Pharmacotherapeutic Interventions for Cocaine Abuse Matching Patients to Treatments

Abstract

Cocaine abuse treatment has begun to use a variety of adjunctive pharmacotherapies. These medications have been used for both acute crash symptoms and long-term prevention of relapse. A phasic model of recovery was integrated with a patient typology to formulate guidelines for using these rapidly evoling pharmacotherapies. The phases are crash, withdrawal, and extinction, and the patient typology includes psychiatric vulnerability and severity of cocaine abuse as contributors to the neuroadaptation that requires pharmacological amelioration. These guidelines address five issues: whom to treat, when to treat, that treatments are available, where to initiate and maintain treatment, and how to match patients to treatment options.