 Florida Detox provides a three month outpatient treatment program for cocaine dependency. Our cocaine treatment focuses on normalizing neurotransmitter levels, altered by cocaine. Normalization usually begins with prescription medication, to rapidly eliminate intense cocaine cravings. Frequently, we can use naturally occurring, over the counter nutrients to replace all or a portion of the prescription medication. Many cocaine dependent patients self medicate pre-existing, inherited variations in neurotransmitter concentration and receptor density. Over 60 percent of our patients evaluated for cocaine abuse are diagnosed with prefrontal cortex dopamine deficiency. (attention deficit disorder or attention deficit hyperactivity disorder) SPECT and PET brain scan research reveals altered brain blood flow patterns and neurotransmitter reuptake transporter density. When we effectively treat inherited neurotransmitter alterations, patients often tell us they finally feel normal, for the first time in their life. Many cocaine dependent patients succeed with our treatment, after numerous failures, with other treatment programs. Talk therapy and support groups seldom effectively treat cocaine dependence, since they ignore the biochemical and neurological causes.
Cocaine Dependency and Dopamine Deficiency
Cocaine cravings are intense after withdrawal and often result in relapse. Cocaine severely depletes dopamine neurotransmitter levels, producing severe depression. If dopamine deficiency, produced by cocaine use, is not corrected with prescription medication or nutraceutical supplementation, relapse usually occurs. At Florida Detox, we treat the dopamine deficiency, produced by cocaine dependency, to prevent relapse."I have never encountered a single patient who wants to be addicted. They are addicted at enormous personal and social cost, but something fundamental has changed in their brains so that the drives that normally motivate others are disrupted by the drugs," said Nora D. Volkow, MD, Director of the National Institute on Drug Abuse. . .Dr. Volkow described her study of 20 hospitalized cocaine abusers who showed markedly decreased reductions in dopamine D2 receptors, compared with 23 controls. The diminution of receptors was even apparent four months after cocaine discontinuation. These findings extended the results of other studies showing dopamine D2 receptor reductions in current cocaine abusers as well as studies showing reductions in D2 receptors in other addictions such as alcoholism, heroin, and methamphetamine. "This study documented for the first time the biochemical changes in the brain of addicted people, and showed that the reductions [in dopamine D2 receptors] are long-lasting," she said. Addicts have fewer dopamine D2 receptors in several regions of their brains than do controls. . . Upon release, dopamine is almost immediately removed from the synapse by the dopamine transporter, and thus has a very limited opportunity to reach the receptor. Fewer receptors for the same amount of released dopamine means less "received" dopamine and consequently less dopamine signaling. . . EMPHASIS ADDEDHaving more dopamine D2 receptors in the brain may confer protective benefit against vulnerability to addiction, Dr. Volkow noted. She and her colleagues have measured the number of dopamine D2 receptors in a group of nonaddicted subjects, then administered intravenous methylphenidate. (Ritalin) The subjects who described their experience as pleasurable had significantly fewer dopamine D2 receptors than those who described it as nonpleasurable. Liberating more dopamine triggered an aversive experience because it boosted dopamine levels "over the threshold of what would be considered reinforcing." The experience was too intense and so unpleasant that these subjects refused to return for a follow-up study, Dr. Volkow reported.
Yasgur, B. The Neurologic roots of Addiction. NeuroPsychiatry Reviews. Vol. 5, No. 5; July 2004Florida Detox provides a three month outpatient treatment program for cocaine dependency. Our cocaine treatment focuses on normalizing neurotransmitter levels, altered by cocaine. Normalization usually begins with prescription medication, to rapidly eliminate intense cocaine cravings. Frequently, we can use naturally occurring, over the counter nutrients to replace all or a portion of the prescription medication. Many cocaine dependent patients self medicate pre-existing, inherited variations in neurotransmitter concentration and receptor density. Over 60 percent of our patients evaluated for cocaine abuse are diagnosed with prefrontal cortex dopamine deficiency. (attention deficit disorder or attention deficit hyperactivity disorder) SPECT and PET brain scan research reveals altered brain blood flow patterns and neurotransmitter reuptake transporter density. When we effectively treat inherited neurotransmitter alterations, patients often tell us they finally feel normal, for the first time in their life. Many cocaine dependent patients succeed with our treatment, after numerous failures, with other treatment programs. Talk therapy and support groups seldom effectively treat cocaine dependence, since they ignore the biochemical and neurological causes.
Cocaine Dependency and Dopamine Deficiency
Cocaine cravings are intense after withdrawal and often result in relapse. Cocaine severely depletes dopamine neurotransmitter levels, producing severe depression. If dopamine deficiency, produced by cocaine use, is not corrected with prescription medication or nutraceutical supplementation, relapse usually occurs. At Florida Detox, we treat the dopamine deficiency, produced by cocaine dependency, to prevent relapse."I have never encountered a single patient who wants to be addicted. They are addicted at enormous personal and social cost, but something fundamental has changed in their brains so that the drives that normally motivate others are disrupted by the drugs," said Nora D. Volkow, MD, Director of the National Institute on Drug Abuse. . .Dr. Volkow described her study of 20 hospitalized cocaine abusers who showed markedly decreased reductions in dopamine D2 receptors, compared with 23 controls. The diminution of receptors was even apparent four months after cocaine discontinuation. These findings extended the results of other studies showing dopamine D2 receptor reductions in current cocaine abusers as well as studies showing reductions in D2 receptors in other addictions such as alcoholism, heroin, and methamphetamine. "This study documented for the first time the biochemical changes in the brain of addicted people, and showed that the reductions [in dopamine D2 receptors] are long-lasting," she said. Addicts have fewer dopamine D2 receptors in several regions of their brains than do controls. . . Upon release, dopamine is almost immediately removed from the synapse by the dopamine transporter, and thus has a very limited opportunity to reach the receptor. Fewer receptors for the same amount of released dopamine means less "received" dopamine and consequently less dopamine signaling. . . EMPHASIS ADDEDHaving more dopamine D2 receptors in the brain may confer protective benefit against vulnerability to addiction, Dr. Volkow noted. She and her colleagues have measured the number of dopamine D2 receptors in a group of nonaddicted subjects, then administered intravenous methylphenidate. (Ritalin) The subjects who described their experience as pleasurable had significantly fewer dopamine D2 receptors than those who described it as nonpleasurable. Liberating more dopamine triggered an aversive experience because it boosted dopamine levels "over the threshold of what would be considered reinforcing." The experience was too intense and so unpleasant that these subjects refused to return for a follow-up study, Dr. Volkow reported.
Yasgur, B. The Neurologic roots of Addiction. NeuroPsychiatry Reviews. Vol. 5, No. 5; July 2004 
PET brain scans reveal chemical differences in the brain between addicts and nonaddicts.The normal images in the bottom row come from non-addicts; the abnormal images in the top row come from patients with addiction disorders. The PET scans from the cocaine abuser, the alcoholic, and the obese patient with food addiction show reduced levels of dopamine receptors (molecules that transmit pleasure signals in the brain). Low levels of dopamine receptors suggest an understimulated biochemical "reward system" in the brain. The PET scan from the cigarette smoker with nicotine addiction shows lower levels of monoamine oxidase (MAO), a brain enzyme that regulates dopamine levels. BER researchers are investigating pharmaceutical therapies for curbing or curing addictive behaviors.UPTON, NY - In a discovery that strikes at the very heart of cocaine addiction, scientists from the U.S. Department of Energy's Brookhaven National Laboratory may have found a clue to why addicts crave the drug so strongly and use it repeatedly.Their study, published in this month's issue of The American Journal of Psychiatry, describes signs of damage to the very chemical pathways that send signals between the cells in cocaine addicts' brains.
"While we do not yet know if this is damage caused by the cocaine use or is already present in the addicts' brain chemistry, this is an important step in understanding why people use cocaine repeatedly, feeding an addiction that is destructive both physically and socially," said team leader and BNL Medical Department chair Nora Volkow.Volkow and her colleagues found the signs of brain-chemistry damage using a brain-scanning technique known as positron emission tomography, or PET. They scanned the brains of 27 volunteers - 13 cocaine addicts and 14 non-drug users - twice, then looked for differences.The first scan was performed after the volunteers were given a placebo, the second after they had been given the drug lorazepam, known commercially as Ativan and used to treat anxiety.
"We used lorazepam because it stimulates the same chemical pathways that transfer signals between brain cells when a person uses cocaine," Volkow explained. "These pathways let our brains receive the message sent by the neurotransmitter chemical dopamine - the message that tells us that what we're doing is pleasurable and we should do it again."Volkow and others have shown that cocaine and other drugs affect the brain's dopamine system, causing the "pleasure message" to be repeated and reinforcing the desire to take the drug.
The PET scans showed drastic differences between lorazepam's effect on cocaine addicts' brains and the effects in the comparison volunteers. The difference, said Volkow, indicates that addicts are more sensitive to lorazepam because of damage to a crucial chemical pathway called GABA. As the brain's main inhibitory neurotransmitter, GABA tells neurons to stop firing.Cocaine addicts' abnormal response to lorazepam, which stimulates GABA pathways, may also explain their increased propensity to seizures and the sleep abnormalities seen in such subjects. . .Side-by-side comparison of two PET scans from two subjects. The top two scans show a non-drug user?s brain before and after taking a dose of lorazepam; the bottom two are from a cocaine addict. Note the difference in activity between the two scans in the right-hand column; these differences indicate an altered response to stimulation of the GABA pathways that transmit dopamine "pleasure signals" in the brain.
Blood Pressure Medication May Improve Cocaine Treatment Results in Patients With Severe Withdrawal Symptoms By Robert Mathias, NIDA NOTES Staff Writer A medication used to treat high blood pressure may be an effective add-on therapy for cocaine-dependent patients who suffer severe withdrawal symptoms when they stop using the drug, a NIDA-funded study indicates. Patients who experienced severe anxiety and other symptoms and were treated with the medication -- propranolol -- stayed in treatment longer and used less cocaine than a comparable group of patients who were treated with a placebo, the study shows.Cocaine-dependent patients who experience severe withdrawal symptoms generally use cocaine heavily and are more dependent on the drug than patients who have less severe withdrawal symptoms. "These patients are unable to stop using the drug for significant periods and are more likely to drop out of treatment programs," says Dr. Kyle Kampman of the University of Pennsylvania School of Medicine in Philadelphia, who conducted the study. "This is not a tiny subgroup. We've found that about 40 percent of the cocaine abusers who come into the Day Treatment Program of the Philadelphia Veterans Affairs Hospital have withdrawal severity scores that are high enough to put them at risk for doing poorly in treatment."Dr. Kampman and his colleagues theorized that propranolol might lessen the severity of symptoms such as anxiety and craving experienced by newly abstinent cocaine treatment patients. Propranolol belongs to a class of medications called beta-adrenergic blockers that inhibit the effects of adrenaline in the central and peripheral nervous systems, where it works to arouse the body's "fight or flight" response to dangerous or stressful situations. Beta-adrenergic blockers have been used clinically to treat general anxiety and anxiety associated with alcohol withdrawal. The researchers thought propranolol's tempering of symptoms such as palpitations and sweating might also reduce cocaine craving associated with such symptoms.Nearly 69 percent of cocaine treatment patients experiencing severe withdrawal symptoms who received propranolol completed the treatment program, compared to 29 percent of patients with similar symptoms who were treated with a placebo.Following a 1-week lead-in period in which all subjects were given a placebo, researchers randomly assigned patients to receive either propranolol or a placebo daily for 8 weeks. All subjects also received cognitive-behavioral counseling twice a week. Urine tests for cocaine were conducted three times a week throughout the trial to assess cocaine use. Treatment retention, cocaine withdrawal symptoms, craving, mood, and anxiety symptoms were evaluated weekly.www.drugabuse.gov/NIDA_Notes/NNVol16N6/Blood.html PET brain scans reveal chemical differences in the brain between addicts and nonaddicts.The normal images in the bottom row come from non-addicts; the abnormal images in the top row come from patients with addiction disorders. The PET scans from the cocaine abuser, the alcoholic, and the obese patient with food addiction show reduced levels of dopamine receptors (molecules that transmit pleasure signals in the brain). Low levels of dopamine receptors suggest an understimulated biochemical "reward system" in the brain. The PET scan from the cigarette smoker with nicotine addiction shows lower levels of monoamine oxidase (MAO), a brain enzyme that regulates dopamine levels. BER researchers are investigating pharmaceutical therapies for curbing or curing addictive behaviors.UPTON, NY - In a discovery that strikes at the very heart of cocaine addiction, scientists from the U.S. Department of Energy's Brookhaven National Laboratory may have found a clue to why addicts crave the drug so strongly and use it repeatedly.Their study, published in this month's issue of The American Journal of Psychiatry, describes signs of damage to the very chemical pathways that send signals between the cells in cocaine addicts' brains.
"While we do not yet know if this is damage caused by the cocaine use or is already present in the addicts' brain chemistry, this is an important step in understanding why people use cocaine repeatedly, feeding an addiction that is destructive both physically and socially," said team leader and BNL Medical Department chair Nora Volkow.Volkow and her colleagues found the signs of brain-chemistry damage using a brain-scanning technique known as positron emission tomography, or PET. They scanned the brains of 27 volunteers - 13 cocaine addicts and 14 non-drug users - twice, then looked for differences.The first scan was performed after the volunteers were given a placebo, the second after they had been given the drug lorazepam, known commercially as Ativan and used to treat anxiety.
"We used lorazepam because it stimulates the same chemical pathways that transfer signals between brain cells when a person uses cocaine," Volkow explained. "These pathways let our brains receive the message sent by the neurotransmitter chemical dopamine - the message that tells us that what we're doing is pleasurable and we should do it again."Volkow and others have shown that cocaine and other drugs affect the brain's dopamine system, causing the "pleasure message" to be repeated and reinforcing the desire to take the drug.
The PET scans showed drastic differences between lorazepam's effect on cocaine addicts' brains and the effects in the comparison volunteers. The difference, said Volkow, indicates that addicts are more sensitive to lorazepam because of damage to a crucial chemical pathway called GABA. As the brain's main inhibitory neurotransmitter, GABA tells neurons to stop firing.Cocaine addicts' abnormal response to lorazepam, which stimulates GABA pathways, may also explain their increased propensity to seizures and the sleep abnormalities seen in such subjects. . .Side-by-side comparison of two PET scans from two subjects. The top two scans show a non-drug user?s brain before and after taking a dose of lorazepam; the bottom two are from a cocaine addict. Note the difference in activity between the two scans in the right-hand column; these differences indicate an altered response to stimulation of the GABA pathways that transmit dopamine "pleasure signals" in the brain.Blood Pressure Medication May Improve Cocaine Treatment Results in Patients With Severe Withdrawal Symptoms By Robert Mathias, NIDA NOTES Staff Writer A medication used to treat high blood pressure may be an effective add-on therapy for cocaine-dependent patients who suffer severe withdrawal symptoms when they stop using the drug, a NIDA-funded study indicates. Patients who experienced severe anxiety and other symptoms and were treated with the medication -- propranolol -- stayed in treatment longer and used less cocaine than a comparable group of patients who were treated with a placebo, the study shows.Cocaine-dependent patients who experience severe withdrawal symptoms generally use cocaine heavily and are more dependent on the drug than patients who have less severe withdrawal symptoms. "These patients are unable to stop using the drug for significant periods and are more likely to drop out of treatment programs," says Dr. Kyle Kampman of the University of Pennsylvania School of Medicine in Philadelphia, who conducted the study. "This is not a tiny subgroup. We've found that about 40 percent of the cocaine abusers who come into the Day Treatment Program of the Philadelphia Veterans Affairs Hospital have withdrawal severity scores that are high enough to put them at risk for doing poorly in treatment."Dr. Kampman and his colleagues theorized that propranolol might lessen the severity of symptoms such as anxiety and craving experienced by newly abstinent cocaine treatment patients. Propranolol belongs to a class of medications called beta-adrenergic blockers that inhibit the effects of adrenaline in the central and peripheral nervous systems, where it works to arouse the body's "fight or flight" response to dangerous or stressful situations. Beta-adrenergic blockers have been used clinically to treat general anxiety and anxiety associated with alcohol withdrawal. The researchers thought propranolol's tempering of symptoms such as palpitations and sweating might also reduce cocaine craving associated with such symptoms.Nearly 69 percent of cocaine treatment patients experiencing severe withdrawal symptoms who received propranolol completed the treatment program, compared to 29 percent of patients with similar symptoms who were treated with a placebo.Following a 1-week lead-in period in which all subjects were given a placeb o, researchers randomly assigned patients to receive either propranolol or a placebo daily for 8 weeks. All subjects also received cognitive-behavioral counseling twice a week. Urine tests for cocaine were conducted three times a week throughout the trial to assess cocaine use. Treatment retention, cocaine withdrawal symptoms, craving, mood, and anxiety symptoms were evaluated weekly. www.drugabuse.gov/NIDA_Notes/NNVol16N6/Blood.html |
