Pharmacological blocking agents for treating substance abuse

Article Abstract:

Pharmacological blocking agents are receiving renewed attention for the treatment of substance abuse. These blocking agents are drugs that are administered to prevent the desired action of the abused substance. The effect can take the form of a reaction with the abused substance to produce unpleasant side effects, as in the case of disulfiram for alcohol abuse, or may act as an antagonist that simply blocks the effect the abused drug, as in the case of naltrexone for opioid abuse. Other than disulfiram and naltrexone, blocking agents are currently unavailable in the US. Biological and behavioral aspects of substance abuse treatment must both be considered. That is, pharmacological blocking agents will not effective if the behavior of the individual does not change. The behavioral component assumes that substance abuse is a type of conditioned behavior. Confounding the process of recovery are withdrawal and abstinence effects, uncomfortable physiological and psychological side effects of recovery. Development of pharmacological blocking agents needs to be multidisciplinary so that physiological and psychological aspects of substance abuse and substance abuse treatment can be considered. Behavioral aspects include patient compliance with medication instructions and avoidance of the abused substance when faced with abstinence and withdrawal effects. Biological aspects include development of safe and effective blocking agents that alone, or in conjunction with other drugs, minimize abstinence and withdrawal symptoms. The uses of disulfiram and naltrexone are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Health aspects, Usage, Physiological aspects, Naltrexone, Substance abuse, Drug addicts, Drug abusers, Substance abuse treatment, Pharmaceutical research, Disulfiram

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Designing drug efficacy trials in the treatment of cocaine abuse

Article Abstract:

A 1984 survey estimated that there were about 3 million regular users of cocaine in the US. In an effort to combat escalating usage, the efficacy of drug therapy has been investigated. Few studies have used placebo-controls; another factor that needs to be considered is the fact that many patients abuse more than one drug. Several considerations should be accounted for when planning a study design. Pilot studies may be useful and subjects need to be carefully selected. To study the side effects of treatments, a controlled inpatient environment may be ideal. Researchers must decide on criteria for dependence or abuse, and whether polysubstance abuse should exclude potential subjects. Automatic criteria to consider are medical contraindications that may be dangerous. Sample size must be considered as well, and statisticians may be consulted for guidance. Duration of study, rationale for treatments under study, monitoring results, and follow-up must all be carefully planned. The planning of drug efficacy trials is difficult and time consuming, but crucial to providing meaningful research data. In the area of cocaine abuse, there are many medications that may be useful for treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Methods, Experimental design, Research design

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Pharmacotherapeutic interventions for cocaine abuse: matching patients to treatments

Article Abstract:

Several drugs are now used to treat cocaine abuse. These medications are used for both short-term 'crash' symptoms and for long-term prevention of return to cocaine use. A theory of the different phases of recovery was combined with a patient typology to formulate guidelines for use of these rapidly evolving drug therapies. The phases are crash, withdrawal, and extinction of addiction. The patient typology includes measures of psychological vulnerability and severity of cocaine use as indicators of how dependent upon cocaine the brain has become. The guidelines address five issues: whom to treat, when to treat, what treatments are available, where to initiate and maintain treatment, and how to match patients with the various treatment options available.

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