Ketamine is hypothesized to extend beyond NMDAR modulation to downstream effects on other neurotransmitter systems and pre-frontal synaptogenesis. A separate study using the same higher ketamine dose yielded decreased cocaine self-administration 28 hours post-infusion compared to the control condition (0.025 mg/kg midazolam) [125]. Furthermore, ketamine increased self-reported distress tolerance 48 hours post-infusion relative to controls. By creating a reprieve from reactivity to distress, ketamine treatment may help individuals with CUD to access and experience the full benefit of behavioural interventions. In a recent trial, doxazosin-treated (8 mg/day) individuals exhibited a greater reduction in cocaine use relative to those treated with placebo [45].
Furthermore, attention to medication adherence is highly inconsistent throughout clinical trials or inadequate (e.g. counting pills [55]). One possible solution to this problem is the employment of biomarkers to track medication exposure. The precise reasons for dropout are often unknown or unreported, but this information may prove invaluable to determining better tolerated treatment trial parameters. Several pre-clinical studies support the potential efficacy cocaine addiction treatment of GABAergic medications for the treatment of CUD. GABA is an important modulator of the mesolimbic reward system [109–112], and medications that increase GABAergic activity such as vigabatrin and baclofen have been shown to reduce cocaine self-administration in animal models. Although clinical trials to date have not demonstrated efficacy for baclofen [37], positive outcomes have been found for vigabatrin in a study that ensured high medication adherence [38].
What medications and devices help treat drug addiction?
Standard outpatient drug counseling typically consists of one or two sessions per week; the duration of an individual counseling session is typically between 30 and 60 min, while group sessions are 60 to 90 min in length. Participation in mutual help groups (such as 12-step meetings) is generally encouraged. But it carries many risks, including overdose and serious physical and mental side effects as well as addiction. If you or someone you know has problems with cocaine use, seek help from a doctor or mental health professional. In this meeting, loved ones typically highlight specific behaviors and instances wherein the individual’s drug abuse has affected them personally.
- Agonist treatment utilizes a substitution approach to replace (or displace) the illicit drug for the purpose of stabilizing functioning.
- While cocaine can adversely affect every organ in the body, its most dangerous and life-threatening effects are on thecardiovascular system.
- If they don’t agree right away, don’t blame yourself—give it time and ask again.
In the third trial, Nuijten et al. (66) conducted a trial of topiramate involving 74 crack cocaine–dependent outpatients. The subjects were randomized to receive either 12-week CBT plus topiramate staring at 25 mg daily and rapidly titrated over 3 weeks to 200 mg daily or 12-week CBT only. Secondary outcomes included medication adherence, safety, cocaine and other substance use, health, social functioning, and patient satisfaction. In the intent-to-treat analyses, topiramate neither improved treatment retention nor reduced cocaine and other substance use (66).
How to Treat Cocaine Addiction
During treatment, you’ll attend group therapy sessions and lectures on drug abuse, addiction, and recovery. If you choose to attend an outpatient program, it’s important that you have a strong support system at home to help ensure your recovery. If you believe you won’t be able to avoid triggers and will have easy access to drugs, however, you may wish to pursue inpatient treatment instead. Cocaine use disorder causes a host of medical, psychological, and social problems worldwide, including cardiovascular disease, infection, violence, and crime. The United Nations Office on Drugs and Crime [1] estimates that, in 2018, 19 million people used cocaine, a number that is expected to grow against the backdrop of the socioeconomic crisis caused by SARS-CoV-2 pandemic. Yet, despite decades of clinical research, thus far no pharmacological treatments for cocaine use disorder have been established.
For diagnosis of a substance use disorder, most mental health professionals use criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. Because addiction can affect so many aspects of a person’s life, treatment should address the needs of the whole person to be successful. Counselors may select from a menu of services that meet the specific medical, mental, social, occupational, family, and legal needs of their patients to help in their recovery. In early tests, a vaccine helped reduce the risk of relapse in people who use cocaine.