Treatment Options for Cocaine Addiction

Treatment Options for Cocaine Addiction

Although there is no proven pharmacological drug yet to treat addiction to cocaine, the National Institute on Drug Abuse (NIDA) is working to develop medications that are suitable for use in the treatment of cocaine addiction. There’s even research into the development of a vaccine for cocaine that would eliminate the drug’s effects.

In the meantime, before any other kind of treatment, such as behavioral modification, counseling, group sessions, etc., can begin, detoxification (or withdrawal from cocaine) is a required first step. Detoxification treats both the acute physiological effects and also removes residual toxins remaining in the body from chemicals in drugs and/or alcohol. For cocaine addiction, detox is either a 21- or 28-day process.

Pharmaceutical Drugs used in Cocaine Detoxification

The process of detoxification from cocaine addiction is helped by the use of several types of pharmaceutical drugs. These drugs help address the intense drug craving, anxiety and depression experienced by cocaine addicts. They are, however, short-lived and help reduce problems related to cocaine abuse and addiction by providing systematic relief.

• Amantadine, a medicine (antidyskinetic) used in patients with Parkinson’s disease, may be effective for treatment of severe withdrawal from cocaine and help to minimize craving for the drug.

• Antidepressants – a combination of phentermine and fenfluramine, or desipramine, help reduce cocaine withdrawal symptoms of depression and anxiety.

• Benzodiazepines – tranquilizers such as Diazepam help combat anxiety.

• Bromocriptine – which works on the brain’s dopamine system, may also prove useful in decreasing cocaine craving. Bromocriptine can also help to reduce mood disturbance.

• Beta-blockers – such as Propanolol, a beta-blocker antihypertensive drug, which inhibits the effects of adrenaline, may be useful. Propanolol helps to calm the “fight or flight” response to stress. And beta-blockers have been used in clinical treatment of anxiety related to alcohol as well as general anxiety. By reducing palpitations and sweating, the drug has proven effective in reducing cocaine cravings. But the use of Propanolol is not without risk. It can be associated with decreased blood flow to the heart and may cause arrhythmia. In addition, delayed toxic effects may be possible. A caution is that any treatment for cocaine addiction that includes beta-blockers should be carefully monitored.
Treatment Approaches

For any treatment of cocaine addiction to be successful, it needs to begin with a focus on the individual. What are the individual’s needs on both a physiological and psychological basis? Since cocaine addiction is a multiple problem, involving biological changes in the brain, as well as social, familial and environmental factors, it requires a multi-part treatment program to address all aspects of the user’s abuse. There are residential and out-patient treatment programs. Many residential drug treatment programs require a minimum 30-day commitment. Some offer 90-day and beyond residential treatment programs, tailored to the specific individual.

Behavioral modification helps cocaine addicts to break old habits. This includes any friendships with persons who use cocaine. Learning what “triggers” may cause relapse into cocaine use are also examined in this approach.

Many individuals attend 12-step kinds of self-help programs and attend regular meetings. Some of these include Cocaine Anonymous (CA) and Narcotics Anonymous (NA), along with Alcoholics Anonymous (AA). These get-togethers help reinforce reminders of why the drug is so powerful – and why they need to avoid it completely.

The NIDA has sponsored a number of studies of cocaine treatment methods and published several manuals. Group Drug Counseling (GDC) describes one such approach and is the subject of one of these manuals. GDC is used in conjunction with Individual Drug Counseling (IDC), Individual Supportive-Expressive Psychotherapy (SEP), Individual Cognitive Therapy (CT), or alone.

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