Alcohol and Cocaine Co-usage

Addiction is a chronic relapsing disorder, which creates challenges for its treatment. Chronic use of drugs of abuse can change the neurobiology and neurochemistry of brain circuits and underlies drug relapse during voluntary abstinence. The role of dopamine (DA) and glutamate in drug addiction has been extensively investigated, and interactions between these neurotransmitters are important for the development of drug use disorders and drug relapse. For the past two decades, the role of glial glutamate transporters has emerged as a key mechanism in drug dependence and relapse. This chapter focuses on the role of these mechanisms in two commonly abused drugs, ethanol and cocaine, that are often abused at the same time. Here, the effect of acute and chronic exposure to cocaine and ethanol on glutamatergic systems in different brain regions within the mesocorticolimbic pathway is considered. The ultimate goal of research into mechanisms of co-use of cocaine and ethanol is to consider how co-use amplifies the changes in this circuitry and complicates attempts to abstain from drug use. This research has the ultimate goal of identifying therapeutic targets that will be effective in preventing relapse in individuals suffering from concurrent alcohol and cocaine use disorders.