The standard treatment for cocaine addiction involves a combination of individual and group therapies and possibly inpatient rehabilitation. Several pharmaceutical approaches to reducing cravings and withdrawal have been tested, but so far, there is no “silver bullet.” Medications approved for treating cocaine addiction include Provigil (modafanil), Depacon (valproate), and Antabuse (disulfiram). Another interesting line of research is the so-called “cocaine vaccine,” which consists of an injection that causes the body’s immune system to attack cocaine molecules before they can reach the brain (Shorter and Kosten, 2011). Because the public health burden of cocaine abuse and addiction is massive and ongoing, research into effective treatments continues at a rapid pace.
At Duke University, a clinical trial of a new treatment approach is now recruiting subjects. Cocaine-addicted individuals aged 18 to 60 years will be placed in one of two experimental groups. Exclusion criteria include homelessness, impending jail terms, and severe mental health issues beyond cocaine addiction. The first group will receive individual and group counseling that conforms to the guidelines of the National Institute on Drug Abuse. A second group will receive similar therapy in addition to computer-aided treatment in the form of virtual reality software. The software is designed to reinforce the benefits of abstinence and reduce cravings. When subjects are outside of the clinical setting, a cell phone-based application will provide positive reinforcement during moments of crisis. The researchers hope to show that technological devices represent an effective and relatively inexpensive form of treatment. In addition, computer software carries far less risk of adverse events or noncompliance than pharmaceutical approaches. If successful, more research on the proper use of computer-aided treatments is certain to follow.
As part of the study, participants will provide urine samples for analysis three times per week. Previous research has demonstrated that urine testing often leads to higher levels of abstinence, and researchers at Duke will have to be mindful of this factor so as not to generate artificially positive results. Future research may investigate whether computer-aided treatment combined with pharmaceutical treatments might be more effective than either one alone. At any rate, the innovations and discoveries now taking place promise a brighter future for those involved in public health and cocaine addiction treatment.
References
- Developing Computer Based Treatments for Addiction. (n.d.). ClinicalTrials.gov. Retrieved May 24, 2012, from http://clinicaltrials.gov/ct2/show/NCT00586534?recr=Open&cond=%22Behavior%2C+Addictive%22+AND+%22Compulsive+Behavior
- Sanchez-Hervas, E., Romaguera, F., Gomez, F., Secades-Villa, R., Garcia-Rodriguez, O., & Yanez, E. (2010). Urine testing during treatment predicts cocaine abstinence. Journal of Psychoactive Drugs, 42(3), 347-352.
- Shorter, D., & Kosten, T. (2011). Novel pharmacotherapeutic treatments for cocaine addiction. BMC Medicine, 9(119). Retrieved May 24, 2012, from http://www.biomedcentral.com/1741-7015/9/119

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