factor against drug use, but the relationship between marriage and drug use has not been explored longitudinally during addiction treatment. The current study assessed individual trajectories of substance use during treatment as a function of marital status and perceived closeness of the marital relationship. A parallel-process growth model was used to (1) estimate the rate of change in percentage of cocaine-positive and heroin-positive urine samples, and (2) examine the relationship between marital status and drug use trajectories over 35 weeks, during and after treatment. Percent days of use for both drugs were lowest for married participants across all time points. Among married participants, reporting a close relationship with one's partner predicted less cocaine and heroin use. These findings suggest that being married and having a close relationship with one's spouse are associated with better outcomes over time. The causal nature of the association is suggested by previous research that has demonstrated the effectiveness of couples therapy as an adjunct to methadone maintenance.

PMID: 19008050 [PubMed - as supplied by publisher]

Environmental enrichment decreases the rewarding but not the activating effects of heroin.

Psychopharmacology (Berl). 2008 Nov 14;

Authors: El Rawas R, Thiriet N, Lardeux V, Jaber M, Solinas M

RATIONALE: Environmental conditions during adolescence, a critical period of brain maturation, can have important consequences on subsequent vulnerability to drugs of abuse. We have recently found that the behavioral effects of cocaine as well as its ability to increase expression of zif-268 are reduced in mice reared in enriched environments (EE). OBJECTIVES: The present experiments examined whether environmental enrichment has protective influences on the effects of heroin, a drug of addiction whose mechanism of action differs from that of cocaine. MATERIALS AND METHODS: Mice were housed either in standard environments (SE) or in EE from weaning to adulthood before any drug exposure. EE were constituted by big housing cages and contained constantly a running wheel and a small house and four to five toys that were changed once a week with new toys of different shapes and colors. We assessed the influence of EE on the ability of heroin to (1) induce conditioned place preferences, (2) induce behavioral sensitization, (3) increase dopamine levels in the nucleus accumbens (NAc), and (4) increase expression of the immediate early gene zif-268 in the striatum. RESULTS: Conditioned place preference but not behavioral sensitization was reduced in EE mice compared to SE mice. Heroin induced similar increases in dopamine levels and in the expression of zif-268 in the NAc of EE and SE mice. CONCLUSIONS: The rewarding effects of heroin are blunted by EE and appear to be, at least in part, independent from activation of the mesolimbic system.

PMID: 19005643 [PubMed - as supplied by publisher]

Adult neurogenesis, mental health, and mental illness: hope or hype?

J Neurosci. 2008 Nov 12;28(46):11785-91

Authors: Eisch AJ, Cameron HA, Encinas JM, Meltzer LA, Ming GL, Overstreet-Wadiche LS

Psychiatric and neurologic disorders take an enormous toll on society. Alleviating the devastating symptoms and consequences of neuropsychiatric disorders such as addiction, depression, epilepsy, and schizophrenia is a main force driving clinical and basic researchers alike. By elucidating these disease neuromechanisms, researchers hope to better define treatments and preventive therapies. Research suggests that regulation of adult hippocampal neurogenesis represents a promising approach to treating and perhaps preventing mental illness. Here we appraise the role of adult hippocampal neurogenesis in major psychiatric and neurologic disorders within the essential framework of recent progress made in understanding "normal" adult neurogenesis. Topics addressed include the following: the life cycle of an adult hippocampal stem cell and the implications for aging; links between learning and hippocampal neurogenesis; the reciprocal relationship between cocaine self-administration and adult hippocampal neurogenesis; the role of adult neurogenesis in an animal model of depression and response to antidepressant exposure; the impact of neonatal seizures on dentate gyrus neurogenesis; and the contribution of a schizophrenia-susceptibility gene to adult hippocampal neurogenesis. These topics are discussed in light of the regulation of adult neurogenesis, the relationship to normal neurogenesis in adulthood and aging, and, importantly, the manipulation of neurogenesis to promote mental health and treat mental illness.

PMID: 19005040 [PubMed - in process]

Gamma hydroxybutyrate: an ethnographic study of recreational use and abuse.

J Psychoactive Drugs. 2008 Sep;40(3):245-53

Authors: Lee SJ, Levounis P

Gamma hydroxybutyrate (GHB) is a psychoactive substance with complex neurophysiological activity and significant potential for abuse, addiction, and dangerous toxicity. In this study, a semistructured interview was administered to 17 subjects to investigate GHB use, including: manner of use; setting; positive and negative consequences; other drug history; and sexual practices. Respondents were overwhelmingly male, but otherwise had a broad demographic background. Settings varied from nightclubs to private use at home. There was significant variability in the drug obtained, which subjects found problematic because of the narrow therapeutic window and ease of accidental overdose. Common positive experiences included increased sexual desire, decreased sexual inhibitions, and decreased anxiety. Common negative consequences included oversedation, loss of consciousness, motor incoordination, and mental confusion. Nine subjects reported that they would use GHB again, some despite severe negative consequences. Although most subjects reported negative experiences, only three felt their use was problematic, and none sought treatment for GHB abuse or addiction. Subjects were highly drug-experienced, most commonly using MDMA, ketamine, cocaine, alcohol, and methamphetamine. Some reported that GHB could cause poor decision making in sexual situations. This effect has significant ramifications for issues such as date rape and control of sexually transmitted diseases, such as HIV.

PMID: 19004416 [PubMed - in process]

Loss of the Ca2+/calmodulin-dependent protein kinase type IV in dopaminoceptive neurons enhances behavioral effects of cocaine.

Proc Natl Acad Sci U S A. 2008 Nov 11;105(45):17549-54

Authors: Bilbao A, Parkitna JR, Engblom D, Perreau-Lenz S, Sanchis-Segura C, Schneider M, Konopka W, Westphal M, Breen G, Desrivieres S, Klugmann M, Guindalini C, Vallada H, Laranjeira R, de Fonseca FR, Schumann G, Schütz G, Spanagel R

The persistent nature of addiction has been associated with activity-induced plasticity of neurons within the striatum and nucleus accumbens (NAc). To identify the molecular processes leading to these adaptations, we performed Cre/loxP-mediated genetic ablations of two key regulators of gene expression in response to activity, the Ca(2+)/calmodulin-dependent protein kinase IV (CaMKIV) and its postulated main target, the cAMP-responsive element binding protein (CREB). We found that acute cocaine-induced gene expression in the striatum was largely unaffected by the loss of CaMKIV. On the behavioral level, mice lacking CaMKIV in dopaminoceptive neurons displayed increased sensitivity to cocaine as evidenced by augmented expression of locomotor sensitization and enhanced conditioned place preference and reinstatement after extinction. However, the loss of CREB in the forebrain had no effect on either of these behaviors, even though it robustly blunted acute cocaine-induced transcription. To test the relevance of these observations for addiction in humans, we performed an association study of CAMK4 and CREB promoter polymorphisms with cocaine addiction in a large sample of addicts. We found that a single nucleotide polymorphism in the CAMK4 promoter was significantly associated with cocaine addiction, whereas variations in the CREB promoter regions did not correlate with drug abuse. These findings reveal a critical role for CaMKIV in the development and persistence of cocaine-induced behaviors, through mechanisms dissociated from acute effects on gene expression and CREB-dependent transcription.

PMID: 19001277 [PubMed - in process]

Substance abuse vaccines.

Ann N Y Acad Sci. 2008 Oct;1141:257-69

Authors: Orson FM, Kinsey BM, Singh RA, Wu Y, Gardner T, Kosten TR

Conventional substance-abuse treatments have only had limited success for drugs such as cocaine, nicotine, methamphetamine, and phencyclidine. New approaches, including vaccination to block the effects of these drugs on the brain, are in advanced stages of development. Although several potential mechanisms for the effects of antidrug vaccines have been suggested, the most straightforward and intuitive mechanism involves binding of the drug by antibodies in the bloodstream, thereby blocking entry and/or reducing the rate of entry of the drug into the central nervous system. The benefits of such antibodies on drug pharmacodynamics will be influenced by both the quantitative and the qualitative properties of the antibodies. The sum of these effects will determine the success of the clinical applications of antidrug vaccines in addiction medicine. This review will discuss these issues and present the current status of vaccine development for nicotine, cocaine, methamphetamine, phencyclidine, and morphine.

PMID: 18991962 [PubMed - in process]

Antagonists at metabotropic glutamate receptor subtype 5: structure activity relationships and therapeutic potential for addiction.

Ann N Y Acad Sci. 2008 Oct;1141:221-32

Authors: Carroll FI

As a result of intensive investigation, particularly in the pharmaceutical industry, a number of potent and selective metabotropic glutamate receptor subtype 5 (mGluR5) antagonists have been discovered. The structure activity relationship studies that led to the discovery of these mGluR5 antagonists are presented in this review. Results from studies on selected mGluR5 antagonists in animal models that simulate drug reward, reinforcement, and relapse appear promising. The comorbidity between drug abuse and anxiety and depression make drugs active in these disorders of great interest. Clinical studies showed that the mGluR5 antagonist fenobam was an active anxiolytic drug. Several new mGluR5 antagonists produced anxiolytic and antidepressant-like effects in animal models of these disorders. The results from the clinical and animal studies provide information for new approaches to finding mechanistically distinct pharmacotherapies to help patients achieve and maintain abstinence from cocaine, methamphetamine, opiates, ethanol, and nicotine (smoking).

PMID: 18991960 [PubMed - in process]

Prenatal nicotine and/or cocaine differentially alters nicotine-induced sensitization in aging offspring.

Ann N Y Acad Sci. 2008 Oct;1139:466-77

Authors: Sobrian SK, Johnston M, Wright J, Kuhn D, Ameis K

Repeated exposure to psychostimulant drugs can result in behavioral sensitization, an amplified response in locomotor activity and stereotypy, which is used to model aspects of drug addiction. The expression of behavioral sensitization, induced by i.p. injections of nicotine once daily for 5 days, was examined in 450-day-old male rats exposed prenatally on GD 8-20 to one of the following conditions: (1) low nicotine: 2.5 mg/kg/day nicotine [LN]; (2) high nicotine: 5.0 mg/kg/day nicotine [HN]; (3) low nicotine/high cocaine: 2.5 mg/kg/day nicotine plus 40 mg/kg/day cocaine [LN/HC]; (4) high nicotine/low cocaine: 5.0 mg/kg/day nicotine plus 20 mg/kg/day cocaine [HN/LC]; (5) pair-fed controls: food intake yoked to HC dams [PF]; and (6) saline controls: daily injections of 0.9% NaCl solution[SAL]. Initial injection of nicotine did not alter activity or stereotypy in comparison to saline injections, with offspring in all prenatal treatment groups showing a desensitization to nicotine. Five consecutive daily nicotine injections resulted in behavioral sensitization in HN and HN/LC prenatal drug groups. Offspring exhibited an increase in horizontal activity that was evident on day 3, and still present after a 1.0 mg/kg i.p. nicotine challenge 72 hours after the last injection (day 8). SAL offspring exhibited attenuated sensitization. In contrast, nicotine sensitization was not seen in the LN, HC/LN, and the PF offspring; activity remained at the level seen after the initial injection of nicotine. Moreover, nicotine significantly reduced total activity in the LN and PF groups in comparison with their saline-injected counterparts. These data suggest that gestational exposure to high-dose nicotine, either alone or in combination with cocaine, may carry a greater risk than low-dose nicotine exposure of stimulant abuse in later life.

PMID: 18991894 [PubMed - in process]

Functional expression of brain neuronal CB2 cannabinoid receptors are involved in the effects of drugs of abuse and in depression.

Ann N Y Acad Sci. 2008 Oct;1139:434-49

Authors: Onaivi ES, Ishiguro H, Gong JP, Patel S, Meozzi PA, Myers L, Perchuk A, Mora Z, Tagliaferro PA, Gardner E, Brusco A, Akinshola BE, Liu QR, Chirwa SS, Hope B, Lujilde J, Inada T, Iwasaki S, Macharia D, Teasenfitz L, Arinami T, Uhl GR

Major depression and addiction are mental health problems associated with stressful events in life with high relapse and recurrence even after treatment. Many laboratories were not able to detect the presence of CB2 cannabinoid receptors (CB2-Rs) in healthy brains, but CB2-R expression has been demonstrated in rat microglial cells and other brain-associated cells during inflammation. Thus, neuronal expression of CB2-Rs has been ambiguous and controversial, and its role in depression and substance abuse is unknown. In this study we tested the hypothesis that genetic variants of the CB2 gene might be associated with depression in a human population and that alteration in CB2 gene expression may be involved in the effects of abused substances, including opiates, cocaine, and ethanol, in rodents. Here we demonstrate that a high incidence of Q63R but not H316Y polymorphism in the CB2 gene was found in Japanese depressed subjects. CB2-Rs and their gene transcripts are expressed in the brains of naïve mice and are modulated after exposure to stressors and administration of abused drugs. Mice that developed an alcohol preference had reduced CB2 gene expression, and chronic treatment with JWH015 a putative CB2-R agonist, enhanced alcohol consumption in stressed but not in control mice. The direct intracerebroventricular microinjection of CB2 antisense oligonucleotide into the mouse brain reduced mouse aversions in the plus-maze test, indicating the functional presence of CB2-Rs in the brain that modifies behavior. Using electron microscopy we report the subcellular localization of CB2-Rs that are mainly on postsynaptic elements in rodent brain. Our data demonstrate the functional expression of CB2-Rs in the brain that may provide novel targets for the effects of cannabinoids in depression and substance abuse disorders beyond neuroimmunocannabinoid activity.

PMID: 18991891 [PubMed - in process]

Screening for marijuana and cocaine abuse by immunoanalysis and gas chromatography.

Ann N Y Acad Sci. 2008 Oct;1139:422-5

Authors: Garcia-Jimenez S, Heredia-Lezama K, Bilbao-Marcos F, Fuentes-Lara G, Monroy-Noyola A, Deciga-Campos M

Drug abuse among college students is characterized by lower academic performance and long-term negative consequences. Screening to detect students at high risk of consuming drugs is of primary importance to insure early identification and appropriate levels of care. As a result, this study aimed to determine the current or past use of drug abuse through a questionnaire applied to a student population at the Universidad Autónoma del Estado de Morelos. The results were confirmed by immunoanalysis and gas chromatography of urine. We interviewed 181 students aged 15 to 21 (gender was not considered in this study), and urine samples were collected for analytical analysis. For detection of metabolites Delta9-THCA-A and benzoylecgonine from marijuana and cocaine, respectively, a homogenous enzymatic inmmunoanalysis was used; subsequent samples were analyzed by a mass spectrometer with quadrupole detector. Seven samples of the total (181) did not completely fit the inclusion criteria and were eliminated. The results showed 0.50% and 1.16% positive samples for benzoylecgonine and Delta9-THCA-A, respectively. These results are not different from those of the National Questionnaire on Addiction. We can establish a program for detecting drug consumption in our students. This kind of study is important in order to implement programs that can help us to decrease the abuse of drugs in our college population.

PMID: 18991889 [PubMed - in process]

An endocannabinoid hypothesis of drug reward and drug addiction.

Ann N Y Acad Sci. 2008 Oct;1139:412-21

Authors: Onaivi ES

Pharmacologic treatment of drug and alcohol dependency has largely been disappointing, and new therapeutic targets and hypotheses are needed. There is accumulating evidence indicating a central role for the previously unknown but ubiquitous endocannabinoid physiological control system (EPCS) in the regulation of the rewarding effects of abused substances. Thus an endocannabinoid hypothesis of drug reward is postulated. Endocannabinoids mediate retrograde signaling in neuronal tissues and are involved in the regulation of synaptic transmission to suppress neurotransmitter release by the presynaptic cannabinoid receptors (CB-Rs). This powerful modulatory action on synaptic transmission has significant functional implications and interactions with the effects of abused substances. Our data, along with those from other investigators, provide strong new evidence for a role for EPCS modulation in the effects of drugs of abuse, and specifically for involvement of cannabinoid receptors in the neural basis of addiction. Cannabinoids and endocannabinoids appear to be involved in adding to the rewarding effects of addictive substances, including, nicotine, opiates, alcohol, cocaine, and BDZs. The results suggest that the EPCS may be an important natural regulatory mechanism for drug reward and a target for the treatment of addictive disorders.

PMID: 18991888 [PubMed - in process]

Role of the NMDA receptor and nitric oxide in memory reconsolidation of cocaine-induced conditioned place preference in mice.

Ann N Y Acad Sci. 2008 Oct;1139:350-7

Authors: Itzhak Y

Classical pavlovian conditioning has a major role in the development and persistence of drug addiction. Appetitive conditioning by drug reward, as measured by the conditioned place preference (CPP) paradigm, is an exemplar of classical pavlovian conditioning. Aversive conditioning by footshock involves learning and memory processes similar to those involved in appetitive conditioning. Studies on fear conditioning have shown that long-term fear memory can be extinguished by disruption of reconsolidation of specific memories associated with the fear response. Hence disruption of memory reconsolidation may hold promise for the extinction of maladaptive conditioned behavior. In the present study the effects of the NMDA receptor antagonist, MK-801, and the nNOS inhibitor 7-nitroindazole (7-NI) on memory reconsolidation of cocaine-induced CPP in mice were investigated. We report that, following the acquisition of cocaine CPP, a single acute administration of either MK-801 or 7-NI immediately after retrieval of place preference extinguished subsequent place preference. Moreover, a priming dose of cocaine did not reinstate place preference in the drug-treated groups compared to controls. Male nNOS knockout (KO) mice acquired short-lived cocaine CPP compared to wild-type (WT) mice. A single acute administration of the NO-donor molsidomine to nNOS KO mice immediately after retrieval of CPP prolonged the expression of place preference compared to controls that received saline, suggesting partial strengthening of memory reconsolidation. Taken together, these findings support the role of the NMDAR/NO signaling pathway in memory reconsolidation of cocaine CPP, and suggest that disruption of this pathway during memory reconsolidation may afford resistance to drug-seeking behavior.

PMID: 18991881 [PubMed - in process]

A role for mGluR5 receptors in intravenous methamphetamine self-administration.

Ann N Y Acad Sci. 2008 Oct;1139:206-11

Authors: Osborne MP, Olive MF

Selective antagonists of the mGluR5 receptor attenuate rewarding and reinforcing effects of various drugs of abuse, including alcohol, nicotine, and cocaine. However, the ability of mGluR5 antagonists to alter the reinforcing effects of methamphetamine has not yet been explored. In this study, male Sprague-Dawley rats were trained to perform an operant lever-pressing task in order to obtain intravenous infusions of methamphetamine (0.2 mg/kg/infusion) or presentation of food pellets on a fixed ratio (FR1) schedule of reinforcement. After stabilization of methamphetamine or food self-administration, the selective mGluR5 antagonist 3-[(2-methyl-1,3-thiazol-4-yl) ethynyl]pyridine (MTEP; 0.3, 1.0, or 3.0 mg/kg i.p.) or vehicle were administered to the animals in a randomized counterbalanced cross-over design. MTEP at doses of 1.0 and 3.0 mg/kg significantly reduced methamphetamine self-administration by 26 and 36%, respectively, but did not alter food reinforcement at any dose tested. These data suggest that mGluR5 receptors are involved in the reinforcing effects of methamphetamine, and that antagonists of this receptor may serve as novel pharmacologic agents for the treatment of addiction to methamphetamine.

PMID: 18991866 [PubMed - in process]

c-Fos is an intracellular regulator of cocaine-induced long-term changes.

Ann N Y Acad Sci. 2008 Oct;1139:1-9

Authors: Xu M

Development of drug addiction is accompanied by the induction of long-lasting neurobiological changes. Dopamine D1 receptors are involved in mediating cocaine-induced neuroadaptation, yet the underlying intracellular mechanisms remain less clear. Using a genetically modified mouse in which Fos is primarily mutated in D1 receptor-bearing neurons in the brain, we examined a potential role of the immediate early gene Fos, which is rapidly induced by cocaine via D1 receptors, in mediating cocaine-induced persistent neurobiological changes. We found that the composition of AP-1 transcription complexes and expression levels of AP-1 complexes, and several transcription factors, neurotransmitter receptors as well as intracellular signaling molecules following repeated cocaine administration are altered in Fos-deficient brains. Moreover, dendritic reorganization of medium spiny neurons induced by repeated exposure to cocaine is attenuated in the mutant brains. The mutant mice also exhibit reduced behavioral sensitization after repeated cocaine administration. These findings suggest that c-Fos expressed in D1 receptor-bearing neurons mediates cocaine-induced persistent changes.

PMID: 18991842 [PubMed - in process]

Neuroscience: Brain's defence against cocaine.

Nature. 2008 Oct 9;455(7214):743-4

Authors: Chandler LJ, Kalivas PW

PMID: 18843354 [PubMed - indexed for MEDLINE]

Cocaine and aneurysms.

J Neurosurg. 2008 Oct;109(4):779; author reply 779-80

Authors: Majlesi N, Greller H, Su M

PMID: 18826369 [PubMed - indexed for MEDLINE]

[Patterns and modalities of illicit drug consumption in France]

Bull Acad Natl Med. 2008 Feb;192(2):261-70; discussion 270-4

Authors: Apaire E

After recalling the current patterns and trends of illicit drug use in France, the MILDT president outlined a four-year plan of prevention, treatment, enforcement and research. The overriding aim is to reduce overall drug consumption and thereby to diminish its morbidity and mortality, and its negative impact on the family and society. The president ended by describing the public tools and resources available to reach these objectives, and underlined the central role of MILDT in developing and coordinating these tools.

PMID: 18819681 [PubMed - indexed for MEDLINE]

Administration of ziprasidone for 10 days increases cocaine toxicity in mice.

Hum Exp Toxicol. 2008 Jun;27(6):499-503

Authors: Heard K, Krier S, Zahniser NR

Long-term treatment with antipsychotic medications alters the regional density of several of the neurotransmitter receptors that mediate cocaine toxicity. However, the effect of either up- or down-regulation of the neurotransmitter receptors on cocaine toxicity is unknown. In this study, we determined if subacute administration of the atypical antipsychotic ziprasidone altered the toxic effects of cocaine in mice. Ziprasidone (4 mg/kg) or placebo was administered to the first two groups of CF-1 mice for 10 days and, then on day 10, an estimated LD50 dose of cocaine (102 mg/kg) was given to these mice. In a third group, in order to produce a ziprasidone withdrawal state, we administered ziprasidone for 10 days, followed by no treatment for 2 days before cocaine administration. There was no significant difference among the three groups in overall survival: 63% in the treatment group, 60% in the withdrawal group, and 80% in the placebo group. Survival time was significantly shorter for the withdrawal group than for the control group. Our study may have been limited by lower than expected serum ziprasidone concentrations and lower than expected lethality from cocaine. However, our findings suggest that administration of an atypical antipsychotic for 10 days may increase the toxic effects of cocaine.

PMID: 18784203 [PubMed - indexed for MEDLINE]

Validity of self-reported substance use in men who have sex with men: comparisons with a general population sample.

Ann Epidemiol. 2008 Oct;18(10):752-9

Authors: Fendrich M, Mackesy-Amiti ME, Johnson TP

PURPOSE: To understand the validity of self-reported recent drug use in men who have sex with men (MSM). METHODS: We obtained a probability sample of Chicago men who have sex with men (MSM; n=216) and administered urine and saliva drug testing after a self-administered interview. Analyses examined participation in drug testing, the agreement between self-reported past month drug use and drug test results, correlates of underreporting, and the relative utility of drug testing versus self-reports in identifying recent marijuana and cocaine use. For marijuana and cocaine, findings were compared with those obtained from a general population sample of men (n=241). RESULTS: More than three quarters of the participants in both samples provided at least one specimen for drug testing. Self reports in both samples showed a high degree of correspondence with drug tests for marijuana but not for cocaine. Sensitivity for cocaine use reporting was 60% for the MSM sample and 40% for the general-population men. Conditional kappa and sensitivity statistics for marijuana, cocaine, 3,4 methylenedioxymethamphetamine (i.e., MDMA, "ecstacy"), and methamphetamine suggested that self reports among MSM are provided with a high degree of validity. Underreporting was a correlate of social class (education, income, and employment) in the general population but not in the MSM sample. The utility of drug testing was dependent on social class in the general population sample. CONCLUSIONS: Drug testing is feasible in epidemiological surveys of drug use. Self reports among MSM are at least as valid as those provided by a general population sample of men. In some instances (e.g., cocaine use), they may actually be of higher quality. Although the findings support the merit of epidemiological studies of MSM drug use that have relied completely on self-reporting, drug tests may be useful for clarifying club drug ingestion patterns.

PMID: 18693041 [PubMed - indexed for MEDLINE]

[Psychostimulants]

Rev Med Liege. 2008 May-Jun;63(5-6):411-6

Authors: Pinto E, Pitchot W, Ansseau M

Over the last twenty years, cocaine, amphetamines and MDMA (ecstasy) have found new categories of users, seeking for their stimulating effects. These substances may lead to real dependence and may cause serious somatic and psychiatric damage. In this perspective, we reviewed the available literature concerning problematic psychoactive drug use in Belgium.

PMID: 18669213 [PubMed - indexed for MEDLINE]