New Pharmacotherapies for Cocaine Dependence... Revisited

Over the past decade, a number of factors have served to focus national attention on the prospects for developing effective pharmacologic treatment to reduce cocaine dependence, and a growing base of research on the neuropharmacology of cocaine suggested that some new pharmacotherapy offered the best and most cost-effective hope for a seemingly intractable and growing problem.

Abstract

Over the past decade, a number of factors have served to focus national attention on the prospects for developing effective pharmacologic treatment to reduce cocaine dependence. The media, the general public, and its elected leaders became alarmed about the spread of cocaine use, abuse, and dependence.1Traditional drug treatment programs reported that cocaine dependence was less amenable to established treatment strategies,2,3while researchers cited animal data on the powerful reinforcing potency of the drug.4The historical success of methadone maintenance treatment for heroin addiction, combined with a growing base of research on the neuropharmacology of cocaine, suggested that some new pharmacotherapy offered the best and most cost-effective hope for a seemingly intractable and growing problem. Knowledge of some of the residual effects of cocaine and/or stimulants in the central nervous system5-7and of kindling phenomena related to repeated cocaine administration8led to a number of