Pharmacological Treatments for Cocaine Craving: What Is the Way Forward? A Systematic Review PMC

Half of the studies with 5HT agents had an attrition rate greater than 50%. Notably, studies that included adjuvant non-pharmacological therapies had lower attrition rates. In summary, psychosocial treatments represent the current gold-standard for CUD treatment. Within this broader category, CM and CBT-SUD currently have the greatest empirical support in positive treatment outcomes (eg, reduced cocaine use), collectively garnered over approximately 3 decades of research and application. Nonetheless, ongoing barriers remain including implementation barriers such as stigma towards these practices, pragmatic limitations (eg, cost, staff availability), and model adherence.

cocaine addiction treatment

One study administering acute fenfluramine [22] found evidence of anti-craving effects 2-fold greater than placebo. Characteristics and main findings of the studies included in the systematic review–Psychostimulants. Combined, the studies included had 8137 participants; the smallest study had eight participants, whereas the largest had 358 participants. Men comprised the majority (75%) of the sample and 21 studies had only male participants. Two authors, D.L.S.L. and J.M.C.M. independently assessed the risks of bias in each study included, using the Study Quality Guide from the Cochrane Consumers and Communication Review Group [18]. Another study with positron emission tomography (PET) [9] using personalized cues and autobiographical memories found a decreased activity in the prefrontal cortex, lending support to previous findings showing a disruption of prefrontal activity during craving [4].

What are the principles of effective treatment?

Sessions with a trained therapist can help you make changes to your behaviors and thought processes. You may need to stay in a rehabilitation center (also known as rehab) for intensive therapy and support. If you do attend rehab, continuing treatment afterward (aftercare) is important to help you avoid relapse.

cocaine addiction treatment

My concern, though, is that those who would believe me already understand addiction and can separate the illness from the individual. The promise of February sunshine, palm trees, and sobriety cocaine addiction treatment had brought us both across several state lines to South Florida. In the throes of fentanyl withdrawal, I hardly appreciated his childlike energy at first — or the palm trees, for that matter.

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The overall proportion of subjects who achieved three consecutive weeks of abstinence was larger in the MAS-ER and topiramate group (33.3%) than in the placebo group (16.7%). There was a significant moderating effect of baseline total number of cocaine use days on outcome, suggesting that the combination treatment was most effective for participants with a high baseline frequency of cocaine use (67). To test the potential of topiramate for the treatment of CUD, our laboratory (60) carried out a pilot study involving 40 subjects with DSM-IV cocaine dependence, treated for a period of 13 weeks. Subjects were randomly assigned to topiramate (200 mg) daily or to placebo. Topiramate-treated subjects showed a significantly higher rate of abstinence during the last 5 weeks of the trial compared to placebo-treated patients.

At the same time, you might develop what’s called sensitization to the drug. That means it takes less of it to cause negative effects like anxiety and convulsions. Your brain may become less responsive to other natural rewards, such as food and relationships. Instead of using baking soda as you would with crack, you add ammonia to “free” the cocaine base from its natural form. For this reason, you might hear the terms “crack” and “freebase” used interchangeably.

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