Cocaine
For every news story in the popular press detailing the horrors and the violence associated with cocaine, there have been corresponding studies in the medical litera ture shedding new light on our understanding of this most troublesome drug. Our knowledg
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DRUGS OF ABUSE
A Comprehensive Series for Clinicians
Volume 1
MARIJUANA Mark S. Gold, M.D.
Volume 2
ALCOHOL Norman S. Miller, MD., and Mark S. Gold, M.D.
Volume 3
COCAINE Mark S. Gold, M.D.
Cocaine Mark S. Gold, M.D. Departments of Neuroscience and Psychiatry University of Florida College of Medicine Gainesville, Florida
Plenum Medical Book Company New York and London
Library of Congress Cataloging-in-Publication Data
Gold, Mark S. Cocaine / Mark S. Gold. p. cm. -- (Drugs of abuse) Inc I udes bib Ii ograph, ca I references and , ndex. ISBN-13: 978-1-4684-6035-3 e-ISBN-13: 978-1-4684-6033-9 DOl: 10.1007/978-1-4684-6033-9 1. Cocaine hab,t. 2. Coca,ne--Phys,ological effect. 3. Cocaine I. Title. II. Ser,es: Drugs of abuse (New York, hab't--Treatment. N.Y. ) RC568.C6G653 1993 616.86'47--dc20 92-45165 CIP
© 1993 Plenum Publishing Corporation Softcover reprint of the hardcover 1st edition 1993 233 Spring Street, New York, N.Y. 10013
Plenum Medical Book Company is an imprint of Plenum Publishing Corporation All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher
Preface
For every news story in the popular press detailing the horrors and the violence associated with cocaine, there have been corresponding studies in the medical literature shedding new light on our understanding of this most troublesome drug. Our knowledge of addiction, and specifically cocaine addiction, has increased dramatically within the last few years. We stand on the threshold of an exciting new era in addictionology that promises better treatments, improved diagnostic procedures, and more effective preventative strategies. We must prepare today for the avalanche of exciting discoveries that will arrive in the coming years. Along with the first two volumes in this series, Marijuana and Alcohol, this book strives to help the general medical community to stay abreast of the latest medical information on addiction, while presenting a fundamental resource on the neurobiology, physiology, epidemiology, history, diagnosis, treatment, and prev
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PREFACE
vention of cocaine abuse. In addition, the comorbidity of cocaine abuse and eating disorders, depression, anxiety, hypertension, and various other disorders is discussed in detail. Finally, the last chapter presents new strategies tailored to specific patient groups and aimed at confronting the ever-changing face of drug abuse. The medical community should realize that the recent and dramatic decline in drug use, detailed in Chapter 1, has stemmed primarily from educational efforts aimed at preventing drug use. This educational undertaking derived largely from the medical and research efforts that proved the deleterious effects of cocaine abuse. Clinicians, researchers, residents, and students alike must not ignore the valuable role they can playas educators in their community. Similarly,
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