According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2013, the number of current cocaine users ages 12 or older was 1.5 million. From 2010 to 2017, the number of cocaine-related deaths increased by 3.5, topping out at almost 15,000. Despite the widespread problem, as of now there are no FDA approved medications to treat cocaine addiction, nor is there an overdose-reversing drug. Treatment currently consists of behavioral therapy such as cognitive-behavioral therapy, contingency management or motivational incentives, and community-based programs. However, researchers have recently begun looking at a most unlikely possibility for improving brain function in people with cocaine addictions – the ADHD drug Ritalin.
The theory is that one reason people become addicted is that they have less self-control. The area of the brain called the orbitofrontal cortex (OFC), a part of the frontal lobe that is in charge of the decision-making process, is responsible for the decision to take or not take a drug. The OFC gets information from two regions of the brain: the nucleus accumbens (NAcc), which learns about rewards, and the prefrontal cortex (PFC) and Anterior Cingulate Cortex (ACC), which inhibit impulse and keeps craving under control. In a person who is not an addict, the ACC and PFC usually have the most control, telling the OFC to not give in to the desire to take the drug. However, in people who are predisposed to addiction, the NAcc is stronger, and every time that person uses a drug it affects that part of the brain that makes you feel reward and pleasure, increasing its sensitivity to both the drug and its cravings. At the same time, it weakens the control you have over your inhibitions, further misguiding the OFC.
This is where Ritalin comes in. It’s a stimulant, like cocaine, that increases dopamine levels, although it works at a slower pace and over a longer period of time. This means there’s no sudden rush of dopamine. This is similar to how methadone is used to wean people off of heroin, by providing a longer lasting effect. Ritalin is also known to increase cognitive control – which is why some people improperly use it when cramming for tests – which theoretically means it could help shore up the OFC against misdirection.
In a study published in JAMA Psychiatry, researchers from the Icahn School of Medicine at Mount Sinai evaluated 18 cocaine addicts. Each was given either a single oral dose of Ritalin or a placebo and then had their brains scanned by MRIs. The brain scans showed that a single dose of Ritalin was enough to strengthen connectivity between these areas of the brain that regulate emotion and behavior control.
Keep in mind, however, that you don’t want to trade one drug for another. Ritalin, along with other ADHD medications, is frequently abused. Fortunately, it’s difficult to develop a dependence to the drug if you aren’t actively misusing it.
If you or a loved one need help with quitting drugs or alcohol, consider Asana Recovery. We offer medical detox, along with both residential and outpatient programs, and you’ll be supervised by a highly trained staff of medical professionals, counselors, and therapists. Call us any time at (949) 438-4504 to get started.
