| Cocaine Information |
NARCOTIC NEWS
Cocaine Information
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Cocaine Information
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| COCAINE Info Continued Page #3 |
| Legislation on Cocaine |
| Cocaine effects on Babies born to Cocaine Users |
The full extent of the effects of prenatal drug exposure on a child is not completely known, but many
scientific studies have documented that babies born to mothers who abuse cocaine during pregnancy
are often prematurely delivered, have low birth weights and smaller head circumferences, and are
often shorter in length.
Estimating the full extent of the consequences of maternal drug abuse is difficult, and determining the
specific hazard of a particular drug to the unborn child is problematic for many reasons. Multiple
factors—such as the amount and number of all drugs abused; extent of prenatal care; possible neglect
or abuse of the child; exposure to violence in the environment; socioeconomic conditions; maternal
nutrition; other health conditions; and exposure to sexually-transmitted diseases—can contribute to
the difficulty in determining direct impact of prenatal cocaine use on maternal, fetal, and child
outcomes.
Many recall that “crack babies,” or babies born to mothers who used crack cocaine while pregnant,
were at one time written off by many as a lost generation. They were predicted to suffer from severe,
irreversible damage, including reduced intelligence and social skills. It was later found that this was a
gross exaggeration. However, the fact that most of these children appear normal should not be
overinterpreted as indicating that there is no cause for concern. Using sophisticated technologies,
scientists are now finding that exposure to cocaine during fetal development may lead to subtle, yet
significant, later deficits in some children, including deficits in some aspects of cognitive performance,
information-processing, and attention to tasks—abilities that are important for success in school.
scientific studies have documented that babies born to mothers who abuse cocaine during pregnancy
are often prematurely delivered, have low birth weights and smaller head circumferences, and are
often shorter in length.
Estimating the full extent of the consequences of maternal drug abuse is difficult, and determining the
specific hazard of a particular drug to the unborn child is problematic for many reasons. Multiple
factors—such as the amount and number of all drugs abused; extent of prenatal care; possible neglect
or abuse of the child; exposure to violence in the environment; socioeconomic conditions; maternal
nutrition; other health conditions; and exposure to sexually-transmitted diseases—can contribute to
the difficulty in determining direct impact of prenatal cocaine use on maternal, fetal, and child
outcomes.
Many recall that “crack babies,” or babies born to mothers who used crack cocaine while pregnant,
were at one time written off by many as a lost generation. They were predicted to suffer from severe,
irreversible damage, including reduced intelligence and social skills. It was later found that this was a
gross exaggeration. However, the fact that most of these children appear normal should not be
overinterpreted as indicating that there is no cause for concern. Using sophisticated technologies,
scientists are now finding that exposure to cocaine during fetal development may lead to subtle, yet
significant, later deficits in some children, including deficits in some aspects of cognitive performance,
information-processing, and attention to tasks—abilities that are important for success in school.
| Treatment for Cocaine |
There was an enormous increase in the number of people seeking
treatment for cocaine addiction during the 1980s and 1990s.
Treatment providers in most areas of the country, except in the
West and Southwest, report that cocaine is the most commonly
cited drug of abuse among their clients. The majority of individuals
seeking treatment smoke crack, and are likely to be polydrug users,
or users of more than one substance. The widespread abuse of
cocaine has stimulated extensive efforts to develop treatment
programs for this type of drug abuse. Cocaine abuse and addiction
is a complex problem involving biological changes in the brain as
well as a myriad of social, familial, and environmental factors.
Therefore, treatment of cocaine addiction is complex, and must
address a variety of problems. Like any good treatment plan,
cocaine treatment strategies need to assess the psychobiological,
social, and pharmacological aspects of the patient's drug abuse.
treatment for cocaine addiction during the 1980s and 1990s.
Treatment providers in most areas of the country, except in the
West and Southwest, report that cocaine is the most commonly
cited drug of abuse among their clients. The majority of individuals
seeking treatment smoke crack, and are likely to be polydrug users,
or users of more than one substance. The widespread abuse of
cocaine has stimulated extensive efforts to develop treatment
programs for this type of drug abuse. Cocaine abuse and addiction
is a complex problem involving biological changes in the brain as
well as a myriad of social, familial, and environmental factors.
Therefore, treatment of cocaine addiction is complex, and must
address a variety of problems. Like any good treatment plan,
cocaine treatment strategies need to assess the psychobiological,
social, and pharmacological aspects of the patient's drug abuse.
Many behavioral treatments have been found to be effective for cocaine addiction, including both
residential and outpatient approaches. Indeed, behavioral therapies are often the only available, effective
treatment approaches to many drug problems, including cocaine addiction, for which there is, as yet, no
viable medication. However, integration of both types of treatments may ultimately prove to be the most
effective approach for treating addiction. Disulfiram (a medication that has been used to treat
alcoholism), in combination with behavioral treatment, has been shown, in clinical studies, to be effective
in reducing cocaine abuse. It is important that patients receive services that match all of their treatment
needs. For example, if a patient is un-employed, it may be helpful to provide vocational rehabilitation or
career counseling. Similarly, if a patient has marital problems, it may be important to offer couples
counseling. A behavioral therapy component that is showing positive results in many cocaine-addicted
populations is contingency management. Contingency management may be particularly useful for helping
patients achieve initial abstinence from cocaine. Some contingency management programs use a
voucher-based system to give positive rewards for staying in treatment and remaining cocaine free.
Based on drug-free urine tests, the patients earn points, which can be exchanged for items that
encourage healthy living, such as joining a gym, or going to a movie and dinner.
Cognitive-behavioral therapy, or “Relapse Prevention,” is another approach. Cognitive-behavioral
treatment, for example, is a focused approach to helping cocaine-addicted individuals abstain—and
remain abstinent—from cocaine and other substances. The underlying assumption is that learning
processes play an important role in the development and continuation of cocaine abuse and dependence.
The same learning processes can be employed to help individuals reduce drug use and successfully
cope with relapse. This approach attempts to help patients recognize, avoid, and cope; i.e., recognize the
situations in which they are most likely to use cocaine, avoid these situations when appropriate, and cope
more effectively with a range of problems and problematic behaviors associated with drug abuse. This
therapy is also noteworthy because of its compatibility with a range of other treatments patients may
receive, such as pharmacotherapy.
Therapeutic communities (TCs), or residential programs with planned lengths of stay of 6 to 12 months,
offer another alternative to those in need of treatment for cocaine addiction. TCs focus on resocialization
of the individual to society, and can include on-site vocational rehabilitation and other supportive services.
Of course, there is variation in the types of therapeutic processes offered in TCs.
residential and outpatient approaches. Indeed, behavioral therapies are often the only available, effective
treatment approaches to many drug problems, including cocaine addiction, for which there is, as yet, no
viable medication. However, integration of both types of treatments may ultimately prove to be the most
effective approach for treating addiction. Disulfiram (a medication that has been used to treat
alcoholism), in combination with behavioral treatment, has been shown, in clinical studies, to be effective
in reducing cocaine abuse. It is important that patients receive services that match all of their treatment
needs. For example, if a patient is un-employed, it may be helpful to provide vocational rehabilitation or
career counseling. Similarly, if a patient has marital problems, it may be important to offer couples
counseling. A behavioral therapy component that is showing positive results in many cocaine-addicted
populations is contingency management. Contingency management may be particularly useful for helping
patients achieve initial abstinence from cocaine. Some contingency management programs use a
voucher-based system to give positive rewards for staying in treatment and remaining cocaine free.
Based on drug-free urine tests, the patients earn points, which can be exchanged for items that
encourage healthy living, such as joining a gym, or going to a movie and dinner.
Cognitive-behavioral therapy, or “Relapse Prevention,” is another approach. Cognitive-behavioral
treatment, for example, is a focused approach to helping cocaine-addicted individuals abstain—and
remain abstinent—from cocaine and other substances. The underlying assumption is that learning
processes play an important role in the development and continuation of cocaine abuse and dependence.
The same learning processes can be employed to help individuals reduce drug use and successfully
cope with relapse. This approach attempts to help patients recognize, avoid, and cope; i.e., recognize the
situations in which they are most likely to use cocaine, avoid these situations when appropriate, and cope
more effectively with a range of problems and problematic behaviors associated with drug abuse. This
therapy is also noteworthy because of its compatibility with a range of other treatments patients may
receive, such as pharmacotherapy.
Therapeutic communities (TCs), or residential programs with planned lengths of stay of 6 to 12 months,
offer another alternative to those in need of treatment for cocaine addiction. TCs focus on resocialization
of the individual to society, and can include on-site vocational rehabilitation and other supportive services.
Of course, there is variation in the types of therapeutic processes offered in TCs.
Cocaine was first federally regulated in December 1914, with the passage of the Harrison Act. The
Harrison Act banned non-medical use of cocaine; prohibited its importation; imposed the same
criminal penalties for cocaine users that were levied against users of opium, morphine, and heroin;
and required a strict accounting of medical prescriptions for cocaine. As a consequence of the
Harrison Act - and the emergence in the 1930s of cheaper, legal, and readily available drugs like
amphetamines - cocaine became scarce in the United States. By the 1950s it was no longer
considered a problem worthy of law enforcement attention.
Cocaine use began to rise again in the 1960s, prompting Congress, in 1970, to classify it as a Schedule
II controlled substance, meaning it was potentially susceptible to abuse and could produce
dependency but had legitimate medicinal uses. However, it was still not considered by many in the
medical profession to be a serious health threat. Even as late as 1980, influential scientific writings
reflected the prevailing non-critical assessment of the dangers of cocaine: The 1980 edition of the
Comprehensive Textbook of Psychiatry asserted that cocaine posed no serious problem, if use was
limited to two or three times a week. Like the cocaine epidemic that occurred at the turn of the century,
cocaine once again was embraced by the social elite. The deleterious effects of cocaine that were
discovered merely 60 years earlier appeared inexplicably to have been forgotten. However, by the early
1980s, the nation's attitude toward cocaine had changed and various law enforcement and public
health efforts intended to control its use were underway.
Harrison Act banned non-medical use of cocaine; prohibited its importation; imposed the same
criminal penalties for cocaine users that were levied against users of opium, morphine, and heroin;
and required a strict accounting of medical prescriptions for cocaine. As a consequence of the
Harrison Act - and the emergence in the 1930s of cheaper, legal, and readily available drugs like
amphetamines - cocaine became scarce in the United States. By the 1950s it was no longer
considered a problem worthy of law enforcement attention.
Cocaine use began to rise again in the 1960s, prompting Congress, in 1970, to classify it as a Schedule
II controlled substance, meaning it was potentially susceptible to abuse and could produce
dependency but had legitimate medicinal uses. However, it was still not considered by many in the
medical profession to be a serious health threat. Even as late as 1980, influential scientific writings
reflected the prevailing non-critical assessment of the dangers of cocaine: The 1980 edition of the
Comprehensive Textbook of Psychiatry asserted that cocaine posed no serious problem, if use was
limited to two or three times a week. Like the cocaine epidemic that occurred at the turn of the century,
cocaine once again was embraced by the social elite. The deleterious effects of cocaine that were
discovered merely 60 years earlier appeared inexplicably to have been forgotten. However, by the early
1980s, the nation's attitude toward cocaine had changed and various law enforcement and public
health efforts intended to control its use were underway.
Sources: USDOJ and various Law Enforcement Officials