Cocaine addiction: psychology and neurophysiology
Article Abstract:
The classical definition of an addictive drug as one whose withdrawal is associated with intense physical symptoms does not apply to cocaine, which currently the most abused substance (more than six times as many cocaine addicts as heroin addicts require treatment). The prevalence of cocaine addiction suggests that the concept of addiction needs revision. In fact, the psychological symptoms that accompany drug withdrawal (such as emotional distress and craving for drug-induced euphoria) may present very serious problems for eliminating the addiction. Treatments for the effects of cocaine, viewed as producing 'psychological' rather than 'physiological' effects, may have ignored important neurophysiological mechanisms. Drug dependence is now defined by the American Psychiatric Association in terms of behavioral criteria, rather than purely physiological definitions. A review is presented of evidence that supports the conclusion that cocaine use leads to a neuropsychological addiction. Topics covered include the clinical characteristics of cocaine addiction; cocaine abstinence symptoms; the short- and long-term effects of cocaine; and the effectiveness of different treatment approaches. The initial effects of cocaine include feelings of well-being and alertness, with the magnification of pleasure. With longer-term use, binging begins, characterized by periods of euphoria; these are remembered during dysphoric periods, leading to craving. During binges, cocaine use does not occur on a daily basis. Cocaine abstinence leads to a three-phase response: crashing (depression, anxiety, craving sleep); withdrawal (dysphoria and boredom); and extinction (gradual elimination of craving). The neurochemical mechanisms of cocaine addiction and craving are reviewed. Between 30 percent and 90 percent of the cocaine abusers who attend outpatient programs stop their cocaine use. The study of this addiction holds promise for the development of pharmacologic and psychiatric treatment approaches. Continued research is necessary to explore the mechanisms that underlie cocaine-associated pleasure and pain. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Science
Subject: Science and technology
ISSN: 0036-8075
Year: 1991
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Reviewing the National Performance Review
Article Abstract:
Vice Pres. Al Gore embarked on the National Performance Review (NPR) as part of Pres. Bill Clinton's ambitious project to completely overhaul government by eliminating top down bureaucracy and embracing entrepreneurship. The NPR was formed to create a government that is more efficient and cost-effective by streamlining and consolidating administrative functions. Unfortunately, the program has not been able to achieve the cost savings it had expected when NPR was set up in 1993. Congress appears to have taken a more active role than the Clinton administration in pursuing the reinvention initiative.
Publication Name: Regulation
Subject: Law
ISSN: 0147-0590
Year: 1996
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A chance to wear your heart on your sleeve - or bosom
Article Abstract:
Harry Winston's $500,000 Heartthrob Brooch is a technology-powered crescent brooch whose rubies glow each time the heart beneath them beats. The wearer carries a heartrate sensor in a bra strap or in a strap around the chest, and a signal from radio waves causes light-emitting diodes behind the $400,000 worth of gems to flash. Users also can project the heart rate onto the Internet in real time through a transmitter that is carried in a purse. Harry Winston said the brooch, introduced in the fall of 1996, is ideal for women to stand out in a crowded ballroom.
Publication Name: The New York Times
Subject: Business, general
ISSN: 0362-4331
Year: 1998
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