Cocaine


Rep. Trey Radel, a Florida Republican elected in 2012, will be in court Wednesday on charges that he possessed cocaine.

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Radel, 37, was charged with misdemeanor possession of cocaine in D.C. Superior Court on Tuesday.

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He faces a maximum of 180 days in jail, as well as a fine of up to $1,000. Several sources with direct knowledge say it was the FBI and Drug Enforcement Administration who were involved in the charges.

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Radel has missed all four votes in the House this week.

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Radel, in a statement released by his office, made no mention of resigning from the House. He said he struggles “with the disease of alcoholism, and this led to an extremely irresponsible choice. As the father of a young son and a husband to a loving wife, I need to get help so I can be a better man for both of them.”

A spokesman for Speaker John Boehner (R-Ohio) said, “Members of Congress should be held to the highest standards, and the alleged crime will be handled by the courts. Beyond that, this is between Rep. Radel, his family, and his constituents.”

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The U.S. Attorney’s office for the District of Columbia declined to comment on Radel’s arrest and case.

The Associated Press, citing an unnamed DEA official, said Radel allegedly bought cocaine from a dealer in the Dupont Circle area who had been previously arrested as part of a federal probe. “Later that night, federal authorities went to his apartment and informed him that he would be facing criminal charges related to his purchase of cocaine,” the AP said.

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The Florida Republican, who holds a district on the western coast of Florida that includes the tony Marco Island, is a former journalist, TV anchor and radio talk-show host. He never held elective office before winning his House seat last November. His district was vacated by former Rep. Connie Mack (R-Fla.), who ran for the Senate.

In the statement, Radel said he realizes “the disappointment my family, friends and constituents must feel. Believe me, I am disappointed in myself, and I stand ready to face the consequences of my actions.”

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The arrest, he said, has a “positive side.”

“It offers me an opportunity to seek treatment and counseling,” he said. “I know I have a problem and will do whatever is necessary to overcome it, hopefully setting an example for others struggling with this disease.”

Text by John Bresnahan and Jake Sherman (Politico), 11/19/2013

Actor Charlie Sheen, known for his heavy cocaine use, has been stating in interviews that he freed himself of his drug habit. How likely is that?


When asked recently on The Today Showhow he cured himself of his addiction, Two and a Half Men sitcom star Charlie Sheen replied, “I closed my eyes and made it so with the power of my mind.”
Until last month, he was the highest paid actor on TV, despite his well-known bad-boy lifestyle and persistent problems with alcohol and cocaine. After the rest of his season’s shows were canceled by producers, Sheen has gone on an interview tear with many bizarre statements, including that he is on a “winning” streak. His claims of quitting a serious drug habit on his own, however, is perhaps one of his least eccentric statements.

A prevailing view of substance abuse, supported by both the National Institute on Drug Abuse and Alcoholics Anonymous, is the disease model of addiction. The model attributes addiction largely to changes in brain structure and function. Because these changes make it much harder for the addict to control substance use, health experts recommend professional treatment and complete abstinence.

But some in the field point out that many if not most addicts successfully recover without professional help. A survey by Gene Heyman, a research psychologist at McLean Hospital in Massachusetts, found that between 60 to 80 percent of people who were addicted in their teens and 20s were substance-free by their 30s, and they avoided addiction in subsequent decades. Other studies on Vietnam War veteranssuggest that the majority of soldiers who became addicted to narcotics overseas later stopped using them without therapy.

Scientific American spoke with Sally Satel, a resident scholar at the American Enterprise Institute for Public Policy Research and lecturer in psychiatry at the Yale University School of Medicine, about quitting drugs without professional treatment. Satel was formerly a staff psychiatrist at the Oasis Clinic in Washington, D.C., where she worked with substance abuse patients.

[An edited transcript of the interview follows.]

Is it possible to cure yourself of addiction without professional help? How often does that happen?

Of course it’s possible. Most people recover and most people do it on their own. That’s in no way saying that everyone should be expected to quit on their own and in no way denies that quitting is a hard thing to do. This is just an empirical fact. It is even possible that those who quit on their own could have quit earlier if they sought professional help. The implicit message isn’t that treatment isn’t important for many—in fact it should probably be made more accessible—but it is simply a fact that most people cure themselves.

How do addicts stop on their own?

They have to be motivated. It takes the realization that their family, their future, their employment—all these—are becoming severely compromised. The subtext isn’t that they just “walk away” from the addiction. But I’ve had a number of patients in the clinic whose six-year-old says, “Why don’t you ever come to my ball games?” This can prompt a crisis of identity causing the addict to ask himself, “Is this the type of father I want to be?”

If not, there are lots of recovery strategies that users figure out themselves. For example, they change whom they associate with. They can make it harder to access drugs, perhaps by never carrying cash with them. People will put obstacles in front of themselves. True, some people decide they can’t do it on their own and decide to go into treatment—that’s taking matters into one’s own hands, too.


What do professional drug addiction programs offer that is difficult to replicate on one’s own?


If you’re already in treatment, you’ve made a big step. Even for court-ordered treatment, people often internalize the decision as their own. You get a lot of support. You get instruction in formal relapse prevention therapy. You might get methadone for withdrawal and medications for an underlying psychiatric problem.

Most experts regard drug addiction as a brain disease. Do you agree?
I’m critical of the standard view promoted by the National Institute on Drug Abuse that addiction is a brain disease. Naturally, every behavior is mediated by the brain, but the language “brain disease” carries the connotation that the afflicted person is helpless before his own brain chemistry. That is too fatalistic.

It also overlooks the enormously important truth that addicts use drugs to help them cope in some manner. That, as destructive as they are, drugs also serve a purpose. This recognition is very important for designing personalized therapies.


Don’t most studies show that addicts do better with professional help?


People who come to treatment tend to have concurrent psychiatric illness, and they also tend to be less responsive to treatment. Most research is done on people in a treatment program, so by definition you’ve already got a skewed population. This is called the “clinical illusion,” and it applies to all medical conditions. It refers to a tendency to think that the patients you see in a clinical setting fully represent all people with that condition. It’s not true. You’re not seeing the full universe of people.


Based on his public interviews, does it seem likely that Charlie Sheen cured himself?


I doubt it. Of course, I haven’t examined him, but based on what one sees, one would be concerned about ongoing drug use and underlying mental illness.


Is there brain damage from drug use? Is it possible to recover from such damage?


The only drugs that are neurotoxic are alcohol, methamphetamine, probably MDMA [ecstasy], and some inhalants.* Cocaine can lead to micro strokes. That’s brain damage. Yes, addiction changes the brain but this does not doom people to use drugs forever. The most permanent change is memories. Some people have stronger memories and they are more cue-reactive [more reactive to stimulus that triggers the reward pathway]. Nonaddicts won’t show that level of cue-reactivity.

For some people the addiction and withdrawal will be more intense through genetically mediated problems. Those people have a harder time stopping.


What else might account for Charlie Sheen’s strange behavior in those interviews?


One would want to explore the possibility of underlying psychiatric problems. The grandiosity, the loose associations, the jumbled flow suggest a thought disorder. Heavy, heavy drug use could cause that. Stimulant use can cause temporary thought disorder or intensify an underlying thought disorder or hypomanic state. To try to make a good diagnosis, whatever ongoing drug use there is would have to stop. After the withdrawal phase is resolved clinicians would then need to see if an underlying thought or mood disorder persisted. That would aid in parsing how much of a confusing clinical picture is due to drug use and how much is due to a primary mental disorder.


By Nina Bai , March 4, 2011

It’s hardly a secret that taking cocaine can change the way you feel and the way you behave. Now, a study published in the Jan. 8 issue of Science shows how it also alters the way the genes in your brain operate. Understanding this process could eventually lead to new treatments for the 1.4 million Americans with cocaine problems, and millions more around the world.

The study, which was conducted on mice, is part of a hot new area of research called epigenetics, which explores how experiences and environmental exposures affect genes. “This is a major step in understanding the development of cocaine addiction and a first step toward generating ideas for how we might use epigenetic regulation to modulate the development of addiction,” says Peter Kalivas, professor of neuroscience at the Medical University of South Carolina, who was not associated with the study. 

Though we think about our genes mostly in terms of the traits we pass on to our children, they are actually very active in our lives every day, regulating how various cells in our bodies behave. In the brain this can be especially powerful. Any significant experience triggers changes in brain genes that produce proteins — those necessary to help memories form, for example. But, says the study’s lead author, Ian Maze, a doctoral student at Mount Sinai School of Medicine, “when you give an animal a single dose of cocaine, you start to have genes aberrantly turn on and off in a strange pattern that we are still trying to figure out.”
Maze’s research focused on a particular protein called G9a that is associated with cocaine-related changes in the nucleus accumbens, a brain region essential for the experience of desire, pleasure and drive. The role of the protein appears to be to shut down genes that shouldn’t be on. One-time use of cocaine increases levels of G9a. But repeated use works the other way, suppressing the protein and reducing its overall control of gene activation. Without enough G9a, those overactive genes cause brain cells to generate more dendritic spines, which are the parts of cells that make connections to other cells.
Increases in the number of these spines can reflect learning. But in the case of addiction, that may involve learning to connect a place or a person with the desire for more drugs. Maze showed that even after a week of abstinence, mice given a new dose of cocaine still had elevated levels of gene activation in the nucleus accumbens, meaning G9a levels were still low. It is not known how long these changes can last. Maze also showed that when he intervened and raised G9a levels, the mice were less attracted to cocaine.
It’s a big leap from a mouse study to a human study, of course — and an even bigger leap to consider developing a G9a-based treatment for addiction. The protein regulates so many genes that such a drug would almost certainly have unwanted and potentially deadly side effects. But a better understanding of the G9a pathways could lead to the development of safer, more specific drugs. And studying the genes that control G9a itself could also help screen people at risk for cocaine addiction: those with naturally lower levels of the protein would be the ones to watch. Still, there’s a lot to be learned even from further mouse studies — particularly if the work involves younger mice, unlike the adults used in Maze’s research. (See the top 10 medical breakthroughs of 2009.)


“We know that the greatest vulnerability [to addiction] occurs when adolescents are exposed,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse, which funded the study. “Would you see the same results in adolescent [mice]? And what happens during fetal exposure?”
New treatments are definitely needed for cocaine addiction: there are helpful medications for addiction to heroin and similar drugs, but so far, none are particularly useful against stimulants like cocaine and methamphetamine. And with federal reports now showing that more than two-thirds of all cocaine in the country is cut with a veterinary deworming drug called levamisole, which can cause potentially fatal immune-system problems, the risks from cocaine are greater — and the search for new answers more urgent than ever.

 

* By Maia Szalavitz Friday, Jan. 08, 2010