Methamphetamine Cured my Cocaine Addiction
Received Date: Aug 25, 2010 / Accepted Date: Oct 13, 2010 / Published Date: Oct 14, 2010
Cocaine dependence is an enduring problem and years of research and drug development has yet to produce an effi cacious pharmacotherapy. Recent clinical research suggests that chronic treatment with amphetamine-like medications produces tolerance to cocaine’s reinforcing effects and may offer a viable pharmacotherapy. Three methamphetamine-dependent participants that had been in our clinical laboratory experiments and previously addicted to cocaine are reviewed. Data obtained from initial screen and informal conversation suggested that all participants considered methamphetamine to have helped them stop using cocaine and eliminate cocaine craving. Methamphetamine also signifi cantly decreased their alcohol consumption but did not alter cannabis or nicotine use.
Keywords: Drug abuse; Stimulants; Tolerance; Pharmacotherapies; Prodrug
Cocaine dependence remains a major medical, social, and legal concern. Years of research assessing potential pharmacotherapies for cocaine dependence have not yielded a single effective medication suggesting a different drug development strategy is needed . Cocaine increases central catecholamines that Are linked to its positive subjective and reinforcing effects . Drugs with similar pharmacological action to that of cocaine such as d-amphetamine (AMPH) and medically formulated methamphetamine (METH) administered chronically produce tolerance to its reinforcing effects and may be useful in treating cocaine dependence. Indeed, numerous preclinical animal studies show that chronic treatment with AMPH or METH produces tolerance to cocaine’s behavioral and reinforcing effects in animals [3-9]. Accordingly, recent clinical studies show that (AMPH) attenuates cocaine’s positive subjective effects  and that treatment with sustained-release METH reduces rates of cocaine positive urine and decreases craving for cocaine in cocaine-dependent individuals . Consistent with these studies, we review three unique case histories of METH-dependent participants previously addicted to cocaine who abruptly stopped when they started using METH. In essence, they stated that METH “cured” them of their cocaine addiction.
Materials and Methods
A detailed demographic and drug use history was obtained during a basic screening interview for admission into one of our clinical laboratory trials [12,13]. Participants tested positive for METH on initial screening yet none demonstrated overt clinical signs of METH intoxication. Participant primary and secondary screens were reviewed. Further interviews with the individual by a physician provided more thorough background information regarding their previous addiction to cocaine. Inquiry was aimed at why they thought METH may have helped them and what new adverse consequences they may have experienced by abusing another highly addictive substance.
Participant 1 (P1)
P1 was a 40 year-old male Caucasian of Philippine descent who used cocaine and alcohol heavily prior to 2005. By his own estimation he was “severely” addicted to cocaine and alcohol. Addiction to these substances directly contributed to numerous adverse interactions with law enforcement and irreparable harm in relations with his family and friends. Although his immediate family was wealthy, he was in constant financial difficulty. He described cocaine as the “ultimate evil” that brought out the “hater” in him. Depression, suicidal ideation, financial stress and threats of violence from cocaine dealers forced him to leave his home. Soon after he moved to Houston, he was given METH at a party and felt it had “benefitted his being”. He preferred METH over cocaine, stating that the “high” was cleaner and longer lasting than cocaine. He liked the cognitive effects, and felt he was productive when taking METH. He stated emphatically that he had not used, nor had any craving for cocaine or alcohol, since first starting METH even when given the opportunity to use these substances. During screening, he reported that he used METH 25 days out of the 30 prior to the interview and no cocaine or alcohol for 4 years. Similar to consequences he suffered when abusing cocaine, he continued to have financial and legal problems related to his heavy METH intake. In contrast to his past cocaine and alcohol abuse, METH had no effects on his daily nicotine (1 pack per day) and cannabis (2 joints per day) use. In fact, P1 indicated that cannabis, but not nicotine, increased both the ‘high’ and ‘desire’ associated with using METH.
Participant 2 (P2)
P2 was a 40 year old, Caucasian male musician who had some success touring and recording with various popular bands in the 1980s and 1990s. He described his 20 years of heavy drinking and 10 years of abusing cocaine as “insane” yet “normal” (similar to his peers) given his profession. He also worked as a bar tender, which allowed him continuous access to alcohol when he was not touring with his band. Four years ago he stopped doing cocaine and alcohol after he tried METH. According to P2, METH allowed him to be more productive even though he felt he rarely finished any projects he initiated. His last gainful employment was in 2009 teaching guitar lessons which he left likely due to paranoia secondary to METH. Similarly, P2 stated that the reason he left his last band was because the leader: “kept giving me that evil eye, ya know, when they look at you like that, it’s a bad sign. I got out. ”Like P1, P2 felt that the METH high was ‘smoother’ and lasted much longer so it was worth the money, as compared to cocaine. On initial screening, he stated he had ½ a beer in the last 30 days and no craving for either cocaine or alcohol. Interestingly, METH did not alter P2’s daily cannabis (unspecified amount) or nicotine (1 pack per day) use. P2’s responses on our multiple drug use questionnaire indicated that cannabis reduced the ‘high’ associated with METH and decreased ‘desire’ for the drug whereas nicotine had not effect.
Participant 3 (P3)
P3 was a 30 year old Hispanic male, who had been using METH for 7 years. At screening he stated he had used cocaine heavily for approximately 2 years and alcohol for 14 years. He last ingested cocaine in 2005 and described his present alcohol use as 1-2 times a month at the most. Similar to both P1 and P2 METH completely abolished his desire for cocaine and alcohol. Asked why this may be the case he offered that on one occasion he took cocaine while on METH and ‘felt nothing’ and that “METH smokes coke”, implying that METH blocked cocaine’s effects. Similar to the participants reviewed above, P3 enjoyed METH’s cognitive effects and felt he was more productive yet he always needed money to support his large METH intake (approximately 1 gram per day). He was inconsistently employed and held numerous jobs often circumventing resources from them clandestinely. He also stated that METH enhanced his sexual performance, which was important to him since he worked in pornography. METH did not alter his daily cannabis (2-3 joints per day) or nicotine (½ pack per day) use. P3’s multiple drug use questionnaire responses indicated that cannabis increased METH’s ‘high’ which he described the combination as a “roller coaster ride”. In contrast, cannabis decreased ‘desire’ for METH whereas nicotine had no appreciable effects.
These cases appear to support preclinical and clinical studies Suggesting that chronic treatment with AMPH-like stimulants— such as METH—may be efficacious for cocaine dependence [11,14]. Interestingly, each participant’s craving for cocaine was abolished once they began using METH. In general, all stated that they liked the ‘high’ better than cocaine. This could suggest that they are likely replacing one addictive substance for another similar to methadone maintenance therapy for opioid dependence. Still, once they started using METH, their craving for cocaine was abolished. Moreover, the one participant who ingested cocaine while on METH felt no effects from the drug indicating that cocaine’s positive subjective effects were blocked. This anecdote is consistent with recent controlled clinical studies showing that chronic treatment with AMPH blocks cocaine’s positive subjective effects and Sustained release formulations of METH decrease cocaine use in humans [10,11]. The neurobiological basis by which chronic METH decreases cocaine’s subjective effects is unknown. Evidence suggests however, a tolerance-inducing mechanism [4,6]. AMPH and METH are not viable treatments for cocaine dependence due to high abuse liability and obvious adverse social, financial and psychiatric consequences associated with use of these stimulants as demonstrated by the cases described above. Medications used to treat attention deficit hyperactivity disorder in children and adolescents in sustained –release formulations may be a better option. Also, stimulant prodrugs like Lisdexamfetamine dimesylate that is activated only after it is metabolized may offer a viable option since their inherent slow onset of action and entry into the CNS reduces abuse liability [2,15]. Our research group is currently planning laboratory studies assessing stimulant pro-drugs as potential medications for cocaine dependence.
- Karila L, Gorelick D, Weinstein A, Noble F, Benyamina A, et al. (2007) New treatments for cocaine dependence: a focused review. Int J Neuropsychopharmacol 11: 425-438.
- Volkow ND, Wang GJ, Fowler JS, Gatley SJ, Ding YS, et al. (1996) Relationship between psychostimulant-induced “high” and dopamine transporter occupancy. Proc Natl Acad Sci U S A. 93: 10388-10392.
- Emmett-Oglesby MW, Wood DM (1986) Substitution and cross-tolerance profiles of phenmetrazine and diethylpropion in rats trained to detect the stimulus properties of cocaine. NIDA Res Monogr 67: 154-160.
- Peltier RL, Li DH, Lytle D, Taylor CM, Emmett-Oglesby MW (1996) Chronic d-amphetamine or methamphetamine produces cross-tolerance to the discriminative and reinforcing stimulus effects of cocaine. J Pharmacol Exp Ther 277: 212-218.
- Leith NJ, Kuczenski R (1981) Chronic amphetamine: tolerance and reverse tolerance refl ect different behavioral actions of the drug. Pharmacol Biochem Behav 15: 399-404.
- Negus SS, Mello NK (2003) Effects of chronic d-amphetamine treatment on cocaine- and food-maintained responding under a second-order schedule in rhesus monkeys. Drug Alcohol Depend 70: 39-52.
- Negus SS, Mello NK, Blough BE, Baumann MH, Rothman RB (2007) Monoamine releasers with varying selectivity for dopamine/norepinephrine versus serotonin release as candidate “agonist” medications for cocaine dependence: studies in assays of cocaine discrimination and cocaine selfadministration in rhesus monkeys. J Pharmacol Exp Ther 320: 627-636.
- Negus SS (2003) Rapid assessment of choice between cocaine and food in rhesus monkeys: effects of environmental manipulations and treatment with d-amphetamine and flupenthixol. Neuropsychopharmacology 28: 919-931.
- Czoty PW, Martelle JL, Nader MA (2010) Effects of chronic d-amphetamine administration on the reinforcing strength of cocaine in rhesus monkeys. Psychopharmacology 209: 375-382.
- Rush CR, Stoops WW, Hays LR (2009) Cocaine effects during D-amphetamine maintenance: a human laboratory analysis of safety, tolerability and efficacy. Drug Alcohol Depend 99: 261-271.
- Mooney ME, Herin DV, Schmitz JM, Moukaddam N, Green CE, et al. (2009) Effects of oral methamphetamine on cocaine use: a randomized, doubleblind, placebo-controlled trial. Drug Alcohol Depend 101: 34-41.
- Newton TF, De La Garza R, Grasing K (2010) The angiotensin-converting enzyme inhibitor perindopril treatment alters cardiovascular and subjective effects of methamphetamine in humans. Psychiatry Res 179: 96-100.
- De La Garza R, Zorick T, London ED, Newton TF (2010) Evaluation of modafinil effects on cardiovascular, subjective, and reinforcing effects of methamphetamine in methamphetamine-dependent volunteers. Drug Alcohol Depend 106: 173-180.
- Grabowski J, Rhoades H, Schmitz J, Stotts A, Daruzska LA, et al. (2001) Dextroamphetamine for cocaine-dependence treatment: a double-blind randomized clinical trial. J Clin Psychopharmacol 21: 522-526.
- Mattingly G (2010) Lisdexamfetamine dimesylate: a prodrug stimulant for the treatment of ADHD in children and adults. CNS Spectr 15: 315-325.
Citation: Haile CN, De La Garza R, Newton TF (2010) Methamphetamine Cured my Cocaine Addiction. J Addict Res Ther 1:103. DOI: 10.4172/2155-6105.1000103
Copyright: © 2010 Haile CN, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Select your language of interest to view the total content in your interested language
Share This Article
Open Access Journals
- Total views: 14599
- [From(publication date): 10-2010 - Jan 21, 2021]
- Breakdown by view type
- HTML page views: 10720
- PDF downloads: 3879