Subjective response during continuous infusion of cocaine.

The relationship between the subjective effects induced by IV cocaine injection(s) and cocaine plasma concentrations is complex and difficult to interpret. We designed a study in which bolus loading doses of cocaine followed by 4-hr placebo infusions were compared with the same bolus loading doses of cocaine followed by 4-hr infusions of cocaine calculated to maintain the peak plasma concentrations produced by the bolus. Seven cocaine-using volunteers were successfully studied using a randomized double-blind design, in which self- and observer-rating scales were used to measure drug effects. After the cocaine bolus loading doses, scores for most subjective measures remained elevated when the bolus was followed by a cocaine infusion. In contrast, the subjective responses returned to baseline when the bolus was followed by a placebo infusion. However, self-estimates of the intensity of the cocaine "rush" were not altered by the presence of active cocaine infusions and returned rapidly to baseline.