Progress in developing meds for cocaine addiction?

Hi, this is Dr. Brensilver here. I'm a Clinical Research Fellow here at UCLA SARx. Today's post gives an update on medications to help people stop using cocaine and stay off cocaine.  Back in the 80’s and 90’s, more than 10% of American adults used cocaine at least some of the time.  Since then, the rates of cocaine use have declined, but many millions of people use the drug worldwide and a high proportion of those who use cocaine become addicted.  Behavioral treatments reduce cocaine use, but 70% of people are unsuccessful in their treatment attempts – so, we’ve turned to medications to see if they can be combined with counseling to help people stop using.  Some medications try to block the high that people get when they use cocaine.  The thinking is simple: if cocaine no longer gives you good feelings when you’re on the medication, you’ll use less or stop altogether.  Other medications try to help people feel better when they’re trying to stop but are experiencing cravings for the drug.  The particular way that cocaine affects the brain has made it difficult to develop an effective medication, and there is currently no FDA approved treatment for cocaine addiction.  

Part of the problem is that the label “cocaine addiction” lumps so many different people together.  People with cocaine addiction all have the same problem, but lots of other things about them might be different – so it makes sense that a particular medication probably won’t work for all people.  What researchers are trying to do is figure out what characteristics make a person more or less likely to respond to a particular medication.  That way, doctors may have a better idea of what medication to recommend when someone asks for help.  There are some signs that vigabtrin (Sabril), ondansetron (Zofran), disulfiram (Antabuse) and modafinil (Provigil), might work for certain people, but the evidence is mixed.  A ‘cocaine vaccine’ is under development and has shown some promise.  Although it doesn’t work exactly like a vaccine you might get at the doctor, it has the effect of preventing cocaine from crossing the blood-brain barrier thereby blocking the euphoric effect.  More research is being done on these and other drugs.  

As always thanks for visiting and if you have questions or comments leave them on our twitter feed (UCLASARx) and we will do our best to address them!

Tags: cocaine, medication, modafinil, vaccine