Abstract
Background: Cocaine use disorder (CUD) is a growing public health concern, but so far no effective pharmacotherapies have been demonstrated. Stimulant medications have proved to be promising in CUD treatment. The self-medication hypothesis (SMH) can help to explain this phenomenon better, especially in cases where CUD co-occurs with adult attention deficit hyperactivity disorder (A-ADHD). Methods: In the present retrospective study, a sample of 20 consecutive patients (aged from 18 to 65 years) with dual disorder (A-ADHD/CUD), under treatment with methylphenidate (MPH) or atomoxetine (ATM) medications, was followed to study the effects of A-ADHD treatment on cocaine use. Patients were followed for a mean period of 7 months (minimum 1, maximum 30 months). All individuals were assessed with standardized questionnaires to evaluate diagnosis, treatment efficacy, and clinical improvement. Results: the results showed that behaviors reflecting cocaine addiction were sharply reduced during the stimulant treatment of A-ADHD, and were not correlated with age, gender, familiarity, length of treatment, or medication used. CUD improvement was closely correlated with the A-ADHD improvement. This study supports the validity of the SMH in ADHD patients with co-occurring CUD.
Highlights
Cocaine use disorder (CUD) is a growing public health concern
Research information on patients included in the present study came from the adult attention deficit hyperactivity disorder (A-attention deficit hyperactivity disorder (ADHD)) Clinic (A-ADHD outpatient clinic) study, a cohort study including information on individual patients admitted to stimulant medication treatment for A-ADHD at the Second Psychiatric Unit of Santa Chiara
For the aims of the present study, data collected at the time of enrolment into the study and at the last available evaluation, invariably including the presence of a condition of cocaine use in each patient, were extracted from the A-ADHD-Clinic dataset
Summary
Cocaine use disorder (CUD) is a growing public health concern. As estimated in the annualWorld Drug Report for 2018 of the United Nations Office for Drugs and Crime (WDR 2018), in 2016, the number of past-year cocaine users increased globally by almost 7% from the previous year to18.2 million (range: 13.9–22.9 million). Cocaine use disorder (CUD) is a growing public health concern. Cocaine use disorder (CUD) is a growing public health concern, but so far no effective pharmacotherapies have been demonstrated. Stimulant medications have proved to be promising in CUD treatment. The self-medication hypothesis (SMH) can help to explain this phenomenon better, especially in cases where CUD co-occurs with adult attention deficit hyperactivity disorder (A-ADHD). Methods: In the present retrospective study, a sample of 20 consecutive patients (aged from 18 to 65 years) with dual disorder (A-ADHD/CUD), under treatment with methylphenidate (MPH) or atomoxetine (ATM) medications, was followed to study the effects of A-ADHD treatment on cocaine use. Results: the results showed that behaviors reflecting cocaine addiction were sharply reduced during the stimulant treatment of A-ADHD, and were not correlated with age, gender, familiarity, length of treatment, or medication used. This study supports the validity of the SMH in ADHD patients with co-occurring CUD
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