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Daniele Zullino1, Louise Penzenstadler1, Tiphaine Robet1

  • 1Service d'addictologie, Hôpitaux universitaires de Genève, 1211 Genève 14.

Revue Medicale Suisse
|June 6, 2025
PubMed
Summary
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Cocaine-assisted treatment offers a harm-reduction approach for increasing crack cocaine use in Europe. This medically supervised model may improve adherence and reduce health risks compared to current limited options.

Area of Science:

  • Addiction Medicine
  • Pharmacology
  • Public Health

Context:

  • Rising crack cocaine use across Europe, especially in urban marginalized communities.
  • Limited efficacy of existing pharmacological treatments for cocaine use disorder.
  • Need for innovative harm-reduction strategies in addiction treatment.

Purpose:

  • To explore cocaine-assisted treatment as a harm-reduction alternative for cocaine use disorder.
  • To evaluate the potential benefits of medically supervised cocaine administration.
  • To discuss various administration routes and their implications for treatment.

Summary:

  • Proposes cocaine-assisted treatment, mirroring heroin-assisted models, for managing cocaine use disorder.
  • Involves medical supervision, controlled dosing, and patient preference alignment.

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  • Considers pharmaceutical-grade powder, user-prepared crack, and inhalable forms for administration.

    • Impact:

    • Potential to reduce health risks associated with illicit crack cocaine use.
    • Improved treatment adherence through tailored formulations and pharmacokinetics.
    • Facilitates structured care by adapting to different treatment phases and user needs.