COMORBIDITY OF COCAINE USE AND MENTAL DISORDERS
Comorbid mental illnesses are common in and can worsen CUDs. The factors responsible for morbidity appear to differ among cocaine users with mental illness as compared to cocaine users without mental illness.

OTHER IMAGING STUDIES IN COCAINE USE DISORDERS
Computed Tomography (CT)
The popularity of CT in addiction research has diminished considerably because of its resolution power and the risk of ionizing radiation. In 1991, a planimetric CT study found significant cerebral atrophy among 35 habitual cocaine abusers as compared to 16 self-reported first-time users and 54 control subjects.

IMAGING STUDIES OF COCAINE USE DISORDERS
Brain Blood Flow Studies
Cerebral blood flow is a valuable indicator of brain function. Global and regional brain perfusion has been investigated in cocaine users at rest or during experimental cocaine administration, with and without the performance of mental tasks. These studies are briefly summarized below.

CNS EFFECTS OF “RECREATIONAL” COCAINE USE
Psychiatric Effects of Cocaine
Acute euphoria. The acute psychiatric effects of cocaine include a brief “rush,” excitability, hyper-vigilance and anxiety. Cocaine euphoria can positively reinforce drug-taking behavior. In “recreational” cocaine use, psychiatric status and safety depends on the degree of emotional instability, physical exhaustion, behavioral agitation, sleep alterations and suicidal behavior.

COCAINE OVERDOSE
Fatal and near-fatal cases of cocaine overdose are not uncommon. The dose of cocaine that might result in fatal outcomes depends on an individual’s weight, height and general health status. Also, fatal outcomes may occur irrespective of the frequency of use or route of administration.

INTRODUCTION
Cocaine use disorders (CUDs) have continued to be a public health problem characterized by multiple neuropsychiatric sequelae. Although the neuropsychiatric complications of cocaine partially account for the morbidity and mortality in CUDs, their role in the transition from initial to compulsive use is controversial.