Pubdate: Tue, 06 Jan 2004
Source: Medical Post (Canada)
Copyright: 2004 The Medical Post
Contact:  http://www.medicalpost.com/
Details: http://www.mapinc.org/media/3180
Author: Nancy Deutsch

COULD SPINAL CORD MEDS CURE COCAINE ADDICTION?

Study Results So Surprising Researchers Sent Them for Independent
Analysis

LOS ANGELES - Baclofen, used for years to treat spasticity, has
produced surprising results in cocaine abusers seeking to overcome
their addiction. Baclofen may help cocaine addicts by inhibiting the
release of dopamine in the brain, reducing the high associated with
use of the narcotic, according to researchers here who conducted a
randomized, double-blind study of 70 cocaine-addicted
outpatients.

The researchers found those who received baclofen in conjunction with
counselling had significantly fewer positive urine samples (indicating
cocaine use) than those receiving placebo and counselling.

The results were especially favourable for those with chronic, heavy
rates of crack cocaine use at the beginning of the study.

Heavy users were defined as those who provided three or more urine
samples positive for cocaine metabolites during the two-week baseline
screening period.

"I was surprised by the results of our study," said principal
investigator Dr. Steve Shoptaw (PhD), a psychologist at the University
of California Neuropsychiatric Institute here.

Until now, he said, "no medications have shown efficacy in
placebo-controlled trials for treating cocaine dependence."

Third-Party Analysis

The researchers were so surprised by their findings they had an
independent analysis of the study done by the Biostatistics Group at
Stanford University Medical Centre.

Stanford researchers replicated the findings using different
models.

During the 16 weeks of the study, baclofen patients provided an
average of 12.7 cocaine metabolite-free urine samples, compared to 9.0
for the placebo patients. There were 48 urine samples collected per
patient during the study. The 35 patients receiving baclofen were
given a standard dose of baclofen 20 mg three times daily.

It would be helpful to find a way to give the medication less often,
Dr. Shoptaw said.

"Thrice daily dosing is a demanding schedule for medication compliance
in a group that is historically non-compliant with medications and
with counselling."

Beginning in March 2004, an eight-centre, eight-week U.S. trial will
test the results of the study.

Should the results of the new trial support these findings, "I think
that would generate a great deal of excitement in addiction medicine,"
Dr. Shoptaw said.

"Addicts seeking treatment often do so when they have few resources.
Providers often are frustrated by a lack of effective treatment for
cocaine dependence."

The study appeared in Clinical Psychiatry and was funded by the
National Institute on Drug Abuse. 
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MAP posted-by: Richard Lake