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Can Amphetamines Help Cure Cocaine Addiction?

Monday, December 08, 2008

TIME (USA)

When methadone was first proposed for the treatment of heroin addiction, it sounded like a pointless gambit - sort of like substituting vodka for gin. That's enabling addicts, critics said, not helping them.

But over the years, maintenance treatment with methadone and other synthetic opiates like buprenorphine has proved successful - more than any other heroin-addiction therapy - in getting people off illicit drugs and lowering HIV transmission rates, crime and death among users. That success, in part, has got researchers wondering whether addiction to other drugs - namely to the stimulants cocaine and methamphetamine - could be curbed in the same way, by substituting a chemically similar alternative. (See the Year in Health, from A to Z.)

"It's an idea that really does need to be rigorously evaluated," says Frank Vocci, director of the pharmacotherapy division at the National Institute on Drug Abuse (NIDA). "But right now there is more discussion than data."

The problem of stimulant addiction in the United States has dropped out of the spotlight of late, but it has not disappeared. According to a 2007 government survey, 2.1 million Americans had used cocaine in the month prior to the survey and 1 million had taken other stimulants for non-medical purposes, including more than half a million users of methamphetamine. There are currently no overwhelmingly effective addiction treatments. Abstinence-based rehab therapy for meth and cocaine work about as well as rehab for other drugs ó meaning that about one-third of users improve following treatment, but most relapse repeatedly. And despite decades of study of dozens of compounds, there are yet no federally approved medications for cocaine or meth addiction.

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