MS Drug Offers Hope to Cocaine Addicts

It helped users kick their habit, new research finds

TUESDAY, Dec. 16, 2003 (HealthDayNews) -- Doctors use pills to treat everything from alcoholism to heroin and tobacco addiction, but cocaine abusers are left out in the cold. Only willpower helps them kick the habit.

But preliminary research suggests they may get help from a medication used to treat multiple sclerosis that seems to make them less susceptible to the effects of cocaine.

"It's an initial first step, it's a first look," says study co-author Steven Shoptaw, a psychologist at the University of California, Los Angeles. "There's some hope that medication development is moving forward, and that we're going to be aggressive about finding a medication for cocaine dependence."

In 1997, the U.S. government estimated that 1.5 million Americans smoked, chewed, injected or snorted cocaine. And an estimated 30 percent of drug-related emergency room visits involve the use of cocaine.

Unlike other drugs, cocaine affects a variety of neurotransmitters, major players in the brain's chemical relay system. "That complicates a targeted approach" to reversing addiction, Shoptaw says.

Cocaine primarily appears to prevent the brain from recycling dopamine, a neurotransmitter that's linked to good feelings, he says. As dopamine builds up in their brain, people feel the euphoric high of cocaine use.

However, drugs that restore normal dopamine levels don't help cocaine users at all, he says.

In the new study, researchers enrolled 70 cocaine addicts and gave half of them a multiple sclerosis drug called baclofen. The other half got a placebo. All also underwent drug counseling.

After 16 weeks, the addicts who took baclofen were more likely to kick the habit. The drug seemed to do the most good for the most addicted patients.

At much higher doses, doctors use baclofen to treat muscle spasms in multiple sclerosis patients. According to the National Multiple Sclerosis Society, side effects -- including drowsiness and weakness -- typically disappear as the body adjusts to the drug.

The researchers aren't sure why the medication seems to help cocaine addicts, although they think it may inhibit the release of dopamine and undercut the "high" caused by cocaine.

Along with dampening the effects of cocaine itself, it may prevent disruption of neurotransmitters in the brain when people aren't using cocaine, adds Dr. Thomas Kosten, a cocaine expert and a professor of psychiatry at Yale University.

Shoptaw puts it this way: "My hunch is that it's helping people feel better."

Researchers still need to make sure the study results aren't a fluke, and they plan to launch a more extensive study of baclofen next year.

Other related drugs wait in the pipeline, too. "It's not the only medication that has some promise," Kosten says.

The results of the new research appear in the Dec. 15 edition of the Journal of Clinical Psychiatry.

More information

Learn more about baclofen from the National Multiple Sclerosis Society. And get details about cocaine addiction from the National Institute on Drug Abuse.

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