Abstract

According to the latest European drug report, levels of cocaine use in England and Wales are now the highest in Europe. Although cocaine is a highly addictive drug, not everybody who uses cocaine becomes addicted to it. Survey data suggest that about 15% of people who try cocaine will become dependent on it within 10 years of their first use. The likelihood of dependence is, however, increased for people who have a family history of drug or alcohol dependence. In other words, there seems to be a genetic risk for addiction but we currently know very little about how this risk is inherited.

We do however know that prolonged abuse of cocaine is associated with widespread deficits in neuropsychological function. Deficits are most pronounced in executive domains, which are subserved by the same brain circuitries that are associated with cocaine addiction. It is conceivable that malfunction of these brain circuitries has predated drug-taking, and presumably has facilitated the drug-induced neuroplasticity. The cognitive status of drug users’ unaffected siblings could shed on light on the question as to whether the cognitive deficits that we see in the drug users are inherited and represent a vulnerability marker for drug addiction.