David A Gorelick

David A Gorelick
University of Maryland, Baltimore | UMB · Department of Psychiatry

MD, PhD

About

288
Publications
63,984
Reads
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13,034
Citations
Citations since 2017
9 Research Items
4809 Citations
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20172018201920202021202220230200400600800
20172018201920202021202220230200400600800
20172018201920202021202220230200400600800
Additional affiliations
October 2013 - present
University of Maryland, Baltimore
Position
  • Professor (Full)
September 1989 - October 2013
National Institute on Drug Abuse
Position
  • staff clinician
July 1987 - August 1989
University of California, Los Angeles
Position
  • Professor (Associate)
Description
  • clinical care, teach, and research in addiction psychiatry

Publications

Publications (288)
Article
Full-text available
Objective: To assess divided-attention performance when driving under the influence of cannabis with and without alcohol. Three divided-attention tasks were performed following administration of placebo, cannabis, and/or alcohol. Methods: Healthy adult cannabis users participated in 6 sessions, receiving combinations of cannabis (placebo/low-THC...
Article
Full-text available
Schizophrenia is a complex mental illness characterized by positive and negative symptoms. Antipsychotic medications are the main treatment for this condition; however, many patients have only a partial response. All currently available antipsychotics involve modulation of the dopamine system, although the underlying pathophysiology of this illness...
Article
Background: Previous studies showed reduction of brain cannabinoid CB1 receptors in adults with cannabis and alcohol use disorders. Preclinical data suggest that these receptors also contribute to nicotine reward and dependence. Tobacco smoking may confound clinical studies of psychiatric disorders because many patients with such disorders smoke t...
Article
Background: Food intake and use of drugs of abuse like cocaine share common central and peripheral physiological pathways. Appetitive hormones play a major role in regulating food intake; however, little is known about the effects of acute cocaine administration on the blood concentrations of these hormones in cocaine users. Methods: We evaluate...
Article
Background: Women have been largely underrepresented in clinical trials in schizophrenia yet have a different presentation of symptoms, such as higher affective symptoms compared to men. Thus, adjunctive antipsychotic treatment, particularly low-dose aripiprazole, in women may be an effective strategy, particularly for its effects on anxious or dep...
Article
Background: Hyperprolactinemia, a side effect of antipsychotic treatment, causes amenorrhea, oligomenorrhea, galactorrhea, gynecomastia, and sexual dysfunction. These side effects increase risk of antipsychotic nonadherence and pose significant problems in the long-term management, particularly in women with severe mental illness. Methods: Women wi...
Article
Full-text available
Although evidence suggests cannabis impairs driving, its driving-performance effects are not fully characterized. We aimed to establish cannabis’ effects on driving longitudinal control (with and without alcohol, drivers’ most common drug combination) relative to psychoactive ∆⁹-tetrahydrocannabinol (THC) blood concentrations. Current occasional (≥...
Article
Background: Cannabis is the most widely used illicit psychoactive substance world-wide, yet no medication is approved for the treatment of intoxication, withdrawal, or cannabis use disorder (CUD). Objective: To comprehensively review the current state of knowledge. Method: Search of the PubMed electronic data base and review of reference lists...
Article
Cocaine use disorder (CUD) remains a significant public health challenge. Levo-tetrahydropalmatine (L-THP), a well-tolerated and non-addictive compound, shows promise for the management of CUD. Its pharmacologic profile includes blockade at dopamine and other monoamine receptors and attenuation of cocaine self-administration, reinstatement, and rew...
Article
Full-text available
Oral fluid (OF) is an advantageous matrix for cannabis detection, with on-site tests available for roadside drug-impaired driver screening. Limited data exist for device performance following consumption of vaporized cannabis, which reduces exposure to harmful combustion by-products. We assessed cannabinoid OF disposition, with and without alcohol,...
Article
Accurate on-site devices to screen for drug intake are critical for establishing whether an individual is driving under the influence of drugs (DUID); however, on-site oral fluid (OF) cocaine device performance is variable. We evaluated the performance of a newly developed benzoylecgonine (BE) test-strip for the Draeger® DrugTest 5000 device (20 µg...
Article
Limited oral fluid (OF) pharmacokinetic data collected with commercially available collection devices after controlled cocaine administration hinder OF result interpretations. Ten cocaine-using adults provided OF, collected with Oral-Eze® (OE) and StatSure Saliva Sampler™ (SS) devices, an hour prior to and up to 69 h after 25 mg intravenous (IV) co...
Article
Full-text available
Background: In driving-under-the-influence cases, blood typically is collected approximately 1.5-4 h after an incident, with unknown last intake time. This complicates blood Δ(9)-tetrahydrocannabinol (THC) interpretation, owing to rapidly decreasing concentrations immediately after inhalation. We evaluated how decreases in blood THC concentration...
Chapter
Cocaine use disorders represent a substantial clinical and public health burden in many countries, yet there are no well-proven and broadly effective treatments available, and no medication approved for this indication by any national regulatory authority. Psychosocial treatments are the mainstay of care, guided by the general principles of prompt...
Article
Substance use disorders (addiction; abuse or dependence in DSM-IV terms) are chronic, relapsing conditions. Our current state of knowledge does not allow for accurate prediction of the trajectory of substance use patterns or development of the disorder in the general population, in a small subgroup (e.g. participants in a clinical trial), or in ind...
Article
Full-text available
DBS are an increasingly common clinical matrix. Sensitive and specific methods for DBS and venous blood cocaine and metabolite detection by LC-HRMS and 2D GC-MS, respectively, were validated to examine correlation between concentrations following controlled intravenous cocaine administration. Linear ranges from 1 to 200 µg/l were achieved, with acc...
Article
Full-text available
Vaporized cannabis and concurrent cannabis and alcohol intake are commonplace. We evaluated the subjective effects of cannabis, with and without alcohol, relative to blood and oral fluid (OF, advantageous for cannabis exposure screening) cannabinoid concentrations and OF/blood and OF/plasma vaporized-cannabinoid relationships. Healthy adult occasio...
Article
Full-text available
Abstract BACKGROUND: Increased medical and legal cannabis intake is accompanied by greater use of cannabis vaporization and more cases of driving under the influence of cannabis. Although simultaneous Δ9-tetrahydrocannabinol (THC) and alcohol use is frequent, potential pharmacokinetic interactions are poorly understood. Here we studied blood and p...
Article
Full-text available
Increased medical and legal cannabis intake is accompanied by greater use of cannabis vaporization and more cases of driving under the influence of cannabis. Although simultaneous Δ(9)-tetrahydrocannabinol (THC) and alcohol use is frequent, potential pharmacokinetic interactions are poorly understood. Here we studied blood and plasma vaporized cann...
Article
Full-text available
Synthetic cannabinoids (SC), originally developed as research tools, are now highly abused novel psychoactive substances. We present a comprehensive systematic review covering in vivo and in vitro animal and human pharmacokinetics and analytical methods for identifying SC and their metabolites in biological matrices. Of two main phases of SC resear...
Article
Methamphetamine is included in drug testing programmes due to its high abuse potential. d-Methamphetamine is a scheduled potent central nervous system stimulant, while l-methamphetamine is the unscheduled active ingredient in the over-the-counter nasal decongestant Vicks® VapoInhaler™. No data are available in oral fluid (OF) and few in plasma afte...
Article
Full-text available
Δ9-Tetrahydrocannabinol (THC), the primary psychoactive constituent in cannabis, impairs psychomotor performance, cognition and driving ability; thus, driving under the influence of cannabis is a public safety concern. We documented cannabis' psychomotor, neurocognitive, subjective and physiological effects in occasional and frequent smokers to inv...
Article
Full-text available
Opiates are included in drug testing programs because of their psychoactive properties and abuse potential, but excluding poppy seed ingestion is necessary to correctly interpret positive opiate results. There are few available data for plasma and oral fluid (OF) following poppy seed ingestion, and most do not report opiate content in the ingested...
Article
Evaluation of cannabinoid stability in authentic oral fluid (OF) is critical, as most OF stability studies employed fortified or synthetic OF. Participants (n = 16) smoked a 6.8% delta-9-tetrahydrocannabinol (THC) cigarette, and baseline concentrations of THC, 11-nor-9-carboxy-THC (THCCOOH), cannabidiol (CBD), and cannabinol (CBN) were determined w...
Chapter
Transcranial magnetic stimulation (TMS) is a rapidly developing noninvasive physical approach to psychiatric treatment, including substance use disorders. It involves projecting a fluctuating magnetic field (magnetic pulses), usually repetitively (rTMS), through the skull into the brain, which generates electrical currents in brain tissue and, thus...
Article
Full-text available
Background: Craving is a major issue in drug addiction, and a target for drug treatment. The Marijuana Craving Questionnaire-Short Form (MCQ-SF) is a useful tool for assessing cannabis craving in clinical and research settings. Objective: To validate the French version of the MCQ-SF (FMCQ-SF). Methods: Young adult cannabis users not seeking tr...
Article
Risk-based decision making is altered in people with schizophrenia and in people with cannabis use compared to healthy controls; the pattern of risk-assessment in people with co-occurring schizophrenia and cannabis dependence is poorly understood. This study examined measures of risk-taking and decision-making in people with and without schizophren...
Article
Full-text available
Objective: The current study examined the efficacy and safety of rasagiline, a selective MAO-B inhibitor, for the treatment of persistent negative symptoms. Methods: Sixty people with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, schizophrenia or schizoaffective disorder, who met a priori criteria for persistent negative sy...
Article
Oral fluid (OF) is an increasingly popular alternative matrix for drug testing, with cannabinoids being the most commonly identified illicit drug. Quantification of multiple OF cannabinoids and understanding differences in OF cannabinoid pharmacokinetics between frequent and occasional smokers improve test interpretation. The new Oral-Eze® OF colle...
Article
Full-text available
Legitimate use of legal intranasal decongestants containing l-methamphetamine may complicate interpretation of urine drug tests positive for amphetamines. Our study hypotheses were that commonly used immunoassays would produce no false-positive results and a recently developed enantiomer-specific gas chromatography–mass spectrometry (GC–MS) procedu...
Article
Opiates are an important drug class in drug testing programmes. Ingestion of poppy seeds containing morphine and codeine can yield positive opiate tests and mislead result interpretation in forensic and clinical settings. Multiple publications evaluated urine opiate concentrations following poppy seed ingestion, but only two addressed oral fluid (O...
Article
Full-text available
Breath has been investigated as an alternative matrix for detecting recent cocaine intake; however, there are no controlled cocaine administration studies that investigated the drug's disposition into breath. Breath was collected from 10 healthy adult cocaine users by asking them to breathe into a SensAbues device for 3 min before and up to 22 h fo...
Article
Full-text available
Oral fluid (OF) enables non-invasive sample collection for on-site drug testing, but performance of on-site tests with occasional and frequent smokers’ OF to identify cannabinoid intake requires further evaluation. Furthermore, as far as we are aware, no studies have evaluated differences between cannabinoid disposition among OF collection devices...
Article
Transcranial magnetic stimulation (TMS) is a noninvasive method of brain stimulation used to treat a variety of neuropsychiatric disorders, but is still in the early stages of study as addiction treatment. We identified 19 human studies using repetitive TMS (rTMS) to manipulate drug craving or use, which exposed a total of 316 adults to active rTMS...
Article
Objectives Chronic, frequent cannabis smokers may experience residual and offset effects, withdrawal, and craving when abstaining from the drug. We characterized the prevalence, duration, and intensity of these effects in chronic frequent cannabis smokers during abstinence on a closed research unit.Methods Non-treatment-seeking participants (N = 29...
Article
Full-text available
Background: Cannabis use is common among opioid-dependent individuals, but little is known about cannabis withdrawal in this population. Methods: Thirty inpatients (57% men) completed the Marijuana Quit Questionnaire (MJQQ) after completing acute heroin detoxification treatment in Saint Petersburg, Russia. The MJQQ collected data on motivations...
Article
Full-text available
Background: Δ(9)-Tetrahydrocannabinol (THC), 11-hydroxy-THC (11-OH-THC), and 11-nor-9-carboxy-THC (THCCOOH) have been reported in blood from frequent cannabis smokers for an extended time during abstinence. We compared THC, 11-OH-THC, THCCOOH, cannabidiol, cannabinol, THC-glucuronide, and 11-nor-9-carboxy-THC-glucuronide (THCCOO-glucuronide) blood...
Article
Full-text available
Analyte stability is an important factor in urine test interpretation, yet cannabinoid stability data are limited. A comprehensive study of Δ 9-tetrahydrocannabinol (THC), 11-hydroxy-THC (11-OH-THC), 11-nor-9-carboxy-THC (THCCOOH), cannabidiol, cannabinol, THC-glucuronide, and THCCOOH-glucuronide stabilities in authentic urine was completed. Urine...
Article
Background / Purpose: The influence on outcomes of excluding people with schizophrenia with current substance use disorder from clinical trials is not well understood. This study addressed this issue by comparing symptom profiles in 15 clinical trial participants with DSM-IV schizophrenia or schizoaffective disorder and no current substance use d...
Article
Full-text available
3,4-Methylenedioxymethamphetamine (MDMA) is an illicit phenethylamine ingested for entactogenic and euphoric effects. Although blood is more commonly submitted for forensic analysis, previous human MDMA pharmacokinetics research focused on plasma data; no direct blood-plasma comparisons were drawn. Blood and plasma specimens from 50 healthy adult v...
Article
Full-text available
Background: There is extended urinary excretion of Δ(9)-tetrahydrocannabinol (THC), 11-hydroxy-THC (11-OH-THC), and 11-nor-9-carboxy-THC (THCCOOH) in abstinent frequent cannabis smokers. We characterized THC, 11-OH-THC, THCCOOH, cannabidiol, cannabinol, THC-glucuronide, and THCCOOH-glucuronide disposition in urine of frequent and occasional cannab...
Article
Full-text available
Background: Δ(9)-Tetrahydrocannabinol (THC), 11-nor-9-carboxy-THC (THCCOOH), and cannabinol (CBN) were measured in breath following controlled cannabis smoking to characterize the time course and windows of detection of breath cannabinoids. Methods: Exhaled breath was collected from chronic (≥4 times per week) and occasional (<twice per week) sm...
Article
Δ9-tetrahydrocannabinol (THC) promotes sleep in animals; clinical use of THC is associated with somnolence. Human laboratory studies of oral THC have not shown consistent effects on sleep. We prospectively evaluated self-reported sleep parameters during controlled oral THC administration to research volunteers. Thirteen male chronic daily cannabis...
Article
Full-text available
Oral fluid (OF) is an alternative biological matrix for monitoring cannabis intake in drug testing, and drugged driving (DUID) programs, but OF cannabinoid test interpretation is challenging. Controlled cannabinoid administration studies provide a scientific database for interpreting cannabinoid OF tests. We compared differences in OF cannabinoid c...
Article
Full-text available
Electroencephalographic changes in limbic and cortical structures in freely moving male rats were examined before and after the delivery of footshock, the presentation of a sedated opponent, and the administration of mescaline hydrochloride (50mg/kg ip). These stimuli presented separately did not produce significantly abnormal EEG activity. However...
Article
Background: The majority of cannabis smokers who quit do so without formal treatment, suggesting that motivations to quit are an important part of cessation process. However, little is known about how motivations relate to successful quitting. Method: A convenience sample of 385 non-treatment-seeking adult cannabis smokers (58% male, age 16-64ye...
Article
Full-text available
Introduction: The relevance of tobacco use in opioid addiction (OA) has generated a demand for available and more effective interventions. Thus, further analysis of less explored nicotine-opioid clinical interactions is warranted. Methods: A post-hoc analysis of OA participants in a double-blind, randomized very low dose naltrexone (VLNTX) inpat...
Article
Full-text available
Background: Blood and plasma cannabinoid stability is important for test interpretation and is best studied in authentic rather than fortified samples. Methods: Low and high blood and plasma pools were created for each of 10 participants after they smoked a cannabis cigarette. The stabilities of Δ(9)-tetrahydrocannabinol (THC), 11-hydroxy-THC (1...
Article
Full-text available
Oral fluid (OF) offers a noninvasive sample collection for drug testing. However, 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) in OF has not been adequately characterized in comparison to plasma. We administered oral low-dose (1.0 mg/kg) and high-dose (1.6 mg/kg) MDMA to 26 participants and collected simultaneous OF and plasma specimens for up...
Article
Full-text available
BACKGROUND: Oral fluid (OF) testing offers noninvasive sample collection for on-site drug testing; however, to date, test performance for 9-tetrahydrocannabinol (THC) detection has had unacceptable diagnostic sensitivity. On-site tests must accurately identify cannabis exposure because this drug accounts for the highest prevalence in workplace drug...