While celebrities and U.S. entanglement in the Colombian drug war keep cocaine in the headlines, a larger tragedy hides in the unseen lives of both addicts and former addicts. In 1999, 1.5 million Americans took cocaine at least once a month, according to the federal government's National Household Survey on Drug Abuse. The problem's vast size is aggravated by two stubborn realities: many addicts just can't quit, and those who do might relapse when stressed or tempted. Both groups suffer because cocaine, like an unforgettable experience, has permanently altered their brains.

Biologists began investigating the neuronal changes underlying cocaine addiction many years ago. Some studies focused on what was happening on cell membranes; others tackled the less accessible molecular and genetic developments inside neurons. About five years ago, this intracellular approach largely petered out in the face of dauntingly complex biochemical pathways and proteins with unfathomable functions. A few labs...

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