The cocaine-AIDS connection.

The cocaine-AIDS connection

Bad news and good come from last week's 50th anniversary meeting of the Committee on Problems of Drug Dependence, held in North Falmouth, Mass. While the overall incidence of AIDS among intravenous drug users remains about the same, the use of injected cocaine is rising, as is exposure to the AIDS virus in those users, reports Don C. Des Jarlais of the New York State Division of Substance Abuse Services in New York City. "We don't fully understand the dynamics of this," he said prior to the meeting. "But one reason is the 'binge use,' with users sharing a needle for injection many times in a short period, unlike heroin addicts, who fall asleep after injection."

The potential for further spread of the virus by this route is worrisome, Des Jarlais told SCIENCE NEWS, because studies in New York City and San Francisco show that people who inject cocaine are the drug users most likely to test positive for infection by the AIDS virus. At the same time, he says, "We're starting to see a real reduction in the rate of new infections; drug users are changing their behavior -- something it was widely believed would never happen."

On the darker side, no effective large-scale treatment of cocaine abuse exists, and relapses are common. But systematic trials of various therapies, begun four and five years ago, are now near completion, and other research is beginning to unravel the nature of cocaine withdrawal. Animal studies indicate cocaine use may produce a true physiological addiction and changes the brain's capacity to regulate mood. "The result in users is a diminution of the ability to experience pleasure -- they feel bored," says Frank H. Gawin of Yale University. Gawin and his colleagues have treated addicts with an antidepressant, desipramine. Across the United States, researchers are conducting long-term trials of this and related drugs, which together with psychotherapy, he says, "may help."