The combination of baclofen, a muscle antispasticity agent, and counseling significantly reduces cocaine use compared with placebo plus counseling, according to an article in the December 15th issue of the Journal of Clinical Psychiatry.

“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, PhD, lead author of the study. “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.”

In the current work, a double-blind study evaluated whether baclofen might inhibit dopamine release in the brain and decrease the euphoric “high” associated with cocaine use. A total of 70 outpatients underwent a 16-week cocaine addiction treatment program with half the patients randomized to baclofen and half to placebo. All participants received counseling. Cocaine use by patients was monitored using 3 urine tests each week throughout the study.

During the study, participants in the baclofen group had significantly fewer urine samples indicative of recent cocaine use than did participants in the placebo group. This was particularly true for those participants who started the study with chronic, heavy rates of crack cocaine use.

The National Institutes of Health have funded studies evaluating 60 medications for cocaine addiction. Baclofen is the third medication that has been recommended for a large, multicenter study. An 8-site replication study of the current work is scheduled to begin in February 2004 and will have a much larger participant population.