Possible Cocaine Substitute

Cocaine addicts may benefit from an ADHD medication for a substitute therapy

/ Author:  / Reviewed by: Dominique Brooks, M.D

(RxWiki News) Quitting any addiction cold turkey can be really tough. A replacement for cocaine, like methadone for heroin addicts, may pave the way for a new therapy to help addicts quit. 

In a recent clinical trial, researchers tested the use of a medication used to treat attention-deficit/hyperactivity disorder on a small group of people addicted to cocaine.

The results of this study showed this medication may provide the basis for a possible substitute treatment for cocaine addicts.

Methylphenidate is currently an approved prescription medication for the treatment of ADHD and is marketed under brand names such as Ritalin, Concerta and Metadate CD.

"Seek treatment for cocaine addiction immediately."

Rita Goldstein, PhD, professor of psychiatry at Icahn School of Medicine at Mount Sinai in New York, NY, led an investigation into the use of a medication used to treat attention-deficit/hyperactivity disorder to help treat cocaine addiction.

Methylphenidate, brand name Ritalin, is a psychostimulant medication that has been on the market since 1955.

Dr. Goldstein suggested in a press release that perhaps methylphenidate could work as a substitute for cocaine for people with cocaine use disorders in the same way that nicotine gum or nicotine patches aid smokers and methadone aids heroin addicts.

The researcher recruited 18 people with a cocaine use disorder, that were not in the process of seeking treatment, for the small clinical trial. The participants were split into two groups.

Half of the participants were given 20 mg of methylphenidate and the rest were given a fake pill, or placebo, before having a functional magnetic resonance imaging (fMRI) brain scan.

Brain scans were done before the medication would have had a chance to kick in and a second scan was done 120 minutes after taking the methylphenidate.

The researchers looked at the brain scans for changes in connections between neurons and neural systems in the brain.

The participants were given the Stroop test during the brain scans. In the Stroop test, a person reads words out loud from a sheet of paper. The words are the names of colors and the words are typed in different colors of ink. For example, the word could read “orange,” but be printed in purple ink.

Using the Stroop test during the brain scan helped activate brain activity.

People that had taken methylphenidate had greater activity in the areas of the brain involved with emotional regulation and behavioral control compared to people that had taken the placebo. These areas of the brain do not work well in people who have cocaine use disorder.

The authors concluded that the use of methylphenidate stimulated areas of the brain, which could promote development of improved treatment options for people with cocaine use disorder.

“Cocaine, a powerfully addictive drug derived from the leaves of the South American coca plant, produces an intensely euphoric effect upon users.  The harmful effects of cocaine have been well-documented and include palpitations, heart arrhythmias, seizures, stroke and possibly death,” Jason Poquette, BPharm, RPh, told dailyRx. 

“Some estimates suggest that upwards of 2 million adults are addicted to cocaine in the US. Therefore helping individuals overcome cocaine addiction is a serious healthcare concern."

"The research published in the latest edition of JAMA Psychiatry provides some insights into the possibility of methylphenidate serving as a transitional drug much in the way methadone is currently used to help transition individuals addicted to heroin.” 

“The fact that benefits were observed after only a single dose is especially encouraging.  However, we need to recognize that the results of the study only point to a potential usefulness in the treatment  of cocaine addiction, and that further investigation would be needed to demonstrate effectiveness,” said Dr. Poquette, who was not involved with this study.

This study was published in June in JAMA Psychiatry.

The National Institute on Drug Abuse provided funding for this project. No conflicts of interest were declared.

Reviewed by: 
Review Date: 
June 29, 2013
Last Updated:
July 30, 2013