Effects of Modafinil in a novel model of relapse to cocaine use - Richard Foltin - ISAM 2013 - Kuala Lumpur

Taking individuals who report heavy cocaine use and urine tests supports and we give them cocaine and study them . There is not a treatment component.
Binge pattern of use - we model effect - done periods of hours to days,
On average our guys 3-4 x a week, and spend $300 to $400 a week
We let people use a lot of drugs. Like they did on street in short period of time.  In other studies had used just one dose.
We did a study on Modafanil and showed it significantly reduced cocaine craving
Modafinil also shown to reduce the amount of money people were willing to pay.
Cost $5 to smoke cocaine,  We have them buy dose  of cocaine like on street from money earned in study.
Modelling relapse behaviour in the laboratory.
Playing game of bingo got money.  Had pressing computer bar 4000 to get does of cocaine.  In crease of the cost of cocaine and work didn't reduce the number of dose.
To look at relapse - gave free dose and there was a little increase
Modafinil given for 5 days.  This decreased cocaine use by about 1 dose - they were dosing 4to 6 time.
Modafinil didn't decrease cocaine use when it was cheap but it did when the cocaine was more expensive.  The effects are modest.
Modafinil can be used patients on Methadone
Pretty safe medication
If you drink alcohol modafinil doesn't work as all

 (These are my rough notes. I apologize for any errors. It was a deep discussion of a remarkable and elegant research design.  I was very impressed by the ingenuity of the researchers in setting up laboratory equivalents of the contextual reality of street cocaine use.  There is definitely a place for modafinil in the armamentium of addiction medicine. Another useful tool in the toolbox.)

Cocaine Addicted Psychologists

If only for the reason that courts are relying more on psychologists and psychologists are becoming the de facto therapists recommended by various agencies given the shortages of psychiatrists I was interested in impairment studies among psychologists.  I'd recently encountered a psychologist who considered 'recreational cocaine use'not a cause of  serious concern. I remembered that this what we saw commonly when I began a country general practice 25 years ago. Then we joked, saying a "person didn't have an alcohol problem unless he drank more than his physician".  Yet cocaine is much more concerning than alcohol.
A standing joke in 12 step programs where experience with drugs and alcohol and those who use them is highest is: an alcoholic will steal your wallet but a cocaine addict will steal your wallet and then help you look for it.
So I did a google search on impaired psychologists and found that there were articles, though few, and far less surveillance than doctors, nurses, or lawyers yet the problem is clearly increasing and the risks are far greater in future than in past where psychologists were more supervised than today.
Unfortunately all the references  I found were not free to the public.  In all cases I had to pay to access the material though I can find the incidence of addiction in lawyers per se without such an economic barrier.  That alone concerns me.  Hopefully concerned psychologists will address this issue.

1. Psychologist heal thyself: What is available for the impaired ...

   psycnet.apa.org/journals/amp/40/1/84.html

   by DA Laliotis - 1985 - Cited by 85 - Related articles
   A thorough search of the literature yielded little information on incidence of impairment in psychology. Thoreson et al. (1983) offered a conservative estimate of ...