There are currently no FDA-approved medications for the treatment of cocaine use disorder. A potentially effective medication is modafinil, a medication already approved to treat narcolepsy.
l
Modafinil has been shown to reduce cocaine use (see here) and cocaine induced euphoria (see here) in some trials, while a recent trial showed no effect for modafinil when combined with cognitive-behavioral therapy (see here).
This randomized controlled trial conducted by Kampman and colleagues recruited 94 individuals with DSM-IV cocaine dependence who were seeking treatment for their cocaine use. People with any additional current substance use disorders besides nicotine and cannabis were not eligible to participate.
Participants were randomized to receive 300 mg modafinil (n=47) or an identical placebo (n=47) daily for eight weeks. The groups were similar on demographics and baseline drug use characteristics. All participants also received weekly individual cognitive-behavioral therapy (CBT) based on the Project MATCH manual. Contingency management (CM) was used to increase attendance at assessments for all participants.
For each completed treatment visit, participants were able to draw from a bowl with 500 slips. Half had no monetary value while 1 was worth $100, 219 were worth $1, and 30 were worth $25. Urine samples were collected twice weekly. A participant was considered to be abstinent in a week they self-reported abstinence and had negative results for both urine samples.
Participants in the modafinil group were:
This study had better rates of retention and trial completion than previous trials which may be due to the use of contingency management. While more research is needed to further substantiate results, this is the third trial with findings supporting the effectiveness of modafinil for the treatment of cocaine use disorder.
Cocaine use disorder has proven difficult to treat with psychosocial treatment alone, and there are currently no medications available to enhance treatment despite best efforts to identify effective pharmacotherapies.
Not all medications will work for all patients, and it is important to recognize that this treatment may not be effective in other cocaine using populations such as people with common co-occurring alcohol or other drug use disorders.
More randomized controlled trials in larger samples are needed to further substantiate these results. Studies with longer follow-up are also needed as the 8 week follow-up period from the current study may not be adequate for determining lasting impact of this treatment. Research should also focus on identifying the ideal dose of modafinil for treating cocaine use disorder.
Kampman, K. M., Lynch, K. G., Pettinati, H. M., Spratt, K., Wierzbicki, M. R., Dackis, C., & O’Brien, C. P. (2015). A double blind, placebo controlled trial of modafinil for the treatment of cocaine dependence without co-morbid alcohol dependence. Drug Alcohol Depend, 155, 105-110. doi:10.1016/j.drugalcdep.2015.08.005
l
Modafinil has been shown to reduce cocaine use (see here) and cocaine induced euphoria (see here) in some trials, while a recent trial showed no effect for modafinil when combined with cognitive-behavioral therapy (see here).
This randomized controlled trial conducted by Kampman and colleagues recruited 94 individuals with DSM-IV cocaine dependence who were seeking treatment for their cocaine use. People with any additional current substance use disorders besides nicotine and cannabis were not eligible to participate.
Participants were randomized to receive 300 mg modafinil (n=47) or an identical placebo (n=47) daily for eight weeks. The groups were similar on demographics and baseline drug use characteristics. All participants also received weekly individual cognitive-behavioral therapy (CBT) based on the Project MATCH manual. Contingency management (CM) was used to increase attendance at assessments for all participants.
For each completed treatment visit, participants were able to draw from a bowl with 500 slips. Half had no monetary value while 1 was worth $100, 219 were worth $1, and 30 were worth $25. Urine samples were collected twice weekly. A participant was considered to be abstinent in a week they self-reported abstinence and had negative results for both urine samples.
Participants in the modafinil group were:
This study had better rates of retention and trial completion than previous trials which may be due to the use of contingency management. While more research is needed to further substantiate results, this is the third trial with findings supporting the effectiveness of modafinil for the treatment of cocaine use disorder.
Cocaine use disorder has proven difficult to treat with psychosocial treatment alone, and there are currently no medications available to enhance treatment despite best efforts to identify effective pharmacotherapies.
Not all medications will work for all patients, and it is important to recognize that this treatment may not be effective in other cocaine using populations such as people with common co-occurring alcohol or other drug use disorders.
More randomized controlled trials in larger samples are needed to further substantiate these results. Studies with longer follow-up are also needed as the 8 week follow-up period from the current study may not be adequate for determining lasting impact of this treatment. Research should also focus on identifying the ideal dose of modafinil for treating cocaine use disorder.
Kampman, K. M., Lynch, K. G., Pettinati, H. M., Spratt, K., Wierzbicki, M. R., Dackis, C., & O’Brien, C. P. (2015). A double blind, placebo controlled trial of modafinil for the treatment of cocaine dependence without co-morbid alcohol dependence. Drug Alcohol Depend, 155, 105-110. doi:10.1016/j.drugalcdep.2015.08.005
l
Modafinil has been shown to reduce cocaine use (see here) and cocaine induced euphoria (see here) in some trials, while a recent trial showed no effect for modafinil when combined with cognitive-behavioral therapy (see here).
This randomized controlled trial conducted by Kampman and colleagues recruited 94 individuals with DSM-IV cocaine dependence who were seeking treatment for their cocaine use. People with any additional current substance use disorders besides nicotine and cannabis were not eligible to participate.
Participants were randomized to receive 300 mg modafinil (n=47) or an identical placebo (n=47) daily for eight weeks. The groups were similar on demographics and baseline drug use characteristics. All participants also received weekly individual cognitive-behavioral therapy (CBT) based on the Project MATCH manual. Contingency management (CM) was used to increase attendance at assessments for all participants.
For each completed treatment visit, participants were able to draw from a bowl with 500 slips. Half had no monetary value while 1 was worth $100, 219 were worth $1, and 30 were worth $25. Urine samples were collected twice weekly. A participant was considered to be abstinent in a week they self-reported abstinence and had negative results for both urine samples.
Participants in the modafinil group were:
This study had better rates of retention and trial completion than previous trials which may be due to the use of contingency management. While more research is needed to further substantiate results, this is the third trial with findings supporting the effectiveness of modafinil for the treatment of cocaine use disorder.
Cocaine use disorder has proven difficult to treat with psychosocial treatment alone, and there are currently no medications available to enhance treatment despite best efforts to identify effective pharmacotherapies.
Not all medications will work for all patients, and it is important to recognize that this treatment may not be effective in other cocaine using populations such as people with common co-occurring alcohol or other drug use disorders.
More randomized controlled trials in larger samples are needed to further substantiate these results. Studies with longer follow-up are also needed as the 8 week follow-up period from the current study may not be adequate for determining lasting impact of this treatment. Research should also focus on identifying the ideal dose of modafinil for treating cocaine use disorder.
Kampman, K. M., Lynch, K. G., Pettinati, H. M., Spratt, K., Wierzbicki, M. R., Dackis, C., & O’Brien, C. P. (2015). A double blind, placebo controlled trial of modafinil for the treatment of cocaine dependence without co-morbid alcohol dependence. Drug Alcohol Depend, 155, 105-110. doi:10.1016/j.drugalcdep.2015.08.005
SIGN UP FOR THE BULLETIN
