Unraveling cocaine metabolism in patients with cocaine use disorder for the purpose of potentially improving bioanalytical tests for cocaine use - Unraveling cocaine metabolism in patients with CUD

Start Date12 Nov 2024

Sponsor / Collaborator-

NCT06443255

/ CompletedPhase 3IIT

Comparison of Cocaine, Lidocaine/xylometazoline and Saline for Intranasal Analgesia - a Blinded Triple Crossover Study

When performed by trained personnel nasotracheal intubation is a safe and effective technique for attaining a secure airway in preparation for surgery of the head and neck. The procedure can be deemed necessary due to the nature of the surgical procedure or considerations in regard to the patient's comorbidities. For a certain group of patients with expected difficult airways, the procedure is done whilst they are awake and aided by fiberoptics.
For these awake patients, extra precautions must be taken to ensure the procedure is conducted with minimal pain and discomfort. The pain and discomfort arises from the mechanical manipulation of the nasal mucosa and can be alleviated in part by means of topical analgesia as well as through decongestion, providing more space within the nasal cavity. For these purposes, several drugs in varying combinations and dosages are used, but no single drug choice is universally recommended.
Cocaine is one of these appropriate drugs. It is a magistral formula used especially due to its unique combination of both vasoconstrictive and analgesic properties. Concerns have though been raised regarding cocaine's potential toxicity and alternative medications are continuously sought after.
A combination of lidocaine and xylometazoline can also be used for preparation of the nose prior to awake nasal fiberoptic intubation. Lidocaine contributes with its analgesic effect whilst xylometazoline functions as the vasoconstrictor.
The investigators wish to compare the analgesic effects of cocaine and lidocaine/phenylephrine to each other and saline when subjectively scored on a visual analogue scale of 0-100 mm immediately after simulated awake nasal intubation on healthy volunteers.

Start Date01 Jul 2024

Sponsor / Collaborator

Rigshospitalet

NCT05809453

/ CompletedPhase 1/2IIT

Intranasal Cocaine and Temperature Regulation During Exercise

Assess the effects of intranasal cocaine on temperature regulation and whole-body sweat rate during exercise in warm environmental conditions.

Start Date01 Sep 2023

Sponsor / Collaborator

The University of Texas Southwestern Medical Center

100 Clinical Results associated with Cocaine Hydrochloride

100 Translational Medicine associated with Cocaine Hydrochloride

100 Patents (Medical) associated with Cocaine Hydrochloride

49,673

Literatures (Medical) associated with Cocaine Hydrochloride

01 Jun 2025·Addictive Behaviors Reports

Do we need urine drug screens in opioid addiction treatment: An observational study on self-report versus urine drug screens

Article

Author: Hudson, Jacqueline ; Thabane, Lehana ; Dennis, Brittany B ; Worster, Andrew ; Samaan, Zainab ; McEvoy, Alannah ; Marsh, David C ; Rodrigues, Myanca

BackgroundThe substance use crisis continues to progress. Medication for Opioid Use Disorder (MOUD) are prescribed to reduce opioid use and related harms; however, many individuals continue to use substances while on treatment. The objective of this study was to describe the temporal and demographic trends of the agreement between self-reported and urine tested substances.MethodsThe current study is a retrospective secondary analysis of three phases of a prospective cohort study (Pilot 2011, Genetics of opioid addiction (GENOA) 2013-2017, and Pharmacogenetics of opioid substitution treatment (POST)) 2018-2022) spanning 2011-2022. We compared the self-reported substance use data for opioids, benzodiazepines, amphetamine/methamphetamine (AMP/MET), and cocaine with urine drug results. We compared the positive predictive value (PPV), false omission rate (FOR), sensitivity, and specificity between (i) different drugs; (ii) by sex, and (iii) age group at enrollment in each phase of the study using self-reported substance use at baseline and retrospective electronic health record data on urine drug screenings collected over the same time period.ResultsOverall, the average PPV and FOR for any drug across all phases was 80.7 % and 37.9 %, respectively. Sensitivity and specificity were highest for cocaine and lowest for benzodiazepines. We found no specific trend by sex. Lastly, we found a higher sensitivity for opioids and AMP/MET in those under 25 years of age compared to other age groups. PPV increased over time for benzodiazepines, AMP/MET and cocaine and FOR was higher during the pilot and POST phases than the GENOA phase.ConclusionOur study highlights the unique challenges associated with ascertaining substance use behaviour for individuals receiving MOUD, indicating many patients will accurately report substance use while others do not. It is therefore important to consider the context of the patient, and the type of the co-substance used to select patient-centred testing as indicated. Therefore, the answer to the question of do we need urine drug screen is yes in some cases.

01 Jun 2025·Addictive Behaviors Reports

A novel, multi-component contingency management intervention in the context of a syndemic of drug-related harms in Glasgow, Scotland: First year of the ‘WAND’ initiative

Article

Author: Smith, S ; Hutchinson, S J ; Trayner, K M A ; Priyadarshi, S ; Campbell, J ; Hunter, C ; Craik, J ; McAuley, A

BackgroundTo address high levels of drug-related harms among people who inject drugs (PWID) in Glasgow, a novel contingency management intervention was developed to engage high-risk PWID with four harm reduction measures (known as the WAND initiative: Wound care, Assessment of injecting, Naloxone, and Dried blood-spot test). Our aims were to assess if WAND engaged and re-engaged high-risk PWID.MethodsBaseline data of WAND participants (n = 831) from 1st Sept-2020 to 30th Aug-2021 were analysed. For those who took part in the first six months, extent of re-engagement was determined and, among those re-engaged, intervention coverage was compared between baseline and final engagement.ResultsAmong those who first engaged in WAND from Sept 2020-Feb 2021 (n = 546), 40 % re-engaged by Aug 2021. Compared to those who engaged once (n = 321), those who re-engaged (n = 215) within one year had higher baseline prevalence of injecting risk behaviours such as injecting daily (56 % vs 64 %, p = 0.032), injecting away from home (42 % vs 52 %, p = 0.0179), injecting cocaine (56 % vs 75 %, p < 0.001), having an SSTI (40 % vs 60 %, p < 0.001), and been prescribed naloxone (57 % vs 72 %, p < 0.001). For those who re-engaged six months to one year after initial engagement (n = 107), there was a significant increase in having a BBV test in the last six months (61 % to 81 %, p = 0.003) and carrying naloxone (22 % to 32 %, p = 0.011).ConclusionWAND was able to engage and re-engage large numbers of high-risk PWID with multiple harm reduction initiatives. These findings suggest contingency management could be a useful tool for harm reduction services.

01 Jun 2025·Bioelectrochemistry

Facile preparation of bifunctional monolayers through diazonium grafting and “click” postfunctionalization: A first step towards efficient aptasensing interfaces

Article

Author: Pandele, Andreea Mădălina ; Hanganu, Anamaria ; Iovu, Horia ; Onaş, Andra Mihaela ; Florea, Ciprian Victor ; Raicopol, Matei D ; Pilan, Luisa

Herein, we present an efficient approach for developing electrochemical aptasensing interfaces, by "click" postfunctionalization of phenylethynyl-grafted glassy carbon substrates with mixed monolayers containing biorecognition elements and phosphorylcholine zwitterionic groups. Typically, controlling the composition of multicomponent surface layers by grafting from a mixture of aryldiazonium salts is challenging due to differences in their chemical reactivity. Our approach circumvents this issue by employing the electrochemical reduction of a single aryldiazonium salt containing a silyl-protected alkyne group followed by deprotection, to create phenylethynyl monolayers which can subsequently accommodate the concurrent immobilization of bioreceptors and zwitterionic groups through "click" postfunctionalization. We show that the surface ratio of the components in the bifunctional monolayers, estimated through XPS and electrochemical methods, can be accurately controlled by adjusting the mole ratio of the corresponding azide reagents in the "click" coupling solution. Moreover, electrochemical impedance spectroscopy and fluorescence microscopy investigations on bifunctional monolayers containing ssDNA and phosphorylcholine groups reveal that they effectively prevent nonspecific protein adsorption, while maintaining sufficiently low impedance to facilitate electrochemical detection. Finally, we demonstrate that proof of concept aptasensing interfaces based on binary layers containing a ferrocene-tagged cocaine/quinine aptamer and phosphorylcholine groups exhibit a trade-off between an improved analytical response and antifouling efficiency.

205

News (Medical) associated with Cocaine Hydrochloride

27 Feb 2025

·www.prnewswire.com

CBSA launches Operation Blizzard to target fentanyl and other synthetic narcotics

OTTAWA, ON, Feb. 27, 2025 /PRNewswire/ - The Canada Border Services Agency (CBSA) plays an important role in keeping fentanyl, its precursors and other dangerous narcotics off our streets. Today, the CBSA shared details about additional actions being taken to stop fentanyl and other synthetic narcotics from reaching communities across the country and abroad. As part of Canada's Border Plan, the CBSA has launched Operation Blizzard, a targeted, cross-country initiative aimed at intercepting illegal contraband arriving and leaving Canada, with a focus on fentanyl and other synthetic narcotics. During this blitz, border services officers will be increasing examinations of inbound and outbound shipments. They will also be acting on increased referrals from CBSA's National Targeting Centre based on risk assessments. The goal of the operation is to disrupt the supply chain for fentanyl and other illicit drugs through interception of contraband as part of Canada's overarching efforts to strengthen border security and combat organized crime. In addition to Operation Blizzard, CBSA's collaborative efforts with the Royal Canadian Mounted Police and local law enforcement partners have resulted in significant seizures across the country. In February 2025 alone, the CBSA made six seizures amounting to 56.1g of fentanyl, including the seizure of 20 fentanyl pills and 23 g of a substance suspected to be fentanyl from two U.S. citizens crossing at the Windsor-Detroit Tunnel port of entry. The CBSA has also shared details about the following seizures of other illegal narcotics in the month of February: 186 kg of methamphetamine (estimated value of $1.86 million) and 42 kg of cocaine (estimated value of $1 million) at Coutts port of entry 6.4 kg of meth (estimated value of $500,000) in the Greater Toronto Area (GTA) 38 kg of cocaine (estimated value of $4.7 million) in the GTA 2.3 kg of cocaine (estimated value of $280,000) in the GTA 35 kg of ketamine (estimated value of $2.4 million) at Vancouver International Airport 30.6 g of suspected heroin (estimated value of $12,240) at the Peace Bridge port of entry 30 kg of suspected ketamine (estimated value of $2.1 million) in the GTA Quote "The Government of Canada is tackling the fentanyl crisis head on by disrupting the supply chain of fentanyl and its precursors. Operation Blizzard demonstrates our commitment to protecting North Americans and defending our borders from the organized crime groups who threaten our communities." - The Honourable David J. McGuinty, Minister of Public Safety "Canada is taking significant action to stop the importation, production and trafficking of illegal fentanyl. In addition to the deployment of new tools and technology at the border, we also rely heavily on our frontline personnel to secure our border. Exercises like Operation Blizzard deter criminals and help ensure that our border response to illegal drug trafficking is robust and effective." - Kevin Brosseau, Fentanyl Czar "The CBSA will not allow organized criminal organizations to exploit our borders. We are taking enhanced measures to prevent narcotics, synthetic opioids and fentanyl from reaching Canadians and from being exported to other countries. Operation Blizzard is one of the many steps we are taking to protect our communities from these dangerous substances." - Erin O'Gorman, President, Canada Border Services Agency Quick Facts Fentanyl is a very potent opioid pain reliever. A few grains can be enough to kill you. It is a dangerous drug that is 20 to 40 times more potent than heroin and 100 times more potent than morphine. This makes the risk of accidental overdose very high. In 2024, the CBSA made 28,325 illegal drug seizures, including 4.9 kilograms of fentanyl. For the latest statistics on CBSA's enforcement action seizures, visit Canada Border Services Agency seizures. On February 11, Prime Minister Justin Trudeau announced the appointment of Kevin Brosseau as Canada's Fentanyl Czar. Mr. Brosseau will work closely with U.S. counterparts and law enforcement agencies to accelerate Canada's ongoing work to detect, disrupt, and dismantle the fentanyl trade. The CBSA's response to the opioid crisis includes working with domestic and international law enforcement partners to identify and apprehend individuals, groups, and businesses that are suspected to be involved in the cross border movement of illicit drugs and substances. The CBSA also works with Health Canada in monitoring new and emerging threats of non-regulated substances that may be used for the illegal production of controlled substances, which can lead to scheduling of these chemicals under the Controlled Drugs and Substances Act. Canada's Border Plan is backed by an investment of $1.3 billion and built around five pillars: detecting and disrupting the fentanyl trade; new tools for law enforcement; enhancing operational coordination; increasing information sharing, and minimizing unnecessary border volumes. Contact the Border Watch Line to report suspicious cross-border activities using our secure web form or by calling 1-888-502-9060 toll-free. Follow us on X (@CanBorder), Instagram (@CanBorder), and join us on Facebook or visit our YouTube channel. SOURCE Canada Border Services Agency WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

Executive Change

21 Feb 2025

·www.drugs.com

OD Deaths Decline in U.S., Driven By Drop In Opioid Fatalities

FRIDAY, Feb. 21, 2025 -- America’s opioid crisis is showing signs of subsiding, a new report from the U.S. Centers for Disease Control and Prevention (CDC) says. Drug overdose deaths (OD) decreased by 4% between 2022 and 2023, according to the CDC’s National Center for Health Statistics. The overall OD death rate fell from 32.6 deaths per 100,000 people in 2022 to 31.3 deaths per 100,000 in 2023, the CDC says. This reduction was driven by a decline in OD deaths related to opioids, the report says. “Nationally, between 2022 and 2023, the age-adjusted rate of drug overdose deaths decreased for deaths involving any opioid and synthetic opioids other than methadone (which includes fentanyl ),” concluded the team led by senior researcher Arialdi Minino , a CDC statistician. However, OD deaths increased among users of stimulant drugs like methamphetamine and cocaine, researchers noted. Across the country, drug OD deaths decreased in 20 states and did not change significantly in 25 states, researchers found. The death rate increased in six states: Alabama, Alaska, California, Nevada, Oregon and Washington. Changes in OD death rates varied between states based on specific drug types, the report says: West Virginia (81.9 deaths per 100,000), the District of Columbia (60.7), Delaware (53), Tennessee (52.3), and Louisiana (50.6) had the highest OD death rates in the U.S. in 2023, researchers said. The states with the lowest rates were Nebraska (9 deaths per 100,000), South Dakota (11.2), Iowa (14.9), North Dakota (16.4), Montana (17.1), Arkansas (17.7), and Texas (18.5). Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

20 Feb 2025

·www.drugs.com

2022 to 2023 Saw Decrease in Rate of Drug Overdose Deaths in United States

THURSDAY, Feb. 20, 2025 -- From 2022 to 2023, there was a decrease in the age-adjusted rate of drug overdose death in the United States, according to a report published in the February Health E-Stats , a publication of the National Center for Health Statistics. Matthew F. Garnett, M.P.H., and Arialdi M. Miniño, M.P.H., from the National Center for Health Statistics in Hyattsville, Maryland, describe changes in drug overdose mortality by selected drug type and state from 2022 to 2023. The researchers found that from 2022 to 2023 the age-adjusted rate of drug overdose deaths in the United States decreased 4.0 percent (32.6 to 31.3 deaths per 100,000 standard population). West Virginia and the District of Columbia were the jurisdictions with the highest rates in 2023 (81.9 and 60.7, respectively), while Nebraska and South Dakota were the states with the lowest rates (9.0 and 11.2, respectively). Age-adjusted rates of drug overdose deaths decreased in 20 states, did not change significantly in 25 states, and increased in six states (Alabama, Alaska, California, Nevada, Oregon, and Washington). Nationally, the age-adjusted rate of drug overdose deaths decreased between 2022 and 2023 for deaths involving any opioid and synthetic opioids other than methadone, including fentanyl, and increased for deaths involving psychostimulants with abuse potential and cocaine. "Changes in rates varied by jurisdiction across drug type," the authors write. "Rates for deaths involving synthetic opioids other than methadone decreased in 17 states and increased in 11 states." Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

100 Deals associated with Cocaine Hydrochloride

External Link

KEGG	Wiki	ATC	Drug Bank
D02182	Cocaine Hydrochloride	S01HA01 S02DA02 N01BC01 R02AD03	DB00907

R&D Status

Approved

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Indication	Country/Location	Organization	Date
Anesthesia	United States	Noden Pharma DACStartup	14 Dec 2017

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Cocaine-Related Disorders	Discovery	United States	Biotie Therapies Oy	01 Jun 2008

Clinical Result

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Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


ATS2024	Not Applicable	Compartment Syndromes \| Hyperkalemia	-	Cocaine	uaipfglawt(xxdzvzummp) = showed a Wellens' pattern with ST-elevation and biphasic T-waves in lead V2-V3 hjkitrfbuj (azmbtdrnpn ) View more	-	19 May 2024
ATS2023	Not Applicable	Bronchiolitis	-	Cocaine	hfdopzyndj(mobebpnavv) = iumeyxfpji yshaftcrga (gsjodjjiss ) View more	-	21 May 2023
NCT01906346 (CTgov)	Early Phase 1	Cocaine-Related Disorders	9	Placebo+Cocaine (Low Value Alternative Reinforcer)	qtuboppeld(buexylxbfm) = vgqtdiujdo ujgalrgpmt (lhuldfssrx, ymqlsgphja - kjlvnytbav) View more	-	17 May 2019
				Placebo+Cocaine (Medium Value Reinforcer)	qtuboppeld(buexylxbfm) = pwyjqlerfa ujgalrgpmt (lhuldfssrx, nnwyxqfjts - gxzdjvimqc) View more
NCT02383043 (CTgov)	Early Phase 1	Cocaine-Related Disorders	18	Cocaine+Sustained Release d-Amphetamine	itcqvmqmwz(ftbegqvcyk) = rktskhxulf lfuukynlzh (ampntumhxp, hnqyizesvz - hokgzdhdxl) View more	-	11 Apr 2019
SFN2018	Not Applicable	Cocaine-Related Disorders	-	Cocaine self-administration	frulqsuody(fttjipqkam) = wpfryhmcag pvyzrbqtgz (gbdkdlvtjj )	-	06 Nov 2018
AAN2018	Not Applicable	Acute Ischemic Stroke cocaine use	-	AIS with cocaine use	ojmbomfzyb(udxbmagbzw) = gqrtxcwjcj kfrdaivwob (enstwnjdkp ) View more	-	10 Apr 2018
				AIS without cocaine use	ojmbomfzyb(udxbmagbzw) = lxkiktpppn kfrdaivwob (enstwnjdkp ) View more
ACR2017	Not Applicable	Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ANCA antibodies \| inflammatory markers \| haematology and biochemistry profiles	14	Cocaine-induced vasculitis	tpkhihkpuw(fgxwoklvzo) = kahevwnslg yutspqdekw (relziqzznt ) View more	Negative	06 Nov 2017
				Cocaine (Idiopathic ANCA vasculitis)	tpkhihkpuw(fgxwoklvzo) = wvppdqkgst yutspqdekw (relziqzznt )
NCT00373880 (CTgov)	Phase 2	Cocaine-Related Disorders	26	Placebo+Cocaine (Placebo + 0mg Cocaine)	afwucvgwvm(axwfnlozqz) = xeewkvbjrt gxaorytduy (mqyybubesp, oqcisanddr - emkwabmwez) View more	-	11 Sep 2017
				Placebo+Cocaine (Placebo + 12mg Cocaine)	afwucvgwvm(axwfnlozqz) = aiwtibqdck gxaorytduy (mqyybubesp, qrekfwgdwl - zdssyadrlk) View more
NCT01706952 (CTgov)	Phase 4	Chronic sinusitis	45	Cocaine+adrenaline (Cocaine)	lgsruuzoaj(miysrpuqjq) = eoottbhquf tcropqzibi (jizygmcreo, aeanpdsfly - zfdntzswro) View more	-	03 May 2017
				Cocaine+adrenaline (Adrenaline)	lgsruuzoaj(miysrpuqjq) = rvbbntcalq tcropqzibi (jizygmcreo, dcrgojires - iivgrktvka) View more
SFN2016	Not Applicable	-	-	intravenous cocaine (5s-Rats)	jpueioaxyb(nxsltlpnki) = zoryunduyy fpeeuflcrs (gcpzvgxwhz )	-	16 Nov 2016
				intravenous cocaine (90s-Rats)	jpueioaxyb(nxsltlpnki) = asbvsqmtrz fpeeuflcrs (gcpzvgxwhz )

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