A new tool to combat cocaine addiction

Yale researchers have found that a combination of medication and counseling can be effective in treating cocaine addiction, a significant finding given the lack to date of any generally effective medication to treat cocaine dependence. The research also suggests a promising strategy involving treatment of those who abuse a combination of drugs, such as alcohol and cocaine.

The study, led by Kathleen M. Carroll, Ph.D., associate professor of psychiatry, and researchers at the Substance Abuse Treatment Unit at the Department of Psychiatry, compared different treatments for alcohol and cocaine abusing patients. Some patients received a combination of disulfiram and one of three types of counseling while others received counseling but no medication. Because most cocaine-dependent people also abuse alcohol, the application of disulfiram, also known as antabuse, could have broad implications in the treatment of cocaine abuse. The researchers’ findings were published this year in Addiction. The National Institute on Drug Abuse sponsored the study.

The best outcomes in the 12-week study of 122 people who abused both cocaine and alcohol occurred among those who received both disulfiram and psychotherapies which encouraged them to get involved in self-help groups or taught them skills for coping with situations in which they were likely to use illicit drugs.

Alcohol dependence is often a problem among cocaine users, according to the authors. A 1990 study found that 85 percent of those considered cocaine-dependent also met standards for alcohol abuse. Also, once use of both substances becomes a pattern, it is hard to abstain from one without renouncing both. Researchers have begun new studies to determine the best combination of antabuse and counseling to reduce cocaine use and craving.