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This image shows the difference in doapmine receptors in the brains of cocaine users. This shows how people can become easily dependent on the drug, and how hard things will seem whether from depression or the drugs.

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This article describes how emotions being out of sync in adolescence is especially dangerous, and can lead to the development of harmful habits and dangerous routines in an effort to self-regulate. This article also touches on the subject of escapism, and how substance abuse and other dangerous behaviours or habits can be seen as a way to get out of real life, and not have to deal with the problems that present themselves.

This article supports my essay because I was able to connect my personal experiences to the academic credibility of the contents. This article describes some of the things I have been through, and answers some of the “why” or “how” questions that come with that.

“This outcome may be particularly dangerous in the adolescent, as he might try to regulate these undesired states and symptoms, for example, with substances use and abuse (especially cannabis or entactogen substances such as MDMA), addictive behaviors (Internet Addiction, Internet Gaming Disorder, Mobile-Phone Addiction, Online Gambling), and impulsive and risky conducts (including non-suicidal self-harm injuries). As a consequence, the emergence of suicidal ideation, together with the worsening of the psychiatric symptoms and hopelessness, rapidly becomes critical.”

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This article describes the appeal and risks of using cocaine to deal with depression. This article talks about the rough withdrawal with cocaine, and how this process along with depression, encourages the cycle of addiction. The dangers of doing cocaine long term are also explored, and how doing cocaine can cause users to suffer from depression even if they don't suffer prior to addiction. The article also explains what’s happening to the brain throughout the course of this addiction, and how there’s overlap in what happens with depression, from a chemical standpoint.

The article supports my essay because it supports the idea of self-medication, but it also explains how falling down the rabbit hole of addiction can actually worsen the depression over time. Breaking down this issue allows for the reader to understand how serious this problem is; in doing drugs to feel better, everything gets worse over time. Not only is this a fact, but it also provides another viewpoint to why drugs are appealing to those with depression; it intertwines with the poor mental state and takes over.

“Even when people who have depression and use cocaine do not develop a substance use disorder, they ultimately worsen their depression. Chronic cocaine use changes brain chemistry in a way that deepens and prolongs dysphoria and makes it harder to feel happy. When people use cocaine to feel better, they prevent themselves from achieving long-term recovery from depression symptoms.”

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The Recovery Village Drug and Alcohol Rehab

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Editor Camille Renzoni

It might seem natural for someone who is depressed to use cocaine. The stimulant drug counteracts many of the most painful and debilitating symptoms of depression by boosting mood, energy and confidence. However, these effects are short-lived, leaving people stuck in a cycle of repeated use that can quickly progress to addiction.

Even when people who have depression and use cocaine do not develop a substance use disorder, they ultimately worsen their depression. Chronic cocaine use changes brain chemistry in a way that deepens and prolongs dysphoria and makes it harder to feel happy. When people use cocaine to feel better, they prevent themselves from achieving long-term recovery from depression symptoms.

Article at a Glance:

Many people who struggle with depression use cocaine for relief.

Other people develop depressive symptoms as cocaine use progresses to addiction.

The way cocaine physically changes the brain can make it hard to feel better even when people improve their lives in other ways.

Does Cocaine Make You Depressed?

Many jokes about cocaine in popular culture emphasize the way the drug can make people feel invincible. Unfortunately, fewer people are aware of the lows that inevitably follow these highs. For people who use cocaine, depression after use is common, even when they do not use it on a regular basis.

The reason cocaine and depression have this relationship has to do with how the brain works. As a stimulant, cocaine activates the sympathetic nervous system, which governs the fight-or-flight response. The state of intensified alertness and surging energy triggered by the release of norepinephrine can't be sustained for long and will be followed by a crash.

Most of the time, this shift isn't an issue because people feel relieved to have escaped a threat or to have overcome a stressful challenge and enjoy resting afterward. When substances trigger these changes, however, there is nothing to feel relieved about when their effects wear off. The disappointment people feel as the drug rapidly wears off is one of the ways cocaine can cause depression, especially when people experience it repeatedly.

The primary way cocaine causes depression is by directly changing the brain. In addition to norepinephrine, cocaine also increases serotonin and dopamine levels. When the brain is flooded with higher levels of these chemicals than usual, people feel euphoric. Afterward, the brain enters a recovery period during which these now-depleted neurotransmitters return to normal levels. During this phase, people feel worse than they did before.

Many people are familiar with these short-term effects but aren't sure about the long-term consequences of cocaine use. Does cocaine cause depression that lasts long enough to require treatment? It can, especially if people progress to cocaine dependence and start experiencing cocaine withdrawal symptoms.

Cocaine Withdrawal and Depression

For people who use cocaine, depression the next day can become part of a familiar and worrisome pattern. This post-cocaine depression is more pronounced for people who are dependent on cocaine, compared to people who are not reliant on it.

According to the Diagnostic and Statistical Manual of Mental Disorders, substance dependence involves the presence of three or more of the following symptoms:

Tolerance, or needing to use more of the substance to achieve the same effect

Withdrawal symptoms, or unpleasant physical or mental effects that arise after use

Taking a substance in larger amounts or over a longer period than intended

Wanting or making unsuccessful efforts to control or reduce substance use

Spending a significant amount of time obtaining and using a substance and recovering from its effects

Giving up important social, work-related or recreational activities because of substance use

Continuing to use a substance despite knowing it causes or exacerbates a psychological problem

In other words, the clinical definition of drug dependence does not require people to have medical withdrawal symptoms. It merely involves people continuing to use the drugs despite adverse outcomes.

While cocaine does not cause physical withdrawal symptoms as alcohol and opiates do, it can cause lasting and recurring psychological withdrawal effects, including:

Fatigue

Irritability

Difficulty concentrating

Increased appetite

One of the most pronounced and typical effects of cocaine withdrawal is depression. This mental illness may arise because long-term cocaine use causes key neurotransmitters to dwindle to chronically low levels, because using cocaine damages cells in the brain's pleasure center. Cocaine abuse causes brain cells to " eat themselves." These changes to the brain can cause people to develop chronic depression or have an acute depressive episode.

The good news is that sustained recovery from cocaine dependence allows the brain to heal and recover its previous level of functioning.

Co-Occurring Treatment for Depression and Cocaine Addiction

It can be intimidating to seek treatment for co-occurring disorders. The effects of addiction and untreated depression can make life seem chaotic, overwhelming and even hopeless. People looking for relief can start to feel like there is no way out.

However, the reality is that both disorders can be successfully treated, often with the same interventions. While addiction requires specific treatment, cocaine depression treatment may be no different from regular depression treatment. In some ways, it may even be easier. For many people, elevated depressive symptoms diminish with continued abstinence from cocaine use.

When depression persists after someone stops using cocaine, many different interventions can help. Cognitive behavioral therapy has been proven to be one of the most effective ways to treat a wide range of mental health conditions and to be especially effective for depression. It can be modified to help people address triggers to use substances at the same time they are learning how to challenge and counteract the distorted thinking that maintains depression.

Research shows that selective serotonin reuptake inhibitor (SSRI) antidepressants can not only improve mood and alleviate the cognitive symptoms of depression but also prevent recurrence of use for people with co-occurring depression and cocaine addiction.

For people who need to treat addiction at the same time as a depressive disorder, many rehab facilities offer evidence-based, integrated treatment programs that address mental health conditions while helping people cope with cravings and avoid triggers. This treatment can allow people to experience immediate relief from painful psychological symptoms while facilitating long-term recovery and restoration of neurotransmitter levels.

If you think your cocaine use may have progressed to addiction, you can take this quiz to assess your risk of cocaine addiction. If you know you need help immediately, contact a representative from The Recovery Village today to learn more about integrated treatment options for cocaine addiction and depression. Your journey to recovery can begin today.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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Cocaine Use and Depression: How Cocaine Affects Depression Symptoms | The Recovery Village

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Editor Camille Renzoni It might seem natural for someone who is depressed to use cocaine. The stimulant drug counteracts many of the most painful and debilitating symptoms of depression by boosting mood, energy and confidence. However, these effects are short-lived, leaving people stuck in a cycle of repeated use that can quickly progress to addiction.

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This article goes through a study that was done that showed the changes in demographic and psychological profile of cocaine users. Also explains how the association of cocaine with depression was not prevalent until the 1990s, which explains why suffering from depression can be a factor in developing a coke addiction.

This article supports my essay because it explains why cocaine would seem like a reasonable option for someone suffering from depression, because of the social shift in views of the drug, and how once those shifts are made; another demographic/type of person will be attracted to that drug.

“However, Musto (1999) observed that over the course of the 1980s the most severe effects of cocaine use became apparent as its use became more widespread, and public opinion shifted to view cocaine as a more dangerous drug than previously perceived. Data from national studies show a sharp increase in the perceived risk of cocaine between the years 1986 and 1987, which continued to rise more gradually into the early 1990s”

Original Citation:
Bohnert, Amy S. B., and Richard A. Miech. “Changes in the Association of Drug Use with Depressive Disorders in Recent Decades: The Case of Cocaine.” Substance Use & Misuse, vol. 45, no. 10, July 2010, pp. 1452–1462. EBSCOhost, doi:10.3109/10826081003777550.

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Introduction

Recent changes in the use and social meaning of cocaine warrant a revisit of the substantial body of work about the association of cocaine use with psychiatric disorder ( DeGroot et al., 2003; Drake et al., 2004; Hall, 1996; SAMHSA, 2002). As cocaine's reputation changed from glamorous to dangerous throughout recent decades ( Johnston et al., 2005; Jonnes, 1996), so too did its clientele and the consequences of their cocaine use. Current evidence to support major changes in the use and social context of cocaine use include the finding that the socioeconomic profile of the cocaine user shifted down from upper to lower socioeconomic status in recent decades ( Miech, 2008; Miech et al., 2005), and that the consequences of cocaine use have become more lethal ( Paulozzi, 2006; SAMHSA, 2005). These changes make it increasingly important to fill the gap in our knowledge and to examine recent changes in the psychological profile of cocaine users, with an eye toward identifying newly-emerged, psychological risk factors for cocaine use.

The present study examines changes in the association of cocaine use with depressive disorders in recent decades, and posits that having a depressive disorder became a risk factor for cocaine use in the 1990s and was not in the preceding years. The analysis is based on the Baltimore component of the Epidemiologic Catchment Area Study ( Eaton et al., 1997; Regier et al., 1984). This dataset is particularly well-suited to examine the study hypothesis because it the study collected information on cocaine use before and after the key year of 1990, when a major shift occurred in the reputation and clientele of cocaine. In addition, the data contain measures of depressive disorders in accordance with DSM criteria (American Psychiatric Association, 1980).

Background

Cultural studies provide extensive documentation that the cultural meaning of cocaine use underwent a dramatic transformation through the 1980s. Drug historian David Musto noted that during the mid-1970's in the United States, both cocaine and marijuana were viewed by many to be relatively benign, and the two substances were often compared to make the argument that both should be legalized ( Musto, 1999). In an article appearing in Scientific American in 1982, the authors acknowledged that cocaine had obtained a reputation as a fashionable drug, and declared that the degree to which its use is habit-forming is comparable to that of "peanuts or potato chips" ( Van Dyke and Byck, 1982, pp. 140). However, Musto (1999) observed that over the course of the 1980s the most severe effects of cocaine use became apparent as its use became more widespread, and public opinion shifted to view cocaine as a more dangerous drug than previously perceived. Data from national studies show a sharp increase in the perceived risk of cocaine between the years 1986 and 1987, which continued to rise more gradually into the early 1990s ( Johnston et al., 2005).

Multiple factors drove these changes in the cultural meaning of cocaine use. One was highly-publicized cocaine-related deaths of celebrities, such as the cocaine-related death of Len Bias in 1986, just one day after the Boston Celtics selected him second overall in the NBA basketball draft. A second factor was a national media campaign that forcefully stigmatized illegal drug use, known as the "Just Say No" campaign headed by Nancy Reagan (see Musto, 2002). Additionally, the introduction of crack cocaine during the later years of the 1980s is thought to have shifted cocaine use towards poorer individuals ( Royal College of Psychiatrists, 2000), hastening the fall of cocaine from its reputation as a "glamour" drug. Finally, the perceived dangerousness of cocaine was also driven by increasing objective evidence of its addictive properties and potentially lethal consequences ( Jonnes, 1996). This evidence has increased to the point where today cocaine amounts for over half of all drug-related emergency room visits ( SAMHSA, 2005), cocaine-related overdose deaths now outnumber heroin-related overdose deaths ( Paulozzi et al., 2006), and a recent rate of increase in cocaine-related overdose deaths is about double that of heroin-related deaths ( Paulozzi et al., 2006).

Evidence suggests that as the perception of the dangers of cocaine use shifted, the profile of cocaine users shifted from advantaged to more disadvantaged individuals. A study of national trends in substance use found that a disparity in cocaine use formed around the year 1990 such that cocaine use developed an association with lower educational attainment ( Miech et al., 2005). This was a "historical period" change, in which the newly-emerged association of cocaine use with lower educational attainment among individuals between the ages of 18 and 35 occurred at the same time for all birth cohorts. Harder and Chilcoat (2008) found that few individuals initiated use of cocaine across levels of educational achievement during the 1990s, but non-high school graduates were more likely than those with higher educational attainment to continue to use cocaine after 1990. Similarly, in a study of drug use trajectories between 1984 and 1998, Miech (2008) found that those individuals who used cocaine before and after 1990 had lower educational attainment than those people who stopped using around 1990 or never used.

The Present Study

The present study extends prior work by examining the relationship between cocaine use and depressive disorders over time. As cocaine use became increasingly deviant and stigmatized through the 1980s, we hypothesized that normal, healthy users eschewed the drug. Prior research has found that those who continued to use cocaine were more likely to be socioeconomically disadvantaged ( Miech, 2008; Miech et al., 2005), and we hypothesized that those who continued to use were also more likely to have psychopathology. In the present study, we examined and compared the relationship of cocaine use and depressive disorders before and after the year 1990. The association of cocaine use with depressive disorders is of particular interest because of the important role of psychopathology in drug research and treatment ( DeGroot et al., 2003; Drake et al., 2004).

The present study uses two waves of data on drug use and mental diagnoses in accordance with DSM criteria from adults collected in 1981 and in 1993-1994 in Baltimore, Maryland, as part of the Epidemiologic Catchment Area (ECA) study ( Eaton et al., 1997; Regier et al., 1984). This dataset has several strengths for the purpose of testing the proposed hypothesis. The data collection of the ECA study allows the measurement of depressive disorders according to validated diagnostic categories. The sample of the ECA study includes people with a wide range of ages, which allows some examination of age effects. Finally and most importantly, there were two waves of data collection that serendipitously occurred before and after 1990, the time of the proposed shift.

Methods

Sample

The present study used a longitudinal selection of data from the Baltimore site of the ECA study before and after the year 1990. The ECA has been described in detail elsewhere ( Eaton et al., 1997; Regier et al., 1984). The primary purpose of the ECA study was to estimate rates of psychopathology and health care utilization in the United States. Data was collected using multistage probability sampling of individuals aged 18 or older at several locations in the United States. Original data collected at the Baltimore site occurred during the year 1981 (n=3,006 observations included in the present study). Additional follow-up data at the Baltimore site on the original sample was collected between the years of 1993-1994 (n = 1,679 observations). Written informed consent was obtained for all participants after the study procedures were fully explained. Demographic characteristics of the sample are reported in .

Table 1

Measures

Depressive Disorders

Trained laypersons conducted diagnostic interviews via the Diagnostic Interview Schedule (DIS; Robins et al., 1981). Participants were considered as having a depressive disorder if they met criteria for lifetime Major Depressive Disorder and/or Dysthymia, based on DSM-III criteria (American Psychiatric Association, 1980), which was the form of the DSM available during the time of the baseline assessment in 1981. Interviews in 1993-4 allowed diagnoses of Major Depressive Disorder and Dysthymia using both DSM-III and DSM-IV criteria; DSM-III criteria were used at the 1993-4 wave to have a consistent diagnostic framework for the two waves of assessment. Participants were categorized as having or not having a depressive disorder for the observation at each wave of data collection based on their responses to the DIS questions at that time point alone.

Past Year Cocaine Use

Use of cocaine was determined by self-report. Dichotomous variables were created where "1" indicated cocaine use in the past year as well as use on five or more occasions ever in one's lifetime. This cut-off of five occasions of use was chosen to represent cocaine use that exceeded experimentation. The cocaine use variable was coded as a "0" if the respondent had not ever used on five or more occasions, or had not used in the past year.

Control Variables

The race of participants was measured by self-report. Given the low prevalence of individuals who were neither Caucasian nor Black, participants in the present study were categorized as "Caucasian," "Black," or "Other." For all regression analyses, "Caucasian" is the referent. A dichotomous variable of currently (at the time of interview) married or not married, with not married as the referent, indicated participants' marital status. Similarly, a dichotomous variable represented having (at the time of the interview) a high school diploma or more education, with less than a high school education as the reference group. Gender was determined by the observation of the interviewers at the baseline interview, with male gender as the referent. Additionally, self-reported age was measured at each assessment. Gender and race were time-invariant covariates, while marital status, education, and age were time-variant.

Data Analysis

Analysis of longitudinal time trends was undertaken through a series of logistic regression models. Past-year cocaine use was regressed on depressive disorders, stratified by time period (1981 and 1993-1994). Multivariable regression modeling was theoretically-driven in order to test the proposed hypothesis of an interaction of depressive disorders and time period in the prediction of illegal cocaine use. Generalized estimating equations were used to handle the repeated measurement. The multivariable modeling strategy was repeated using age in the place of time period to assess the possibility of age effects. For both multivariable models, the p-value for interaction terms was set at 0.10 due to the limitations in power when testing for multiplicative interactions. All models were estimated using STATA, version 9 ( Statacorp, 2005).

Missing Data

Of all observations available from the two assessments, 4,685 of 5,484 (78.7%) had complete data on all variables included in the multivariable regression model. Observations with and without missing data were compared on the variables of interest using χ ² and t-tests. Those observations missing data were not different from those included in modeling for either of the variables of primary interest; i.e., they were not different in rates of depressive disorders or past-year cocaine use. Observations that had missing data were more likely to be from the 1981 assessment (25.5% having missing data vs. 12.6% at the 1993-1994 assessment, p < 0.001) and from participants who were not married (20.6% vs. 16.8% for those who were married, p < 0.001), female (22.3% vs. 19.7% for males, p = 0.02), older (mean of 58 for those with missing data and 49 for those without, p < 0.001), caucasian or of other race (21.7% and 63.8% respectively compared to 16.9% of black participants, all p < 0.001), and who have less than a high school degree (24.8% vs. 17.4% for those with a high school degree, p < 0.001).

Results

In simple logistic regression models of past-year cocaine use stratified by time period, having a depressive disorder was not associated with cocaine use at the 1981 assessment (β = 0.28, p = 0.39) but was at the 1993-1994 assessment (β = 1.26, p < 0.05). A multivariable model, where all observations from the two assessments are combined into one analysis pool, is reported in . The adjusted odds ratio (OR) of past-year cocaine use for those with a depressive disorder compared to those without was 1.28 (e 0.25) for the 1981 observations, controlling for demographic characteristics. For the 1993-1994 observations, however, the adjusted OR of past-year cocaine use for those with depression compared to those without was 3.53 (e 0.25 + 1.01) after controlling for demographic characteristics. The interaction term in the multivariable model indicated that the effect of depression on cocaine use was significantly different between the two waves ( p = 0.06) after controlling for potential confounders.

Table 2

Because age is inherently and highly correlated with time period in a cohort study, we could not include age in multivariable modeling and be able to examine effects of time period on the outcome. However, in separate analysis we explored the alternative possibility that the observed change in the relationship between cocaine use and depression over the course of the ECA study was due to an age effect rather than a historical period effect. In a multivariable logistic regression model that included depressive disorders, age, and an interaction term for depressive disorders and age, the interaction was not significant (β = −0.01, p = 0.5). This indicated that age effects were not important to the changing relationship between depression and cocaine use over time in this sample.

Discussion

This study set out to examine a potential, increasing association of cocaine use and depressive disorders in recent decades. We expected this increase in light of evidence that the cultural reputation of cocaine changed from the 1980s to 1990s, and with this change so too did cocaine's clientele change. To date the change in cocaine's clientele has been examined and documented in terms of socioeconomic status, but not yet in terms of psychopathology. This study is particularly well-suited to examine a potential increase in the association of cocaine use and depressive disorders because the data contain information on these factors before and after the year 1990, when the cultural changes in cocaine's reputation - as well as changes in its clientele - would have been complete ( Miech et al., 2005; Miech, 2008).

The analysis indicates that an association of depressive disorders and cocaine use emerged in the 1990s, and emerged quite dramatically. In 1981 the association was small and not statistically significant. But by 1992-3 the association had grown and people with depressive disorders were more than three times more likely to report past-year cocaine use than those without depressive disorders.

This emerging association was most likely a historical period effect and not a result of the aging of the cohort. While it can sometimes be difficult to disentangle period effects from aging effects because both aging and historical time take place concurrently, in this case the evidence points to a period effect because the association of cocaine use and depressive disorders did not differ by age. Before discussing these findings in more detail, we first point out some limitations of this study.

Limitations

It is not possible for the present study to discern between cohort and historical time effects. However, in either case the main substantive conclusion of the study still holds: namely, that the association of cocaine use and depressive disorders emerged in the 1990s and was likely to be a result of social, rather than biological, processes.

The present study is also limited by its use of a lifetime measure of Major Depressive Disorder and Dysthymia to determine depressive disorder status. Using a lifetime diagnosis does not allow the examination of whether the cocaine use occurred at the same time when an individual met criteria for a depressive disorder, as well as whether initiation of cocaine use began before or after the onset of the disorder. Consequently, any implications regarding causation are beyond the scope of this research. Despite the use of lifetime measurements, however, the present research is strengthened by the use of DSM-III diagnoses of Major Depression and Dysthymia instead of simpler survey tools to measure psychopathology. Furthermore, studies of the course of Major Depressive Disorder ( Wells et al., 1992) and Dysthymia ( Klein et al., 1998; Klein et al., 2000) suggest that reoccurring episodes are common and recovery without relapse uncommon for Dysthymia in particular. Nonetheless, while the DSM diagnoses are considered "gold standards" for defining mental illnesses, they rely on some use of judgment which will result in some misclassification, and do not confer much meaning in terms of etiology or prognosis in and of themselves.

The introduction of crack cocaine may explain some of the change observed over time in the present study. Unfortunately, the survey instrument for the 1993-1994 wave did not differentiate between people who used only crack and who use crack and powder cocaine. Consequently, we were unable to examine the degree to which individuals who use crack cocaine and experience a depressive disorder may explain the change in the association of cocaine and depressive disorders over time.

Given the sample size and the relatively low prevalence of many specific mental illnesses and of cocaine use, issues of statistical power precluded us from examining personality disorders and other psychopathology. However, depressive disorders are one of the most prevalent types of psychological disorders in the community, and therefore have substantial public health importance. Power issues also required that we group the two diagnostic categories (Dysthymia and Major Depressive Disorder), rather than examine the relationship of cocaine use with each separately. However, the purpose of the study was to examine the association of cocaine use with depression that is serious enough to be considered clinically significant, and we felt that including only those individuals with MDD while individuals with Dysthymia were included in the non-depressive disorder group would lead to a misclassification bias. In order handle the limitations of power when testing a multiplicative interaction, we used the commonly-practiced method of increasing the type-I error rate to 0.10 (e.g., Marler et al., 2000; Saitz et al., 2003), which does increase the risk of "false positive" findings. Despite the limitations of power and assessment methods, the present study is strengthened by the use of diagnostic criteria to assess psychopathology and assessments before and after the time of a known shift in the profile of cocaine users.

Public Health Implications

The association of depressive disorders and cocaine use that emerged during the 1990s suggests similar shifts may be expected when changes in pharmacokinetic properties (such as route of administration) or environmental conditions (policies, prices, and social acceptability) occur for specific substances of use and abuse. More broadly, such shifts may occur when a behavior, such as use of a specific substance, becomes stigmatized and pathologized. These shifts have important implications for service provision. Individuals with co-occurring problem substance use and mental illness greatly benefit from treatment programs tailored to comorbidity (Drake et al., 2003), and increases in the association of the use of a particular substance with mental illness will result in an increased need for this specialized treatment. Furthermore, understanding past shifts in illicit drug use among those with a mental illness may allow us to predict future changes and prepare for corresponding service needs.

Some have suggested that we are currently experiencing a new period of reduced stigma towards cocaine ( Ryzik 2007), citing the increased visibility of use by popular celebrities and the lack of recent "cautionary tales," i.e. high-profile individuals dying from cocaine overdose. However, this has not borne out yet in an increased rate of lifetime use among youth in national studies ( Johnston et al., 2005). The present results suggest the association of cocaine use with depression among cocaine users may again change if the speculated glamorization of cocaine continues.

Future Directions and Conclusion

The present study is a reminder of the importance for future research to consider specific substances when examining associations with psychopathology, in addition to analysis where all substances are grouped into a general, omnibus category. Analysis of time trends of comorbidity with Major Depression using all substances together did not find a dramatic change in the association over time ( Compton et al., 2006). However, a study of cross-sectional time trends of the association of smoking and depression (measured by combining criteria of Major Depressive Disorder and Dysthymia) found that the association of the two did not arise until smoking became non-normative ( Murphy et al., 2003). Taken collectively, these studies and the present study indicate the importance of substance-specific analysis in order to thoroughly understand the processes at work in determining the relationship between substance use and psychopathology.

Future research should also elucidate mediating factors that explain why individuals with depression are more likely to use illicit substance (such as cocaine) when use is stigmatized, such as social and economic resources, social network influences, employment opportunities, and access to treatment and health services. Future research should also further examine the social components of the association of mental illness with drug use. The present study examined historical trends as one aspect of the social component of co-occurring drug use and mental illness, but other research designs are also strategic for this purpose. For example, one innovative strategy might be qualitative studies of people with a depressive disorder who do and do not use cocaine as well as non-depressed individuals who do and do not use cocaine, in order to examine if cocaine use has different meanings between groups. An additional study design that may elucidate the role of social influences on the co-occurrence of drug use and mental illness is the study of twins. Specifically, ACE models may provide an estimate of the relative size of the genetic and the social components of this association. This is an important and fruitful line of research that should be pursued further in order to better understand the social context of the co-occurrence of drug use and psychopathology.

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Changes in the association of drug use with depressive disorders in recent decades: the case of cocaine

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The social meaning of cocaine changed during the 1980s and 1990s. The present study examined changes in the psychological profile of cocaine users. We used Baltimore data of the NIMH-funded Epidemiologic Catchment Area study during 1981 (n = 3,006; 60% ...

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Article explains how suffering from persistent negative emotions during adolescence can encourage risky and harmful behavior in an effort to self-regulate. Describes that suffering from anhedonia and dysphoria, brought on by mental illness, increases the risk of substance abuse schizophrenics. Article also mentions the overlap in the development of psychosis and addiction, and how the dopaminergic system plays a large role.

This article supports my research because it explains the relationship between mental health and drug addiction by talking about the overlapping causes of schizophrenia and addiction. This article also supports my research because it demonstrates what chemicals and parts of the brain are being altered that will result in these conditions; suffering from anhedonia, dysphoria, and faulty dopaminergic and glutamatergic systems. There are symptoms of schizophrenia that are the same for depression, which provides a connection.

“Anhedonia can be defined as a psychological condition characterized by inability to experience pleasure in normally pleasurable acts, and is related to the concept of dysphoria, which can be defined as a state of feeling unwell or unhappy”

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The article describes common methods and reasoning behind self-medicating with drugs or alcohol. Talks about how depression and anxiety are common disorders that result in turning to substance abuse, and how the nature of those disorders can encourage that course of action. Article also goes through the risks of self-medicating on mental health overall.

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It is remarkably common for people who misuse substances to have additional mental health issues that occur at the same time. However, not everyone understands exactly how to identify whether they are self-medicating or how they can stop.
When drug and alcohol abuse and mental health issues coincide, a person is said to have co-occurring disorders or a dual diagnosis.

Mental health issues, including depression and anxiety, are often recognized as a driving factor behind a person's misuse of drugs or alcohol, though the directionality or sequence of the two issues aren't always clear.

Early intervention is important in all cases of problematic substance use. A person can quickly cross the fine line between self-medicating and a full-blown substance use disorder, so catching the signs of an impending SUD early and treating it accordingly is crucial.

Below, we'll outline some ways that you can identify self-medication with drugs and alcohol in yourself or others, and address it before it develops into a clinically defined substance use disorder.

Substance use disorders and mental health issues commonly co-occur. Indeed, 7.7 million adults are diagnosed in the US with both a mental health and a substance use disorder (SUD). Among people who use substances, around 38% also have a mental health diagnosis. ¹

What is Self-Medicating?

Self-medicating refers to the misuse of drugs or alcohol in an attempt to manage the distressing symptoms of a mental health disorder or other health condition. Although many people that self-medicate may have a concurrently diagnosed health condition, such as a mental illness, cancer, injury, or chronic pain, it's imperative to remember that you do not need to have a formal clinical diagnosis to have already started the act of self-medication.

People tend to self-medicate for two fundamental reasons: ²

First, substances may seem to make the symptoms of a distressing experience, such as an illness or mental health condition, feel more manageable in the moment, serving as a temporary way for them to cope.

Second, many people who abuse substances can't find another way to cope with their feelings or co-occurring health condition.

People commonly report using substances to try to cope with specific mental illnesses such as mood and anxiety disorders. ³ In a review of various scientific literature, one study reported that early 22% of people with anxiety disorder, for example, report self-medication with drugs and alcohol. Another indicated that more than 21% of people with post-traumatic stress disorder had used alcohol or drugs to cope with their disorder, along with approximately 23% of people with major depression and 41% of those with bipolar disorder (type 1). ⁴

"... you do not need to have a formal clinical diagnosis to have already started the act of self-medication."

As mentioned, self-medicating can occur even if someone doesn't have a formally diagnosed mental health condition. Difficult life events, such as grief and abuse, can affect a person's mental health and lead people to turn to alcohol or drugs to cope.

Grief results in increased substance use according to a recent study. 5 Furthermore, when someone is in an abusive relationship or has experienced some form of trauma as a result, they are also at increased risk of using substances to cope with their situation. In fact, adolescents with an SUD are 3 times more likely to have experienced a traumatic event than the average adolescent. ⁶

Why Self-Medicating is Harmful

Self-medicating might appear harmless at first or go completely undetected. A person might innocently use alcohol or drugs in an effort to feel better at that particular moment; indeed, our culture reinforces and normalizes the (sometimes excessive) use of certain drugs to "take the edge" off of their mood.

But over time, self-medicating can complicate the management of mental health issues and can contribute to the development of a substance use disorder. Cocaine use, for example, has been associated with an exacerbation of symptoms and worsened progression of bipolar disorder. ⁷

Addiction and problematic substance use can, in some cases, also lead to brain changes that might predispose vulnerable individuals to developing additional mental health issues-including mood, psychotic, and impulse-control disorders. ⁷ Researchers associate the use of marijuana, for example, with a greater risk of experiencing earlier onset psychosis, with that risk increasing the younger people are at the time of their first cannabis use. ⁸

Therefore, using substances to cope with a mental illness may increase the risk of someone developing a substance use disorder, exacerbate their pre-existing mental health condition, or even prompt the emergence of a new problem. ³

Self-Medicating for Depression and Other Mental Illnesses

As noted earlier, cocaine use in people with bipolar disorder can worsen the course of the mental illness. Likewise, abusing drugs or alcohol to self-medicate for other mental illnesses, like anxiety, depression, post-traumatic stress disorder, personality disorders, and more, can also have negative outcomes. The use of marijuana among people with depression, for example, was associated with worse treatment outcomes for depression treatment. ⁹ Treating depression and substance abuse at the same time can have positive outcomes for both disorders. Among people who suffer from anxiety and substance abuse issues, it is common to see that anxiety not only negatively impacts the person's substance use, but that the substance abuse can worsen anxiety. ¹⁰

Furthermore, in people with schizophrenia, the use of alcohol leads to worse outcomes than for those people who do not use alcohol. 11 It is becoming increasingly recognized that, for optimal recovery outcomes, treatment of co-occurring conditions should simultaneously address both issues.

Both anxiety and depression are also often side effects of drug withdrawal as well, when a person abuses a substance regularly and becomes dependent on it.

How to Stop Self-Medicating

Compulsive self-medication that is suspected to have emerged in association with an untreated (or undertreated) mental health issue can be stopped by adequately managing all underlying issues. The standard of care for people with a substance use disorder and co-occurring mental health condition is to enter a treatment program that addresses both issues simultaneously-a model referred to as integrated treatment. ¹² If you are using substances and also have a co-occurring mental health disorder, the relatively-intensive levels of care found at an inpatient or residential treatment programs may offer the most preferred treatment setting. ¹²

If you believe that you or your loved one is self-medicating with substances such as those mentioned above, it may be time to seek professional help. Only a substance use professional who is experienced in treating dual diagnoses can determine whether you are self-medicating, and what you ought to do about it. American Addiction Centers (AAC) offers treatment for co-occurring disorders at our treatment centers across the country. Call us today to speak with an admissions specialist to arrange for an assessment of your situation and needs.

Stop Self-Medicating: Where to Find Treatment

If you are self-medicating and need a treatment program that can address both your substance use disorder and your mental health issues, know that you are not alone in your struggle. American Addiction Centers offers treatment for co-occurring disorders in each of our several locations across the United States. Call today to speak to one of our admissions navigators, who can speak with you regarding what AAC can offer you.

References

1. National Institute on Drug Abuse. (2018). Comorbidity: Substance Use and Other Mental Disorders.

2. Alexander, A. C., & Ward, K. D. (2018). Understanding post-disaster substance use and psychological distress using concepts from the self-medication hypothesis and social cognitive theory. Journal of Psychoactive Drugs, 50(2), 177-186.

3. Harris, K. M., & Edlund, M. J. (2005).

4. Turner, S., Mota, N., Bolton, J., & Sareen, J. (2018). Self‐medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and Anxiety, 35(9), 851-860.

5. Drabwell, L., Eng, J., Stevenson, F., King, M., Osborn, D., & Pitman, A. (2020). Perceptions of the use of alcohol and drugs after sudden bereavement by unnatural causes: analysis of online qualitative data. International Journal of Environmental Research and Public Health, 17(3), 677.

6. Basedow, L. A., Kuitunen-Paul, S., Roessner, V., & Golub, Y. (2020). Traumatic events and substance use disorders in adolescents. Frontiers in Psychiatry, 11.

7. National Institute on Drug Abuse. (2020). Why is there comorbidity between substance use disorders and mental illness es?

8. Pauselli, L., Birnbaum, M. L., Vázquez Jaime, B. P., Paolini, E., Kelley, M. E., Broussard, B., & Compton, M. T. (2018). Demographic and socioenvironmental predictors of premorbid marijuana use among patients with first-episode psychosis. Schizophrenia Research, 197, 544-549.

9. Bahorik, A. L., Leibowitz, A., Sterling, S. A., Travis, A., Weisner, C., & Satre, D. D. (2017). Patterns of marijuana use among psychiatry patients with depression and its impact on recovery. Journal of Affective Disorders, 213, 168-171.

10. Anker, J. J., Kushner, M. G., Thuras, P., Menk, J., & Unruh, A. S. (2016). Drinking to cope with negative emotions moderates alcohol use disorder treatment response in patients with co-occurring anxiety disorder.Drug and Alcohol Dependence, 159, 93-100.

11. Archibald, L., Brunette, M. F., Wallin, D. J., & Green, A. I. (2019). Alcohol use disorder and schizophrenia or schizoaffective disorder. Alcohol Research: Current Reviews, 40(1).

12. Substance Abuse and Mental Health Services Administration. (2016). Detoxification and substance abuse treatment.

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Are You Self-Medicating Using Substance, Drugs or Alcohol?

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It is remarkably common for people who misuse substances to have additional mental health issues that occur at the same time. However, not everyone understands exactly how to identify whether they are self-medicating or how they can stop. When drug and alcohol abuse and mental health issues coincide, a person is said to have co-occurring disorders or a dual diagnosis.

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Where Does Blame Belong: Person or Disorder (Personal Expertise)

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Where Does Blame Belong: Person or Disorder (Personal Expertise)

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Are there neurological reasons or factors as to why depression can lead to cocaine abuse?

FIndings were that there is a distinct link between mental health and drug addiction that lies in brain chemistry itself, and other social factors that contribute to someone choosing self-medication as treatment. The feelings of depression and cocaine are both explained, and personal experiences are used to connect them.

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This article describes what suffering from depression feels like, and provides an overview of some symptoms. The article continues to list common causes and risk factors for this illness, the difference in this disorder for men and women, and when it’s time to talk to a doctor.

This article supports my essay because in describing how depression feels, it’s understood how miserable and awful it feels to live with this disorder. Going through the symptoms allowed me to make connections to real life experiences to them, and consequences of them.

“Friends and loved ones often get frustrated...They may even say that the person has nothing to be depressed about. Depression is a real mental illness. Those who have depression cannot simply decide to stop feeling depressed. Unlike typical sadness or worry, depression feels all-consuming and hopeless.”

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Depression is a serious mental illness that can interfere with a person's life. It can cause long-lasting and severe feelings of sadness, hopelessness, and a loss of interest in activities.

It can also cause physical symptoms of pain, appetite changes, and sleep problems.

The Centers for Disease Control and Prevention (CDC) found that nearly 10 percent of adults aged 40 to 59 years had depression between 2009 and 2012. However, despite its prevalence, depression isn't always easy to identify.

Symptoms and causes of depression can vary widely from person to person. Gender may also play an important role in why a person is affected by depression, and what it feels like to them.

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It can be hard to explaining how depression feels to someone who has not experienced it.

One of the common misunderstandings about depression is that it's similar to feeling sad or down.

Although many people with depression feel sadness, it feels much more severe than emotions that come and go in response to life events.

The symptoms of depression can last for months or years and can make it difficult or impossible to carry on with daily life.

It can disrupt careers, relationships, and daily tasks such as self-care and housework.

Doctors will usually look for symptoms that have lasted at least 2 weeks as possible signs of depression.

Depression may feel like:

There's no pleasure or joy in life. A person with depression may not enjoy things they once loved and may feel like nothing can make them happy.

Concentration or focus becomes harder. Making any kind of decisions, reading, or watching television can seem taxing with depression because people can't think clearly or follow what's happening.

Everything feels hopeless, and there's no way to feel better. Depression may make a person feel that there's no way ever to feel good again.

Self-esteem is often absent. People with depression may feel like they are worthless or a failure at everything. They may dwell on negative events and experiences and be unable to see positive qualities in themselves.

Sleeping may be problematic. Falling asleep at night or staying asleep all night can feel nearly impossible for some people with depression. A person may wake up early and not be able to go back to sleep. Others may sleep excessvely, but still wake up feeling tired or unrefreshed, despite the extra hours of sleep.

Energy levels are low to nonexistent. Some people feel like they can't get out of bed, or feel exhausted all the time even when getting enough sleep. They may feel that they are too tired to do simple daily tasks.

Food may not seem appetizing. Some people with depression feel like they don't want to eat anything, and have to force themselves to eat. This can result in weight loss.

Food may be used as a comfort or coping tool. Although some people with depression don't want to eat, others can overeat and crave unhealthy or comfort foods. This can lead to weight gain.

Aches and pains may be present. Some people experience headaches, nausea, body aches, and other pains with depression.

Many people mistakenly believe that being depressed is a choice, or that they need to have a positive attitude. Friends and loved ones often get frustrated or don't understand why a person can't "snap out of it." They may even say that the person has nothing to be depressed about.

Depression is a real mental illness. Those who have depression cannot simply decide to stop feeling depressed. Unlike typical sadness or worry, depression feels all-consuming and hopeless.

Depression can be caused by a number of factors. Though a single cause cannot always be found, experts recognize the following as possible causes:

Genetics: Depression and other mood disorders can run in families, though family history alone does not mean a person will get depression.

Life events: Major life changes and stressful events may trigger depression. These events include divorce, the death of a loved one, job loss, or financial problems.

Hormonal changes: Depression and low mood are often associated with menopause, pregnancy, and premenstrual disorders.

Certain illnesses: Anxiety, long-term pain, diabetes, and heart disease may make someone more likely to develop depression. Depression is a symptoms of bipolar disorder.

Drug and alcohol abuse: In some cases, drug and alcohol abuse may cause depression. Other times, depression may cause a person to start abusing drugs or alcohol.

Some medications: Certain prescription medicines may increase the risk of depression. These include some high blood pressure medications, steroids, and some cancer drugs.

Research suggests that the causes of depression may be different for women than for men.

Scientists suggest this is due to:

biological factors

cultural expectations

differences in experience

One study of twin brothers and sisters published in The American Journal of Psychiatry found that personality and relationships with others were more likely to play a role in the onset of depression.

In particular, the study stated that marital problems, the relationship with parents, and lack of social support were more likely to cause depression in women than in men.

Neuroticism, or being in a negative emotional state, was also a primary cause of depression in the women studied.

A study in the Journal of Affective Disorders also found that women's symptoms of depression were different. The women studied were more likely to have panic and anxiety disorders in addition to their depression.

Other studies have indicated that women may be more likely to gain weight and have excessive sleepiness than men.

Women's hormone changes may also play a role in how and when depression affects them.

Research on this hormonal link has found:

Girls who have a family history of depression may be more likely to experience the onset of depression at puberty.

Women with depression have more severe symptoms during the premenstrual phase of their cycle, even if they are already taking antidepressants.

Postpartum depression occurs after giving birth and affects 1 in 7 women.

During the menopause transition, a woman's risk of depression increases.

Women have a two to three times greater risk of getting depression during this time, even if they never had depression in the past.

Losing a job and not being able to provide for the family is a common trigger for depression in men.

A study in The American Journal of Psychiatry found that men were more likely than women to have depression due to the following:

drug abuse

childhood sexual abuse

prior history of depression

major stressful life events

The study also suggested that men may be more likely to become depressed as a result of failures to achieve goals in life and low self-esteem. Financial and legal issues and career problems were found to cause depression more frequently in men than women.

The study mentions events such as losing a job and worrying about failing as a family provider as possible examples of what may trigger depression specifically in men.

Symptoms of depression in men may also be different. An analysis in JAMA Psychiatry found that men were more likely than women to experience anger attacks, aggression, and risk-taking behavior as depression symptoms.

Though it is commonly thought that women suffer from depression more frequently than men, the study suggests that men and women may both equally suffer from depression.

The differences in symptoms and what men report to their doctors may make depression harder to diagnose in men.

Traditional symptoms of depression, such as sadness and crying, may be more frequently hidden or not reported by men. Some may feel that these symptoms go against society's idea of being a man.

Those who are experiencing symptoms of depression should seek medical assistance. Depression can worsen without treatment and affect a person's quality of life.

A family doctor or mental health professional will discuss treatment options to help the person manage their depression and carry on with daily life.

In severe cases, depression can lead to thoughts of suicide or physically harming oneself.

Any suicidal thoughts or statements about "not wanting to live" should be taken seriously. In times of crisis, a person should seek help from a hospital emergency department.

Help is also available from the National Suicide Prevention Helpline by calling 1-800-273-TALK (1-800-273-8255), or visiting the Helpline's website.

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Depression affects far more people than some may realize. Depression is a serious mental health condition that is often misunderstood and misinterpreted by those who come into contact with someone who is medically depressed. This article explains what happens when someone is depressed, the risk factors, and what to do.

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David Eagleman breaks down how the brain works, and uses personal stories and professional studies to explain how outside influences can enhance or damage brain functions. Eagleman talks about the complexities of the brain, and how those complexities help us survive.

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Read 1,725 reviews from the world's largest community for readers. Locked in the silence and darkness of your skull, your brain fashions the rich narrative...

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The article describes how irregularities in the brain are the factors that predispose someone to a drug addiction. The article talks about how researchers were trying to find specific imbalances, but believed that most were inherited. The article also talks about socioeconomic influences that play a role in both mental health and addiction, and how those factors are mostly looked over to spare costs and social stigmas. The article also cities multiple stories from addicts and explains how their addiction started, and what measures were taken to overcome it.

This article supports my essay because it once again describes the factors that lead to self-medication, but it also describes how much better drugs feel because of those factors. The appeal of drugs has been explained, but with the information that drugs feel better to those who are predisposed to addiction reinforces the idea of self-medication in a way, and also shows how people get trapped in the cycle this way.

''For people who are biologically predisposed, the first drink or dose of the drug is immensely reinforcing, in a way others just don't experience it.”

''Many recovering drug abusers tell me, 'The moment I took my first drug, I felt normal for the first time.' It stabilizes them physiologically, at least in the short term.''

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Credit... The New York Times Archives

This is a digitized version of an article from The Times's print archive, before the start of online publication in 1996. To preserve these articles as they originally appeared, The Times does not alter, edit or update them.

Occasionally the digitization process introduces transcription errors or other problems; we are continuing to work to improve these archived versions.

A RADICALLY new approach to fighting drug abuse is emerging from discoveries of brain irregularities that make certain people much quicker to become addicted than others, and much harder to cure.

For several years, scientists have suspected that at least some drug addicts suffer imbalances in brain chemistry that make them vulnerable to depression, anxiety or intense restlessness. For such people, addiction becomes a kind of self-medication in which drugs correct the chemical imbalance and bring a sort of relief.

Now researchers are beginning to identify the particular imbalances associated with addictions to particular drugs like cocaine, heroin or alcohol. Because scientists believe many of these imbalances are inherited, they are seeking to identify genetic markers and other evidence, such as behavioral signs, that indicate a person is vulnerable.

Eventually, scientists say, this research will result in an entirely new strategy for fighting drug addiction: early identification of those most prone to a specific addiction and specific treatments to correct the chemical imbalances implicated.

The new line of research is generating rising enthusiasm among Federal health officials. The Alcohol, Drug Abuse and Mental Health Administration increased its support for studies on the genetic and biological basis of alcoholism alone to $53.5 million in the fiscal year 1991, up from $41.7 million in 1989.

''We already can breed lab animals with these irregularities who selectively crave opiates or stimulants.'' said Dr. Frederick K. Goodwin, administrator of the agency. ''There's a direct analog to humans.''

No one can yet say precisely what portion of addicts have the biological patterns. Dr. Goodwin estimated that a third to half of those addicted to a given drug may have genetic susceptibilities to it.

The biological approach took a big step forward in April, when researchers reported the identification of a specific gene that may play a key role in some forms of alcoholism, as well as in other addictions. Of the alcoholics they studied, 77 percent had the gene. The discovery, announced by researchers at the University of Texas and the University of California at Los Angeles, is for a gene linked to the receptors for dopamine, a brain chemical involved in the sensation of pleasure.

Such discoveries, scientists say, herald biological markers that may one day make possible early identification of those most at risk of becoming addicted, allowing more effective prevention or treatment.

The depression-cocaine link has emerged in several studies. For example, research in 1986 with 30 consecutive patients admitted for treatment of cocaine addiction in a drug unit at Yale Medical School found that half suffered from pre-existing depression. And the heavier the cocaine habit, the deeper the depression. Exhilaration A Natural 'High'

Is Not Enough

He is a 26-year-old advertising executive whose therapist describes him as ''naturally outgoing, energetic and hyped up.'' As a child he was the class clown; in high school his extroversion made him a popular class officer. In college he partied a lot. A few years out of college someone offered him cocaine at a party. He loved it: it made him intensely exhilarated, more chatty than ever. Over the next year he began needing increasingly large doses to get his high.

It was then that he turned to crack, the smokable, fast-acting form of cocaine. His first hit of crack, he said, ''was like an orgasm.'' During the next three hours, he took crack eight times; within a day, all he could think of was getting more crack.

According to Dr. Roy King, a psychiatrist at Stanford Medical School who treated the advertising executive, such energetic, outgoing people often have unusually high levels of dopamine, in contrast to the depressed cocaine user, who has too little.

''If you're highly extroverted, even slightly manic, by temperament, cocaine augments your natural bent,'' said Dr. King. ''For people who are naturally bubbling with excitement, crack seems to intensify the normal biology of a state they seek: it's an exhilarating, exciting high.''

In a 1989 study of 70 cocaine abusers, Dr. King found that those who abused cocaine the most and longest, in all forms, were more outgoing.

''Cocaine makes more dopamine available to the brain, and they already have higher levels of dopamine,'' Dr. King said. ''Smaller amounts of cocaine would have greater effects with them, making it more rewarding than in most people. They become more readily addicted to it because they get more intense pleasure from a given dose. That makes crack, the most intense form, especially appealing.'' Anger Trying to Escape His Pent-Up Rage As a boy, he had been beaten by his father every week or so. His mother was distant and insensitive. He grew up with a brooding resentment; like his father, he was quick to become enraged. In his early 30's, he grew deeply embittered after a series of relationships ended because of his quick temper. A pharmacist now, he could get morphine on the sly easily; more than anything else, he said, he liked its calming effects on his bitter resentment and mounting rage.

''They can't stand monotony,'' Dr. Moss said. ''They're ready to try anything. This makes them at greater risk for drug abuse of all kinds, in addition to alcohol.'' Treatment The Need to Find The Craving Early The immediate implication is to treat addicts with corrective medications. ''Many traditional treatments for alcoholism may be unsuccessful because they do not address the disturbances that predisposed the person to alcoholism in the first place,'' said Dr. Tarter of the Western Psychiatric Institute and Clinic in Pittsburgh.

''A combination of early detection and pharmaceutical intervention is the most sensible way to proceed,'' said Dr. Goodwin of the Alcohol, Drug Abuse and Mental Health Administration.

For some addictions, there may be a critical period in life, such as late adolescence and early adulthood, when the risk of addiction is highest. Offering a medication that corrects the vulnerability during those years is one potential treatment strategy. For instance, for those whose susceptiblity to alcoholism is due to a level of serotonin that is too low, Dr. Goodwin said, ''if they are protected by a drug that enhances and stabilizes serotonin during those years when they are most vulnerable to alcoholism, then later in life they may be able to drink socially with low risk.'' For the dopamine irregularities seen in cocaine addiciton, medications now used as anticonvulsants might counter the craving for cocaine by blocking the dopamine center, he added.

Dr. Goodwin said there was a need for new medications designed to correct the exact irregularities being identified for each addiction. ''We're launching a major medication development program to find drugs tht react with the specific receptors to reduce craving,'' he said. ''Eighty percent of those in therapy programs who leave too early do so because of craving.''

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Scientists Pinpoint Brain Irregularities In Drug Addicts (Published 1990)

# data[].attributes.attachment_link.description
This is a digitized version of an article from The Times's print archive, before the start of online publication in 1996. To preserve these articles as they originally appeared, The Times does not alter, edit or update them. Occasionally the digitization process introduces transcription errors or other problems; we are continuing to work to improve these archived versions.