Contingency management is a form of behavioral psychotherapy known to help people recover from an addiction to the stimulant drug cocaine. This therapy uses vouchers or cash prizes to encourage recovering addicts to stay active in the treatment process and meet their program goals.
In a study published in June 2014 in the journal Drug and Alcohol Dependence, a team of researchers from Wayne State University investigated the question of whether the value of the reward offered during contingency management has an impact on the therapy’s chances of producing beneficial outcomes.
Cocaine Addiction Treatment
People addicted to cocaine have a chemical dependence stemming from the lasting changes that the drug makes inside their brains, as well as symptoms that indicate a loss of control over use of the drug and/or a clearly damaging pattern of behavior centered on drug use. When doctors treat certain forms of substance addiction, they can rely on medications proven to increase the odds that a client/patient will halt substance use and establish long-term abstinence.
However, although a number of medications show promise as potential treatments for cocaine addiction, doctors addressing this type of addiction do not currently have a reliable medication available for their use. This means that treatment programs for people addicted to the drug must use some form of counseling or psychotherapy to provide the needed assistance.
The form of psychotherapy most commonly employed for this purpose is behavioral therapy, a term that describes any therapeutic approach designed to modify and/or replace harmful behaviors that support continued involvement in substance use.
Contingency management (CM) is one of the most frequently used forms of behavioral therapy. One approach to the therapy, called voucher-based reinforcement, provides clients/patients with valuable vouchers as rewards for doing such things as producing drug-free urine tests, regularly attending treatment program activities and otherwise taking the steps required to establish drug abstinence and maintain that abstinence.
Within limits, people enrolled in voucher-based programs can choose how to redeem their vouchers.
Another approach to CM, called prize incentives contingency management, substitutes cash prizes for vouchers. When a client or patient participating in this type of contingency management reaches a program objective, he or she earns the chance to enter a drawing and win varying amounts of cash.
As a rule, the rewards in both types of contingency management go up when a program participant consistently meets his or her treatment goals.
Does The Value Of The CM Reward Matter To Addicts?
The Wayne University researchers assessed the impact of the value of the reward offered on the odds that a recovering cocaine addict will comply with his or her program objectives and avoid cocaine use.
During the study, 15 cocaine addicts participated in 10 sessions that required them to choose between drug use and taking the steps required to receive a financial reward for program compliance. During some of these sessions, the reward offered was $1; other sessions offered a reward of $3 for avoidance of cocaine use. In addition, during some of the sessions, the participants had a chance of winning $6, $12 or $24.
The conditions of the first two types of sessions mimicked the terms of voucher-based contingency management, while the conditions of the third type of session mimicked the terms of prize incentives CM. Prior to the main phase of the study, the researchers made sure that the enrolled participants still viewed cocaine use as an attractive and tempting option.
After completing their testing, the researchers concluded that, during the contingency management sessions that offered a fixed $3 reward for not using cocaine, the study participants were substantially more likely to avoid taking the drug than they were during the contingency management sessions that offered a $1 reward.
They also found that the same results held true when the study participants had to choose between using cocaine and taking a chance at winning $6, $12 or $24.
Are Both Alternative Addiction Treatment Programs Effective?
The results of the study generally confirmed the effectiveness of both voucher-based CM and prize incentives CM as methods for helping recovering cocaine addicts remain drug-abstinent.
The study’s authors also concluded that the chances that both of these approaches to contingency management will produce the desired benefits go up when the amount of the reward for avoiding drug use is relatively high.
Topiramate (Topamax) is a prescription medication originally developed as a treatment for certain seizure disorders. Doctors also sometimes prescribe this medication to people affected by other serious health issues, including alcohol addiction. In a study published in May 2014 in the journal Drug and Alcohol Dependence, researchers from two Dutch institutions explored the potential usefulness of topiramate as a treatment for people addicted to crack cocaine. These researchers found that only a small subset of individuals addicted to this form of cocaine clearly benefit from topiramate use.
How Does Topiramate Work?
Specific seizure disorders treated with topiramate include Lennox-Gastaut syndrome and certain forms of epilepsy. The medication helps people affected by these conditions by easing excessive nerve activity inside the brain. This same effect on brain function can also help stop migraine headaches from occurring.
When given to people affected by alcoholism, topiramate can diminish the severity of some of the symptoms associated with alcohol withdrawal, and can thereby help reduce the likelihood that a recovering alcoholic will lapse back into active drinking. Doctors may also prescribe the medication to people affected by medically serious forms of obesity. Available forms of topiramate include tablets and specially designed granules that users can release from a capsule and mix with food.
Topiramate And Cocaine Addiction
There is no medication in doctors’ treatment arsenals approved to help people affected by cocaine addiction. Instead, successful treatment typically depends on a form of behavior modification therapy called cognitive behavioral therapy or on other non-medication-based therapeutic options. Addiction researchers are actively looking for new medications that could help people addicted to cocaine, as well as existing medications that could be adapted for use in cocaine addiction treatment.
In a study published in October 2013 in the American Medical Association journal JAMA Psychiatry, a multi-university research team studied the effects of topiramate on 71 adults impacted by cocaine addiction. These researchers concluded that, compared to recovering addicts who don’t receive the medication while undergoing cognitive behavioral therapy, those who receive both topiramate and cognitive behavioral therapy experience improvements that include longer periods of cocaine abstinence (verified by an increased number of cocaine-free urine drug tests) and a reduced craving for further cocaine intake.
Potential Usefulness Of Topiramate In Crack Cocaine Treatment
Crack cocaine is powdered cocaine that has undergone an additional step of chemical processing. While the two forms of the drug have the same basic brain effects, crack only produces these effects for a relatively brief amount of time. This means that users of this form of cocaine may take the drug more frequently, and therefore may have greater odds of eventually experiencing the long-term brain changes associated with cocaine addiction.
In the study published in Drug and Alcohol Dependence, researchers from Parnassia Addiction Research Centre and the University of Amsterdam specifically investigated the potential usefulness of topiramate treatment in people addicted to crack cocaine. Thirty-seven participants in the study received a 12-week combination of topiramate and cognitive behavioral therapy, while another thirty-seven participants only received cognitive behavioral therapy.
The researchers mainly measured the effectiveness of topiramate treatment by comparing the rate of continued program involvement among recipients of the medication to the rate of continued involvement among those who did not receive the medication.
Variance Factors In Topiramate Use
In addition, they assessed such things as the regularity with which participants took their prescribed topiramate, the presence of negative side effects in the topiramate users, the ability to avoid using cocaine or other substances, the ability of medication users to interact in socially appropriate ways and the level of satisfaction that the topiramate recipients expressed toward use of the medication.
After completing their assessments, the researchers found that topiramate didn’t produce any serious side effects in the study participants. However, they also found that most of the medication recipients did not take it on a regular basis. In addition, they concluded that use of topiramate neither increased the length of involvement in cocaine addiction treatment nor generally contributed to a reduction in the consumption of cocaine or any other substance.
Critically, one group affected by crack cocaine addiction did benefit from topiramate use: those individuals simultaneously impacted by an addiction to opioid drugs or medications. This subset of addicts significantly lowered their cocaine intake while taking topiramate.
Importance Of Consistency Of Topiramate Use
The authors of the study published in Drug and Alcohol Dependence link the low level of topiramate effectiveness in crack cocaine addicts to highly inconsistent intake of the medication. Because many people in treatment don’t maintain their medication routines, the authors believe that topiramate may only play a relatively minor role in addressing the effects of crack cocaine addiction.
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Read More About The Addiction Treatment Uses For Topiramate
There are currently no fully proven medication-based options available to help people addicted to cocaine recover in treatment programs. Researchers and doctors have devoted a considerable amount of time to addressing this lack by either searching for new options or adapting existing medications to treat cocaine addiction. In a study published in April 2014 in The Journal of Neuroscience, researchers from three U.S. institutions explored the potential role of a medication called baclofen (usually prescribed to ease certain forms of severe muscle spasming) in helping recovering cocaine addicts avoid experiencing a drug relapse.
Can Medication Help Cocaine Addiction?
Researchers across the U.S. are investigating the potential usefulness of a number of existing medications as treatments for people affected by cocaine addiction. Medications currently being studied directly in human beings include disulfiram (Antabuse), normally used in alcoholism treatment; modafinil (Provigil), typically used in the treatment of sleep apnea or narcolepsy; and topiramate (Topamax), normally used to control seizure activity and previously adapted for alcoholism treatment. The National Institute on Drug Abuse (NIDA) reports that the most consistent positive results have come from disulfiram. In addition to these adapted medications, some researchers are exploring the possibility of developing a cocaine vaccine that could prevent the drug from producing its characteristic mind-altering effects.
In the absence of proven medications, most cocaine treatment programs rely on behavioral therapies that achieve their beneficial effects by helping recovering addicts change the ways in which they think and react in the presence of internal and external cues associated with drug use. Common options here include cognitive behavioral therapy (CBT) and contingency management. In CBT, people recovering from cocaine addiction learn to identify the thoughts and emotions that support drug use, then go on to learn how to replace those thoughts and emotions with alternatives that don’t support the urge to use cocaine. Contingency management promotes basic program compliance and goal setting by financially or materially rewarding recovering addicts for following program rules and reaching important treatment milestones.
What Is Baclofen?
Baclofen is a chemical relative of a substance that occurs naturally inside the brain. In the treatment of severe muscle spasms, it produces its beneficial effects by slowing down the rate of nerve cell activity in the spinal cord (which, along with the brain, forms the central nervous system). Specific ailments improved by this slowdown include multiple sclerosis and certain spinal cord problems that trigger contractions in the body’s skeletal muscles. Baclofen is widely available as a generic, unbranded medication and comes in tablet form.
Usefulness In Preventing Relapses
Current scientific evidence indicates that, even after extended periods of drug-free living, a recovering cocaine addict can experience chemical reactions in the brain that trigger drug cravings in the presence of internal or external cues previously associated with drug intake. In the face of these cravings, many people in recovery relapse back into drug use. In the study published in The Journal of Neuroscience, researchers from the University of Pennsylvania, Wake Forest University and the Veterans Administration explored the usefulness of baclofen in preventing the chemical changes in the brain that support cravings and relapse. During the study, 23 men addicted to cocaine received either doses of baclofen or a placebo designed to mimic the medication’s appearance. These men ranged in age from 18 to 55.
One week into the study, the researchers used modern scanning technology to examine the participants’ real-time changes in brain function while they viewed cocaine-related imagery at a pace too rapid to register in conscious awareness. Effectively, these rapidly presented images recreated the types of subliminal drug cues that can trigger drug intake in both active users and recovering addicts. When they compared the brain reactions of the baclofen users to the reactions of other study participants, researchers found that the baclofen users showed a substantially lower level of activity in the brain areas responsible for triggering pleasurable sensations and increasing motivation. Normally, increased activity in these areas helps drive the urge to use more drugs.
Based on their findings, the authors of the study published in The Journal of Neuroscience believe that baclofen can help block the subliminal drug-using cues that support the onset of relapse in people recovering from cocaine addiction. However, their work did not include clinical testing of the medication’s ability to prevent drug cravings and relapse in real-world conditions. They point toward a need for further research to investigate baclofen’s effectiveness in such conditions.
Find Out How Alcoholics Respond To Baclofen
04 Apr 2014
Cocaine is a well-known, illegal stimulant drug of abuse. While short-term use of this drug can lead to serious or even fatal health problems, much of the public health focus on cocaine centers on its ability to produce addiction in chronic users. In a report presented in March 2014 to the White House Office of National Drug Control Policy, researchers from the RAND Corporation made detailed estimates of the number of chronic cocaine users in the U.S. from 2000 to 2010. Unlike most previous efforts, which include only the overall total of chronic users, these estimates also specify levels of involvement in chronic cocaine use.
Who Is Using Cocaine?
A federal agency called the Substance Abuse and Mental Health Services Administration uses a yearly project called the National Survey on Drug Use and Health to estimate the number of people in the U.S. who use any amount of cocaine in the average month. According to the most recent figures from this survey (reported in late 2013), roughly 1.6 million adults and teenagers used the drug in a representative month in 2012. This number represents about 0.6 percent of the entire U.S. population age 12 or older. Since 2002, the highest reported rate of monthly cocaine use is 1.0 percent; the rate reached this peak in three years: 2003, 2005 and 2006. Cocaine use has been trending pretty steadily downward since 2006, with a low monthly rate of 0.5 percent reported in 2011.
What Are The Levels Of Chronic Use?
Chronic drug users are users who consume any given substance repeatedly over time. However, not all chronic users consume drugs with the same level of frequency. On the low end, a chronic cocaine user may consume the drug from roughly four to 10 days in any 30-day time period. Moderate to heavily involved chronic users may consume the drug from 11 to 20 days within the same time period. The heaviest chronic users consume cocaine on at least 21 days within a given month. Any chronic user runs the risk of developing (or already having) diagnosable problems with cocaine abuse or cocaine addiction (both of which are classified as specific forms of a condition called stimulant use disorder). However, as a rule, heavy chronic users have the most seriously elevated risks. In addition, heavy chronic users account for a large percentage of the overall amount of cocaine consumed in any segment of the population.
How Many Chronic Cocaine Users Are There?
In the report presented to the White House Office of National Drug Control Policy, the RAND Corporation researchers used information gathered from the National Survey on Drug Use and Health, the federally sponsored Arrestee Drug Abuse Monitoring Program and several other sources to estimate the number of Americans involved in chronic cocaine use in the first decade of the 2000s. In all likelihood, the total number of chronic users in 2010 (the last year under consideration) was roughly 2.5 million. For the sake of accuracy, the report also includes a low potential figure of 1.6 million chronic users and a high potential figure of 3.9 million chronic users. Most of the chronic cocaine users (1.3 million) consumed the drug four to 10 days per month. Another 500,000 chronic users consumed the drug somewhere in the range of 11 to 20 days per month. In addition, 600,000 chronic users consumed cocaine at least 21 days per month.
Past And Present Cocaine Use
The highest reported number of likely chronic cocaine users between 2000 and 2010 was 3.3 million in the year 2000. Totals for the following six or seven years were fairly close to this peak. However, a downward trend in the number of chronic users began in 2006 and continued through the end of the period under consideration.
The estimate of cocaine use reported by the RAND Corporation is consistently higher than the estimate provided by the National Survey on Drug Use and Health. The difference between the two projects can be broadly attributed to the wider number of sources used by the RAND Corporation researchers, and more specifically attributed to the inclusion of data from the Arrestee Drug Abuse Monitoring Program (which gathered information from people who were incarcerated or otherwise involved in the criminal justice system). The RAND Corporation researchers note that total cocaine use (among both occasional and chronic users) fell by close to 50 percent between 2006 and 2010.
Find Out How An ADHD Medication Disrupts Cocaine Addiction
More than 22 million people in the United States are dealing with drug abuse, and the yearly healthcare dollars spent fighting this problem amount to more than 180 million. Cocaine abuse is one of the largest and most expensive problems under the larger umbrella of drug abuse, resulting in the most emergency room visits of any illicit drug.
Unlike heroin addiction, which can often be treated successfully with a substitute drug called methadone, cocaine addiction has no such handy substitute available. But a small group of scientists have been working on another potential weapon for fighting cocaine abuse: a cocaine vaccine.
The idea for a drug abuse vaccine has been around for more than a quarter of a century. Currently, there are two major research teams actively engaged in developing a vaccine for clinical trials. These research groups are led by Kim Janda, Ph.D, of the Scripps Research Institute, and Thomas Kosten, M.D, of the Baylor College of Medicine. In 2010, Kosten’s team ran the first ever late-stage cocaine vaccine trial, with their vaccine TA-CD.
The Vaccine Principle
Vaccines have been in existence for hundreds of years, perhaps even more than 1,000 years. They operate in a very simple way: introducing a tiny amount of a disease (often in weakened or killed form) or something chemically similar to a disease into a person’s bloodstream so that the immune system is able to identify the invader and create antibodies. Once the human immune system learns to create antibodies for a particular disease, it can do so quickly again if the disease reappears.
However, a drug like cocaine is different from a disease-causing microbe. Cocaine in the bloodstream is much smaller than a microbe, and essentially invisible to the human immune system. As a result, recent approaches to the creation of a cocaine vaccine have involved attaching the vaccine to a virus. This helps the immune system learn to identify the substance and to destroy it.
Success Of Cocaine Vaccine And Questions
Both Kosten’s vaccine, TA-CD, and Janda’s vaccine, known as GNE, have had some measure of success in clinical trials. Janda and his research partner, Ronald Crystal of Weill Cornell, reported that GNE showed an impressive ability to destroy cocaine in the bloodstreams of monkeys. Kosten found similarly effective results from his human trial of TA-CD.
However, questions remain as to whether simply destroying cocaine in a person’s bloodstream is really an effective way of fighting drug abuse. Unlike measles or smallpox, two diseases almost completely eradicated in the first world because of vaccines, drug addiction is not simply a physical illness. Drug abuse can have serious physical effects, but addiction is a brain disease.
In the late-stage trial by the Baylor team, the results showed that the destruction of cocaine in addicts’ bloodstreams did not eliminate or reduce cravings for the drug. In some cases, the addicts in the trial took many times their usual dose of cocaine in an attempt to achieve the high that they were craving. For some subjects, this desperate search for a high was financially disastrous.
Addiction Prevention vs. Addiction Treatment
The purpose of a true vaccine is the prevention, rather than the treatment, of a serious disease. Although a cocaine vaccine may eventually be a successful tool for treating cocaine addiction, it may be even more effective when used as other vaccines are used: to prevent the initial development of a disease.
For individuals who are not addicted to cocaine, a successful drug vaccine could prevent them from ever experiencing any of the physical effects of the drug, including the chemical high that creates an addictive feedback loop in the human brain’s reward centers. This would prevent people from developing a dependency on the drug and suffering from cravings.
However, with so many people in the United States suffering from cocaine addiction, treatment remains a high priority for the scientists working on a vaccine. While an effective vaccine may never be a silver bullet that cures cocaine addiction on its own, it does have great potential as part of a larger treatment program. For example, a vaccine could essentially ensure addicts’ sobriety by destroying any cocaine that enters the system, even if they relapse.
The 18th century British philosopher and statesman Edmund Burke once famously declared: “Those who don’t know history are destined to repeat it.” In the years since, Burke’s quote has been repeated often in slightly different forms by a variety of public figures, which is a testament to how much truth the sentiment behind it contains.
This statement could undoubtedly be applied quite aptly to the ongoing War on Drugs. Over the past several decades United States law enforcement agencies have spent over $1 trillion persecuting this war, and during that time hundreds of millions of tons of illegal drugs have been seized and destroyed here and around the world. And yet, much to the chagrin of those responsible for the continuation of this military-style anti-drug campaign, there is no evidence to suggest that any drug pipelines have been permanently closed off or that the flow of illegal substances has been reduced in any meaningful way as a result of this approach. In fact, the international drug trade appears to be more profitable and efficient than ever before.
Effects Of Drugs On The Black Market
The Sept. 30 edition of the online medical journal BMJ Open includes a report from a multi-national team of researchers who studied and analyzed international drug surveillance databases in order to identify long-term trends in the illegal drug trade. They discovered that despite the stalwart anti-drug efforts of law enforcement, officers and administrators from across the globe, over the last 20 plus years the cocaine, heroin and marijuana available on the international black market has gotten both stronger and less expensive.
In the United States, from 1990 to 2007 the potency of these three substances rose by 60 percent, 11 percent and 160 percent respectively, and yet the street price of these three popular illegal drugs actually fell by 80 percent over the same time period when adjusted for inflation. The increased strength of such drugs is a testament to the fact that demand for illegal substances has remained high enough to spur constant innovation in production methods, while their steadily dropping price shows that supplies are bountiful and that users of cocaine, heroin or marijuana are still very much operating in a buyer’s market.
War On Drugs And Illegal Drug Use
Contrary to hype and popular opinion, the War on Drugs was never designed to stop the trade of illegal substances entirely. Instead, its goal has been to disrupt supply chains just enough to drive prices up and make dangerous intoxicants unaffordable to many who might be tempted to experiment with them. But even this modest goal has proven elusive, and few if any honest observers still believe that ramped up law enforcement strategies will ever reduce illegal drug consumption or prevent millions of users from plunging headfirst into the dark canyon of substance abuse and addiction.
At the present time, the global black market drug trade generates about $350 billion in tax-free profits annually. In the U.S. alone, there are approximately 22 million illegal drug users above the age of 12, and while the majority could not accurately be classified as addicts, those who do become dependent on substances like cocaine, heroin and methamphetamine usually have no difficulty in obtaining the supplies they need to quench their addictive thirsts. And with drugs becoming stronger and cheaper, we may start seeing greater percentages of casual drug aficionados eventually succumbing to addiction, since these individuals will be able to afford greater quantities of illegal substances even as the high they are getting from what they are using intensifies.
Drug Popularity, Reputation And Availability
It is true that the rates of usage of drugs such as cocaine, angel dust and heroin have generally been declining over the years. However, it would be a mistake to assume that the drug war has been successful just because certain drugs have now gone out of style. Once a drug starts to get a bad reputation, its use will usually decline. But as some drugs become less popular, other illegal substances will inevitably flood the market to fill the void, and, as a result, the whole cycle of casual use, abuse, addiction and disillusionment just keeps repeating itself with no apparent end in sight.
What Can Help Drug Addiction?
We can only speculate about what might finally make the merry-go-round of drug dependency stop spinning—expanded availability of treatment, more drug courts, innovative educational campaigns, greater social awareness, a reduction in the rates of poverty and unemployment, community outreach programs, or some combination of all of the above. It seems clear, however, that more interdiction, indictment and incarceration will not make the decisive difference.
The “Just Say No” campaigns were mocked in their day and seem hopelessly quaint now. Trying to shame people into avoiding drugs has not worked any better than treating drug use as a crime. But in the end, illegal drug use will only decline precipitously if enough people decide the risk of addiction is too great to flaunt. So in a sense, it really is about just saying no, and being able to recognize the critically important reasons it is logical to do so. Cheaper and stronger means extreme danger, and consequently a refusal to get involved with drugs in the first place is the smartest decision one can make.
Addiction is a complicated disease. For those of us who have never had an addiction, it can be easy to wonder why addicts can’t seem to make the decision to stop using and then do it. There are complicated brain chemical pathways that are affected by drugs and alcohol that lead to addiction and that make it almost impossible to stop using. Modern research has uncovered much of the role of the brain in addiction, but more recently has found that the immune system is also important.
The Immune System And The Brain
Your body’s immune system is a complex network of different types of cells that are dedicated to protecting you from foreign invaders that cause sickness. Many of those immune cells live in the brain. These are called glial cells and they work alongside your neurons, or brain cells. The brain cells and immune cells that work together to regulate the responses of the immune system are called collectively, the neuroimmune system. This system keeps the brain healthy and mediates communication between the immune system and the central nervous system.
Addiction’s Effects On The Neuroimmune System
Parts of the neuroimmune system are activated by various factors. Stress is one factor, which is why the feeling of being stressed can actually make you physically sick. Alcohol and drugs also trigger responses in the neuroimmune system. The responses can lead to disrupted decision making. This helps to explain why addicts make choices about using even when doing so is bad for them.
The response of the neuroimmune system to drugs and alcohol also changes a person’s affect and causes feelings of depression. Again, these feelings are characteristic of addiction. Researchers have even found that people with certain genetic variations in their neuroimmune system are more likely than others to succumb to addiction.
Innovative Addiction Treatments
With the increased understanding of how the immune system in the brain impacts addiction, researchers are able to come up with new treatments for this devastating disease. One such possible treatment may help addicts who use opioids like heroin and prescription painkillers. Studies have found that morphine, an opioid drug, binds to a certain immune system receptor that changes the dopamine pathway in the brain.
Dopamine is the brain chemical that is released when we feel something pleasurable. Drugs release huge floods of dopamine, which plays a role in developing addictions. The researchers hope that if they can block the immune receptor with a medication, they can stop the release of dopamine when someone uses an opioid. With no pleasurable sensation, there would be no addiction.
Methamphetamine is another seriously addictive drug that can be just as hard to quit as opioids. Research has shown how the drug negatively impacts the immune system of the user, so new studies have focused on targeting the immune system for treatment medications. A drug being developed for a variety of immune diseases may also help meth addicts. The drug reduces the immune response in the brain, which could help meth addicts feel better. One major hurdle to quitting is that the users feel awful when they give up meth. With the new medication, they may feel better, and less inclined to going back to using.
Other researchers have tackled cocaine addiction by working with the immune system. The new treatment is actually a vaccine. The researchers who developed it created a vaccine that would target cocaine and treat it as if it were an invader like a virus or bacterium. After being injected with the vaccine, mice in laboratory experiments showed an immune response that tackled any cocaine in the body. The result was that the mice did not get a high from cocaine. If the vaccine works in human trials, it could help addicts stop using. If they get no high, there will be no reason to use the drug.
The exciting field of addiction and the immune system is coming up with new information about the disease of addiction every day. With this new knowledge, researchers are able to create treatments that are medically- and evidence-based that may truly help people recover from addiction.
What Is Harm Reduction?
Harm reduction is a controversial technique used to help treat addicts, particularly drug addicts. The philosophy behind this method of treatment is to help an addict use safely, rather than forcing him to stop using. By aiding addicts, the caregivers reduce the potential for harm. Although using illegal drugs is always harmful, doing it in a safe environment helps to prevent overdose deaths and the spread of disease. Proponents of harm reduction believe that once a user is in a safe environment, he can make the choice to quit.
The method of harm reduction is not new. It has been around for decades and begun with the practice of giving heroin addicts a substitute drug called methadone. Other harm reduction programs include handing out clean needles to heroin users and providing a safe place to use. Critics of the technique feel that harm reduction only encourages addicts to keep using. In spite of criticisms, harm reduction continues to be used, not just in the US, but in other countries as well. In Colombia, officials are trying harm reduction treatment with cocaine addicts, and finding success.
Colombia – Cocaine Capital Of The World
Colombia is the cocaine capital of the world, producing more of the illegal drug than anywhere else on the planet. Cocaine comes from a plant native to South America called coca. The leaves of this plant naturally contain cocaine, which is a psychoactive stimulant. For many years, the natives of the area have chewed coca leaves for the high, but have also used them for medicinal purposes.
To get the cocaine out of the leaves, drug manufactures must go through a multi-step chemical process and end up with the white powder that is sold in the illegal marketplace. Most of this cocaine comes out of Colombia and is smuggled into the United States. In Colombia and particularly in Bogota, the capital, there is a real problem with addicts who use a base form of cocaine. It is a low-quality, low-purity form of the drug called basuco. It is an intermediate product in the process of making cocaine and it often contains residues of the solvents used, like kerosene. It may also have fillers like crushed bricks or ashes. Basuco is even more addictive than cocaine and is a rising problem in Bogota.
Harm Reduction for Basuco Addicts
Basuco is so addictive and so hard a habit to kick that the public health officials in Colombia have taken action and are using harm reduction. They have created controlled consumption facilities where addicts are given increasingly smaller doses of basuco and given marijuana instead. The idea is to help addicts stop using this very dangerous drug in a controlled manner. Marijuana is used like a substitute. Although it is a drug, it is much safer than basuco.
Addiction experts who espouse a traditional view of treatment believe that addicts must give up a drug completely and refrain from using any other substance. Increasingly, this traditional type of treatment is being proven ineffective. To fill the gap, harm reduction techniques are emerging around the world. The harm reduction programs for basuco addicts in Bogota are already helping people.
Using Marijuana For Harm Reduction
The philosophy of harm reduction, in itself, is controversial. Adding marijuana to the technique adds another level to the debate. To many staunch traditionalists, giving an addict another drug is simply wrong and in opposition to their beliefs about addiction. The facts, however, support this technique. Research investigating the use of marijuana for addicts using prescription painkillers has turned up positive results. The medical marijuana used by these people helped to reduce side effects from the painkillers, helped to manage pain, and helped to reduce the symptoms of withdrawal when the painkillers were taken away.
Other studies also showed evidence that using marijuana could help addicts. One study demonstrated that smoking small amounts of marijuana aided heroin addicts by keeping them in their treatment programs. Another study indicated that cocaine users in rehab who also used marijuana moderately were more successful at quitting than those who never smoked marijuana.
How Harm Reduction Helps
The idea of using drugs to cure addiction may seem radical. Certainly, the philosophy of giving addicts their drugs of choice in a safe environment is not without controversy. As traditional treatments fail to help addicts, however, these other options must be considered. The research and the results are very promising. Harm reduction and the use of marijuana are already helping cocaine addicts, and could help others as well.