Treatment for cocaine users

Treatment for cocaine users

Problem cocaine use and cocaine dependence can lead to numerous adverse psychological and physical consequences.

What works?

  • Psychosocial interventions improve treatment adherence and can increase abstinence at the end of treatment, however effects may not be maintained  in the long term
  • Contingency management is useful to reduce drug use among cocaine users
  • Medicines used to treat other diseases (such as disulfiram for alcohol addiction, antidepressants and antiparkinsonians) can help cocaine users to reduce use
  • Various psycho-social treatment (including contingency management) interventions for crack abuse/dependence show some positive yet also some limited/short-term efficacy
  • For pregnant women, medications to assist detoxification from stimulants can be used but should be reserved for cases when specific symptoms emerge.

What's unclear?

  • It is not clear whether antidepressants help reduce the craving for cocaine
  • It is also not clear if psycho-stimulants can help treat cocaine dependence

What doesn't work?

  • Pharmacotherapies based on dopamine agonists, anticonvulsants as well as antipsychotics are probably of little value in the treatment of cocaine dependence
  • Pharmacotherapy for routine treatment of dependent pregnant women is not recommended
  • Psychosocial interventions alone or in addition to the usual care do not make a difference in both treatment and obstetrical outcomes, when standard comprehensive care options are in place, eg prenatal care, counselling

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