Dec 21, 2002

Understanding polydrug use: review of heroin and cocaine co-use

Addiction
Francesco LeriJ. Stewart

Abstract

The use of cocaine by heroin-dependent individuals, or by patients in methadone or buprenorphine maintenance treatment, is substantial and has negative consequences on health, social adjustment and outcome of opioid-addiction treatment. The pharmacological reasons for cocaine use in opioid-dependent individuals, however, are poorly understood and little is known about the patterns of heroin and cocaine co-use. We reviewed anecdotal evidence suggesting that cocaine is co-used with opioid drugs in a variety of different patterns, to achieve different goals. Clinical and preclinical experimental evidence indicates that the simultaneous administration of cocaine and heroin (i.e. 'speedball') does not induce a novel set of subjective effects, nor is it more reinforcing than either drug alone, especially when the doses of heroin and cocaine are high. There is mixed evidence that the subjective effects of cocaine are enhanced in individuals dependent on opioids, although it is clear that cocaine can alleviate the severity of symptoms of withdrawal from opioids. We also reviewed preclinical studies investigating possible neurobiological interactions between opioids and cocaine, but the results of these studies have been difficult to in...Continue Reading

  • References146
  • Citations175

Citations

Mentioned in this Paper

Central Nervous System
Heroin
Cocaine Dependence
Cocaine
Opioid analgesics
Min-I-Jet Morphine Sulphate
Methadone
Combination of crack and heroin
Cocaine Measurement
Cocaine Hydrochloride

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