Diagnosing rubella.

stitute treatment programme comparable to methadone maintenance for opiate addicts does not seem promising as there is no obvious candidate drug for the substitute.The American use of methylphenidate seems wrong for Britain, where there is a more extensive histoiy of intravenous abuse of this drug.One of the more promising approaches to treatment is using tricyclic antidepressants such as desipramine, which may correct disturbances in dopaminergic pathways and alter receptor supersensitivity resulting from regular cocaine use." 116 Such drugs may thus help to correct the depression or anhedonia which colour the let down from cocaine and which if uncorrected may invite further cocaine use.Alternatively, a drug might be given which would produce cocaine blockade (just as naltrexone does with heroin), but no such drug has yet been reliably identified.There have now been reports that bromocriptine may reduce postwithdrawal craving for cocaine, but these first reports need to be investigated further.7 General treatment approaches used in rehabilitating those addicted to other drugs should be relevant.The use of a structured approach for preventing relapse should help in identifying alternative coping strategies."SSystemic exposure to stimuli that promote craving may also be useful-as it has been with other addicts.19-21 Most important of all may be the non-specific and low key help based on the wide availability of a friendly and knowledgeable person who may inform, support, and cajole.Treatment for those addicted to cocaine and crack must depend on strengthening existing services rather than on creating a new crack specialty.So is crack the tiger or the toy poodle?In the light of the scientific evidence it would be wrong to portray the use of crack as innocent fun.And yet to give crack the image of a mythological monster and portray it sensationally as some- thing uniquely diabolical will only add to its allure.The hype is dangerous as well as the drug.