Brain stimulation therapy.
IT took me many tricks - psychological, social, and medical - over twelve years before I was able to quit my smoking habit of 28 years! Many people were not as lucky as myself; they died of various lung diseases caused by smoking. Smoking marijuana or cocaine has additional consequences of behavioral, social and professional isolation while still alive.
Cocaine addiction affects the brain, central nervous system (CNS), and rest of the body. The brain effect includes altered responses to the essential neurotransmitters like dopamine, serotonin, acetylcholine, and GABA. This results in poor judgment, inability to make right decision and control impulses eventually leading to anxiety, dizziness, headache, psychosis, and confusion. The CNS effects include euphoria, excitement, increased energy, and fatigue leading to emotional instability, restlessness, tremors, and muscle jerks. Body effects may include nasal bleeding, bronchitis, chest pain, neck pain, respiratory failure and heart attack. Together, these effects isolate the surviving addicts from normal behavior and make them a social burden.
According to the National Institute of Drug Abuse, 22.5 million Americans abused illicit drugs in 2011 costing the nation 11 billion dollars relating to the resulting crime, lost productivity and healthcare. USA has 1.4 million cocaine addicts. Medium treatment-rehabilitation cost per patient is ~$10,000 per month. No similar statistics was available to me for Bangladesh except that "millions are addicted" to various drugs. An unverifiable cyber resource named Mukti, Prottay, and APON as 3 treatment and rehabilitation facilities in and around Dhaka, one costing 70,000 taka a patient!
The food and drug administration has not approved any treatment for cocaine addiction. A vaccine that relies on immunological properties of cells, is under development (Arch Gen Psychiatry 66:1116 (2009). The vaccine produces antibodies against cocaine and captures the drug in the blood stream before it reaches the brain. After trials in monkeys yielded promising results, human trials are awaiting. Two pharmacological approaches offer promises. A common blood pressure medication that I take daily, has been shown to make experimental mice "forget" the memory of cocaine (Neuropsychopharmacology, 36:1912 (2011). An anti-seizure drug mix, called topiramate, showed some promise by keeping human addicts free from cocaine crave for two weeks (Biol Psychiatry, 72:943, (2012).
Now experiments with small animals suggest that a noninvasive use of a magnet one day might cure the problem. This treatment should be rapid, potentially with fewer side effects than the pharmacological and immunological approaches. A research group at the University of California, San Francisco, cured cocaine dependency of addicted mice by generating the equivalent of a magnetic field in the pre-frontal cortex. This region of the brain controls impulses, decision making and behavioral flexibility that are affected by cocaine addiction.
The scientists introduced two light-gathering proteins called rhodopsin into the nerve cells in the pre-frontal cortex. Focusing a laser beam on this protein turned the nerve cells on or off. Compulsive behavior of the cocaine addiction was wiped out by turning on the cells, while addiction was created by turning them off. The results appeared online in the British journal Nature (April 3, 2013). These studies in animals suggest that a similar strategy might be applicable to cocaine-addicted humans.
Because a laser beam could be harmful, the same "on and off" effects could be generated on human subjects by an electromagnetic stimulation, called transcranial magnetic stimulation (TMS), outside the scalp.
The writer, a former Dhaka University teacher, is a biomedical scientist working in the USA.