European Stars And Stripes (Newspaper) - November 23, 1986, Darmstadt, Hesse                                Debate Over drug by Erik Eckholm new York times he treatment of cocaine addiction is a fledgling held but there is Little scientific evidence on which methods work Best according to experts. Systematic study of different treatments is urgent Wilh the surge in crack abuse experts say. Crack is purer than cocaine powder smoked rather than snorted and produces More intense highs followed by More intense lows addiction to crack is also Laster and More common. But no Ono knows Why some cocaine or crack users become add clod How Many Slop on their own or Wilh the Aid of self help groups and How Many of those treated stay off the drug for Good said or. Herbert d. Klaber of Yale University an authority on addictions. Federal scientists who research alternative treatment methods say the sparse data suggest More than half of those seeking help Lor cocaine addiction eventually return to the drug. A few private clinics claim that 70 percent who Complete their programs sometimes at enormous expense succeed in shaking their addiction. But treatment experts admit their experience with Crock users is limited. Many addicts drop out of treatment and those from lower socioeconomic groups show higher relapse rates. As demand for cocaine treatment soars experts Are now confronting questions similar to those debated it decades on alcoholism and heroin addiction. Does drug therapy help of Hurt should counselling be directed by former addicts or by professional psychotherapists which patients need to be hospitalized and should former cocaine addicts abstain permanently from alcohol Many Center a method derived Tram experience with alcoholics and heroin addicts Otten involving a 28-Day stay in a Hospital family and group therapy abstinence from All drugs and Long term participation in alcoholics Anonymous Type groups some clinics prefer outpatient treatment to hospitalization except in extreme cases. Other agencies stressing the need Lor a total restructuring of the addict s life and Outlook encourage slays of up to 18 months in an institution. Some centers Ana beginning to supplement psychological approaches with experimental drug therapies which promoters say produce better results. The drugs mainly anti depressants help reducing the addict s craving for cocaine during the critical Early months of abstinence. Others Call the benefits unproven and some oppose using drugs to combat a drug addiction. All the experts agree there is no such thing As a cure for cocaine addiction and no substitute Lor an individual s inner resolve to stay Clear of the drug. Experts say addicts and their families often take dramatic measures to break a cocaine habit such As a sojourn at a special Hospital while underestimating the Luxure Challenge. There s a misconception thai 30 Days in the Hospital can cure you said of. Arnold m. Washton director of addiction treatment at Regent Hospital in Manhattan. People need ongoing assistance. The problem is not to get off the drug for a week of two it s to get off for  drug therapy slams from new understanding of the biochemistry of cocaine addiction said or. Jeffrey s. Rosa can director of Columbia presbyterian medical Center s cocaine treatment unit. Scientists believe hunger for cocaine by heavy users especially Strong among chronic crack smokers is triggered by Subtle changes in brain chemistry. To Hai undermined the distinction traditionally drawn Between psychologically addicting drugs such As cocaine end physiologically addicting drugs such As heroin the craving for cocaine has physiological fool. According id theory cocaine stimulates euphoria by disrupting certain chemical messengers in the brain. Normally the chemicals carry a signal from one nerve ending to receptors in the next and Are then partly reabsorbed by the first nerve. Cocaine scientists believe blocks this reabsorption so Hal the chemical keeps sending us message of pleasure Over and Over Unta the chemical Breaks Down. Heavy cocaine use Over Lima depletes the Supply of messenger chemicals according to theory. This produces depression and the receptors on nerve cells become super sensitive almost As if the individual cells were craving More  Rosa can Eald. When heavy cocaine use is slopped the Supply of chemical messengers is built Back to Normal and the nerve cell receptors repair themselves within a few Days or months scientists believe during this Home yearnings for cocaine Are commonplace addicts tend to sleep excessively and feel depressed irritable and Low in Energy although individual patterns vary. Bui there is no physical illness like that suffered by heroin addicts in withdrawal most treatment programs rely on personal and group counselling often supplemented by frequent urine testing As proof of abstinence to get patients through the trying Early months. But certain anti depressant drugs can help ease the adjustment some scientists say Rosecan has Many patients take the anal depressant ill Pramane which he said helps repair the deranged  reducing the subliminal desire for cocaine. His clinic supplements the anti depressant with amino acids that help rebuild the chemical messengers More quickly. Use of these drugs for up to six months in combination with counselling usually on an outpatient basis Naa produced an improved Success rate Rosecan said. A group at Vale univ arty headed by Kleber is using a related anti depressant Desi praline often in combination with an anti viral drug that seems to Speed up the restoration of chemical messengers. Washton said his clinic does t prescribe drugs and develop to yearlong program q met Lugt to tit Fickter Mouv Atlon Tor d Tow Moil we a dicta or to fwd Frith a Teton my Ficili for psychiatric Proem Faraho to Ltd for imm Muni of two we is. But Emphurs lion of met ont in Almant Watton said. The Long term Success rate for participants is 70 percent he said comparable to the Yale group using drugs with psychotherapy. Aim homing drug tit Tupy Are centers like Phoenix House in new York a non profit program experienced in reeling heroin addicts. Tea emphasis Al Phoenix mouse sat Kevin Mceneaney. The director of clinical services la helping people confront their own problems and turn their lives around Many clients get extensive group and Amity counselling mainly by former drug addicts and live in Phoenix House up tol8 months. Clients Are helped getting into schools or fobs Mceneaney who also opposes methadone use by heroin addicts criticized the tendency to med Mcabe drug addiction. Drug treatment a said cannot substitute Lor addressing the Complex human problem  people seeking cocaine treatment Are con rolled with an array i choices and financial charges ranging from Zero for indigent people admitted to publicly supported facilities to $1,000 a Day at exclusive hospitals. The Best Way to proceed Teber Aid a to find a local expert with experience in this Field preferably one from a University with no personal financial interest in he Choice. The expert can advise on what approach is beat suited to the individual Case. One of the last frontiers How the brain works How drugs work i by Rob Stein United press International Hen a cocaine addict inhales a Ilkiew injects a Milky fix both set off Complex reactions in their brains which scientists Are just beginning to understand. As America launches its latest War on drugs researchers continue a decades Tong quest or insights into How cocaine heroin alcohol and other drugs make people High and Why some users become hooked. This is one of the fast frontiers in Medicine How the brain works and How drugs work in the  said or. Jeffrey Rosecan of the Columbia presbyterian medical Center in new York. The National Institute on drug abuse has spent about $600 million for research in the past decade answering some questions about the physiology of drug use and addiction. Scientists have found receptors Hal opiates use to stimulate brain cells. They have also identified chemicals influenced by cocaine and believe they understand How alcohol affects nerve cells. But How the brain cells produce feelings of euphoria the exact mechanisms of tolerance and addiction and the bes Way to break a habit and remain drug free remain largely As mysterious As the perplexing riddles of the brain itself. Anything that deals with drugs deals with the human brain and mental states of the human being said or. Marvin Snyder director of the division of Preckl Anicat research Al the National Institute on drug abuse. Wiry Little is known about the human  new synthetic designer drugs such As ecstasy Are even less understood. And yet undeveloped drugs of the future will pose new and even More mind boggling questions there will most Likely come a time not too far in the future when there will be chemicals that will la mood. Enhancers Hal May make you eel happier said Snyder. It raises a whole Host of what Are now science fiction  some of these drugs of tomorrow could be developed from what scientists have Learned about chemicals known As endogenous opiates discovered As part of research into heroin addiction the brain makes us own substances to produce. Pleasure and mask pain. These Are probably Al work when Lor example an athlete is injured bul decs nol actually feel the pain until much later. When people get a natural High it s thought they Are cocaine where the real action is in the brain 1 to synapse pc med As Between nerve in ring to to Mai impute. Nan to trigger a new ii a to Page 14 the stars and strikes