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A 28-Year-Old Man Addicted to Cocaine
Steven E. Hyman, MD, Discussant
JAMA. 2001;286:2586-2594.
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INTRODUCTION
DR REYNOLDS: Mr R is a healthy 28-year-old man with a 4-year history of cocaine addiction. He lives in Boston with his girlfriend. He has Massachusetts free care insurance coverage and sees his primary care physician, Dr B, at Beth Israel Deaconess Medical Center.
About 4 years ago at a party, Mr R first tried cocaine intranasally. Although he did not seek out more cocaine, about 6 months later, he smoked some cocaine. He has been pursuing smoked cocaine, or crack, ever since. He began using crack several times a day, subsequently losing jobs, apartments, and relationships. He stole a car from his family and money from his friends.
Family and friends have tried to help Mr R. He has been in 2 inpatient treatment programs, first referred by his brother and then by his parents. He stayed for 5 months of a 6-month program, . . . [Full Text of this Article]
MR R: HIS VIEW
DR B: HER VIEW
AT THE CROSSROADS: QUESTIONS FOR DR HYMAN
Epidemiology Risk Factors Acute Actions of Cocaine and Other Addictive Drugs Tolerance, Dependence, and Addiction Treatment Recommendations
QUESTIONS AND DISCUSSION
Author Affiliation: Dr Hyman is Director, National Institute of Mental Health, Bethesda, Md.
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