Published in the Dec. 15 edition of the peer-reviewed Journal of Clinical Psychiatry, the randomized, double-blind study found that baclofen used in conjunction with substance abuse counseling significantly reduced cocaine use in recovering addicts compared to placebo coupled with counseling. The study was funded by the National Institute on Drug Abuse as part of a project to screen medications with potential for treating cocaine dependence.
"The research shows for the first time, using scientifically rigorous methods, that Baclofen can help people reduce their cocaine use when they are in drug abuse counseling," said Steven Shoptaw, the study's principal investigator and a clinical psychologist at the UCLA Neuropsychiatric Institute. "Our findings give us a strong starting place to conduct more definite studies on whether this medication can help cocaine addicts when used outside controlled research clinics. This offers new hope to hundreds of thousands of cocaine abusers who struggle with addiction."
According to the federal Substance Abuse and Mental Health Services Administration, cocaine addiction affects 1.7 million American adults. In Los Angeles County, cocaine abuse ranks second only to alcohol as the most frequent cause for substance abuse treatment.
Baclofen has been approved and prescribed for years to treat spasticity, particularly in muscular sclerosis patients. Major side effects include fatigue and headache. Baclofen may help cocaine addicts by inhibiting the release of the neurotransmitter dopamine in the brain, undercutting the "high" caused by cocaine.
The study involved 70 outpatients who underwent a 16-week cocaine addiction treatment program. Half the participants received baclofen and counseling and half received a placebo, or sugar pill, and counseling. Cocaine use by the patients was monitored using three urine tests each week throughout the study.
The researchers found that the baclofen group, compared to the placebo group, overall had significantly fewer urine samples that indicated recent cocaine use, particularly for those participants who started the study with chronic, heavy rates of crack cocaine use.
The National Institute on Drug Abuse has funded studies evaluating 60 medications for cocaine addiction. Baclofen is the third medication that has been recommended for a large, multicenter study. An eight-site replication study with larger patient populations led by Shoptaw at UCLA and funded by the institute is scheduled to begin in February 2004.
Shoptaw conducts his research as part of the UCLA Integrated Substance Abuse Programs, a unit of the UCLA Neuropsychiatric Institute, and as a principal investigator with Friends Research Institute.
The UCLA Neuropsychiatric Institute is an interdisciplinary research and education institute devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior, and the causes and consequences of neuropsychiatric disorders.
·UCLA Neuropsychiatric Institute: www.npi.ucla.edu
·UCLA Integrated Substance Abuse Programs: www.uclaisap.org/
·National Institute on Drug Abuse: www.drugabuse.gov
·Friends Research Institute: www.friendsresearch.org/
Journal of Clinical Psychiatry