ABSTRACT
Compulsive foraging behavior associated with use of crack cocaine involves compulsively searching the environment for possibly misplaced pieces of crack. Of 41 crack cocaine addicts evaluated, 33 (80.5%) reported at least some compulsive foraging associated with use of crack; 21 (51.2%) reported such behavior as always associated with crack use. The mean length of time spent in compulsive foraging was 90 minutes. Cocaine-induced foraging may represent a drug-induced model of a type of compulsive behavior.
Subject(s)
Compulsive Behavior/etiology , Crack Cocaine , Substance-Related Disorders/complications , Adult , Compulsive Behavior/diagnosis , Compulsive Behavior/psychology , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Stereotyped Behavior , Substance-Related Disorders/psychologyABSTRACT
OBJECTIVE: Excessive exposure to glucocorticoids can have neurotoxic effects. The behavioral, cognitive, and neurochemical changes observed following the cessation of heavy drinking, therefore, may be associated with disturbances of the hypothalamic-pituitary-adrenal (HPA) axis. To investigate HPA axis disturbances during the ethanol withdrawal syndrome, the authors examined diurnal changes in plasma cortisol in six alcohol-dependent men following the abrupt discontinuation of alcohol intake. METHOD: Plasma cortisol concentrations were quantified every 30 minutes for 24 hours in the early stage (1 day after cessation) and the middle to late stage (3 days after cessation) of the ethanol withdrawal syndrome as well as after the resolution of acute symptoms (8 days or more after cessation). RESULTS: Plasma cortisol concentrations were almost twice as high during acute withdrawal as they were following recovery. The duration of the cortisol diurnal cycle on the first day of withdrawal was negatively correlated with the severity of withdrawal. CONCLUSIONS: There is a marked activation of the HPA axis associated with the ethanol withdrawal syndrome. The authors hypothesize that this activation may account for some of the signs and symptoms of acute and subacute withdrawal. They discuss the potential long-term physiological effects of the episodic increases in cortisol associated with repeated episodes of ethanol withdrawal. The alterations in cortisol rhythmicity during early withdrawal may also have clinical implications.
Subject(s)
Alcoholism/blood , Ethanol/adverse effects , Hydrocortisone/blood , Substance Withdrawal Syndrome/blood , Adult , Circadian Rhythm , Humans , Hydrocortisone/physiology , Hypothalamo-Hypophyseal System/physiopathology , Male , Pituitary-Adrenal System/physiopathology , Substance Withdrawal Syndrome/etiology , Substance Withdrawal Syndrome/physiopathology , TemperanceSubject(s)
Crack Cocaine/adverse effects , Pursuit, Smooth/drug effects , Substance-Related Disorders/physiopathology , Adult , Basal Ganglia/drug effects , Basal Ganglia/physiopathology , Cerebral Cortex/drug effects , Cerebral Cortex/physiopathology , Chronic Disease , Humans , Male , Pursuit, Smooth/physiology , Reference Values , Schizophrenia/physiopathology , Schizophrenia/rehabilitation , Schizophrenic Psychology , Substance-Related Disorders/rehabilitationABSTRACT
The authors have investigated the function of the hypothalamic-pituitary-adrenocortical (HPA) axis during and after withdrawal from alcohol. 24 hour rhythms of cortisol were abnormal in that elevated levels were seen throughout the day in patients with moderate to severe, but not mild, withdrawal. This abnormality of circadian secretion of cortisol, which is similar to that seen in Cushing's syndrome and post-operative trauma, returned to normal after a period of one week of abstinence on their in-patient ward. Such excessive secretion of cortisol may explain some of the complications of chronic alcoholism.