University of Kentucky College of Medicine, Center on Drug and Alcohol Research, Department of Behavioral Science, 515 Oldham Court, Lexington, KY 40502, USA.
Drug Alcohol Depend. 2010 Jan 1;106(1):28-37. doi: 10.1016/j.drugalcdep.2009.07.011. Epub 2009 Aug 29.
Cocaine has high abuse liability but only a subset of individuals who experiment with it develop dependence. The DSM-IV (APA. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-R. American Psychiatric Association, Washington, DC, 2000) provides criteria for diagnosing cocaine abuse and cocaine dependence as distinct disorders- the latter characterized by additional symptoms related to loss of control over drug use. In this study, two groups of cocaine users (n=8/group), matched on demographic factors and length of cocaine use history and meeting criteria for either cocaine abuse (CocAb) or cocaine dependence (CocDep), were compared on (1) measures related to impulsivity and sensation seeking, (2) response to experimenter-administered cocaine (0, 12.5, 25 and 50mg/70 kg, i.v.), and (3) cocaine self-administration using a Relapse Choice and a Progressive Ratio Procedure (0, 12.5 and 25mg/70 kg, i.v.). Groups did not differ on impulsivity or sensation seeking scores. After experimenter-administered cocaine, the CocAb group reported feeling more suspicious and observers rated them significantly higher on unpleasant effects (e.g., irritability, difficulty concentrating). In contrast, the CocDep group reported significantly greater desire for cocaine, which was sustained over the course of the study, and gave higher street value estimates for cocaine (p<0.05). While cocaine self-administration was dose-related and generally comparable across the two procedures, the CocDep users chose to take significantly more cocaine than the CocAb users. These data suggest that, while regular long-term users of cocaine with cocaine abuse or dependence diagnoses cannot be distinguished by trait measures related to impulsivity, they do exhibit significant differences with regard to cocaine-directed behavior and response to cocaine administration.
可卡因具有高度的滥用倾向，但只有一小部分尝试过可卡因的人会发展为依赖。DSM-IV（APA. 精神障碍诊断与统计手册 DSM-IV-R. 美国精神病学协会，华盛顿特区，2000 年）提供了诊断可卡因滥用和可卡因依赖的标准，这两种疾病是不同的——后者的特征是与药物使用失控相关的额外症状。在这项研究中，两组可卡因使用者（每组 8 人），在人口统计学因素和可卡因使用史长度上匹配，并且符合可卡因滥用（CocAb）或可卡因依赖（CocDep）的标准，分别在（1）与冲动性和寻求刺激相关的测量、（2）对实验者给予的可卡因（0、12.5、25 和 50mg/70kg，iv）的反应，以及（3）使用复发性选择和渐进性比率程序（0、12.5 和 25mg/70kg，iv）进行可卡因自我给药方面进行了比较。两组在冲动性或寻求刺激得分上没有差异。在实验者给予可卡因后，CocAb 组报告感到更加怀疑，观察者对他们的不愉快影响（如易怒、注意力不集中）的评分明显更高。相比之下，CocDep 组报告了对可卡因的强烈渴望，这种渴望在研究过程中持续存在，并且对可卡因的街头价值估计更高（p<0.05）。虽然可卡因自我给药与剂量有关，并且在两种程序中通常相似，但 CocDep 使用者选择摄入的可卡因明显多于 CocAb 使用者。这些数据表明，虽然具有可卡因滥用或依赖诊断的经常长期可卡因使用者不能通过与冲动性相关的特质测量来区分，但他们在可卡因导向行为和对可卡因给药的反应方面确实存在显著差异。
