Once bypassed cocaine addiction being studied

Major strides in medication treatment of alcoholism, cigarette smoking and narcotics addiction seem to have bypassed cocaine addicts until now.

“We have been fortunate to receive funding and are now working on three new research studies for medication treatment for cocaine addiction,” reported Robert J. Malcolm, M.D., of MUSC’s Center for Drug and Alcohol Programs (CDAP).

The National Institutes of Mental Health (NIMH) has made medication treatments for cocaine addiction a number-one priority, an important step in light of the crime, social distress and violence associated with cocaine use. Currently, 1.7 million Americans use cocaine daily. This is a dramatic improvement when compared to the 5.7 million cocaine users in 1985. Alarming, however, is the fact that the number of 18-25-year-old illicit drug users has increased.

One medication, owned by a pharmaceutical firm, previously has been shown to decrease cocaine use in animals. Malcolm expects the study to run for two years. He said that participants who do well on the medicine will be allowed to continue using it after the study is over.

Another study involves a combination of Pergolide and Haloperidol. Researchers hope that this combination will decrease cocaine craving and acquisition.

A third and innovative plan to use the high blood pressure treatment medication, Amlodipine, expects this drug to decrease cocaine use and improve the impaired brain circulation that incurs in cocaine addicts with long term use. Malcolm said that CDAP has recently been funded to begin the study in collaboration with Kathleen T. Brady of CDAP and Perry Halushka, Ph.D., M.D., Department of Internal Medicine and Pharmacology. Participants will receive intensive counseling as well as medication or a placebo.

“We are very excited about this study because it represents a real departure from most of the traditional medicines used to treat cocaine addiction which have failed in the past,” Malcolm said. Some of the subjects will participate in neuroimaging which will look for changes in the brain circulation in order to better understand brain mechanisms of craving, he said.

A previous study with Pergolide proved it to be ineffective for the treatment of cocaine addiction. It appeared that Pergolide in high doses made the cocaine addiction worse and the participants appeared to drop out of treatment at a higher rate and had more positive urine drug screens than did the placebo group. This had been a concern, but had never before been demonstrated. MUSC is attempting to get this information published.

For those interested in any of the cocaine medication studies, contact Julianne Moore, MUSC research coordinator and senior research nurse, at 792-1184.

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