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Carvedilol does not reduce cocaine use in methadone-maintained cocaine users
Mehmet Sofuoglu1, James Poling1, Theresa Babuscio1
1VA Connecticut Healthcare System, West Haven, CT, United States; Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, United States.
Journal of Substance Abuse Treatment
|December 27, 2016
Summary
Carvedilol (CAR) did not effectively reduce cocaine use in individuals with cocaine use disorder (CUD). Higher CAR doses may increase cocaine and opioid use, suggesting caution in treatment.
Area of Science:
- Pharmacology
- Addiction Medicine
- Clinical Trials
Background:
- Cocaine use disorder (CUD) is a significant public health issue.
- Adrenergic blockers are being investigated for their potential in treating substance use disorders.
- Carvedilol (CAR) is an adrenergic blocker with potential applications in addiction treatment.
Purpose of the Study:
- To evaluate the efficacy of carvedilol (CAR) in reducing cocaine use among individuals with CUD.
- To compare the effects of two different doses of CAR (25mg and 50mg) against a placebo.
Main Methods:
- A 17-week, double-blind, randomized controlled trial was conducted.
- 106 participants with opioid and cocaine dependence, maintained on methadone, were randomized to placebo, 25mg CAR, or 50mg CAR.
- Cocaine and opioid use were assessed via urine drug screening and self-reported data.
Main Results:
- No significant differences in treatment retention were observed between groups.
- While not statistically significant compared to placebo, the 25mg CAR group showed a trend towards lower cocaine-positive urines than the 50mg group.
- No significant differences were found in self-reported cocaine abstinence or opioid use across groups.
Conclusions:
- Carvedilol (CAR) did not demonstrate efficacy in treating cocaine use in participants with co-occurring opioid and cocaine dependence on methadone.
- Doses of CAR exceeding 25mg should be avoided due to a potential increase in cocaine and opioid use.
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