Key Concepts

Counteracting Cocaine

• Doctors have few pharmacological remedies for addiction and no standard drug therapy for cocaine dependence. A decrease in cocaine use by 10 percent could save the U.S. $745 million in medical, law-enforcement and other cocaine-related expenses.
• Experimental therapies, including one marketed for epileptic seizures and another for the sleep disorder narcolepsy, appear to help addicts quench or diminish the thirst for cocaine.
• Scientists are also trying to enlist the immune system to thwart cocaine abuse.

Many people still chalk up the destructive behavior of a drug addict to a lack of willpower or weakness of character. To a neuroscientist, however, drug addiction is a psychiatric illness that develops when the repeated use of narcotics disrupts brain chemistry. Such a chemical disturbance cries out for a chemical solution—that is, a drug treatment.

Doctors have few pharmaceutical remedies for drug addiction, which is often resistant to talk therapy. Relapse rates run as high as 40 to 60 percent for many types of substance abuse. Heroin addicts often benefit from methadone, a synthetic opioid that thwarts cravings by substituting for some of heroin’s effects; naltrexone, an opioid receptor blocker, helps alcoholics kick their habit by reducing the desire for alcohol. But most victims of drug dependence are left with no antidote to the neurological havoc their habit has wrought in their brain. “We have very few medications for the treatment of addiction,” says Nora D. Volkow, director of the National Institute on Drug Abuse (NIDA), “and it’s urgent” that more such drugs are developed.

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