An antidote for the brain and behavioral effects of cocaine addiction may be on the horizon, according to the current findings of a group of Danish researchers. People affected by cocaine addiction undergo lasting, stimulant-based changes in the normal output and use of a key brain chemical called dopamine. In a study published in January 2015 in The Journal of Biological Chemistry, researchers from Denmark’s University of Copenhagen assessed the potential to develop medications that essentially hijack cocaine’s access to the brain and thereby disrupt the chemical pathway that’s responsible for triggering the onset of cocaine addiction and sustaining such an addiction over time.
All of the major stimulant drugs of abuse—including cocaine, amphetamine and methamphetamine—produce their basic brain effects by doing two things: speeding up the interaction between nerve cells in the central nervous system (spinal cord and brain) and steeply increasing the amount of dopamine in a brain area called the pleasure center. Among its many functions in healthy brain and body function, dopamine helps control the amount and intensity of pleasure produced inside this brain area. When a powerful stimulant like cocaine is consumed, dopamine levels increase enough to trigger an intensely pleasurable sensation called euphoria. The recurring desire to experience euphoria on-demand is one of the chief underlying factors in the development of a cocaine addiction. This fact holds true because repeated consumption of the drug gradually leads to lasting changes in the pleasure center’s dopamine production and processing and thereby sets the stage for the development of a physical dependence on continued cocaine intake. Since cocaine is used outside of a medical context and has no therapeutic usefulness, cocaine dependence can easily turn into uncontrolled cocaine addiction, which brings problems such as an inability to limit intake of the drug, recurring urges to consume the drug (commonly in excessive amounts), repeated cocaine intake in circumstances that make drug use highly dangerous, shirking of responsibility in favor of cocaine use and the need to use increasing amounts of cocaine to feel a notable drug effect.
Current Addiction Treatments
Pharmaceutical researchers have yet to create or identify a medication that’s capable of thwarting cocaine addiction in most individuals. For this reason, current efforts of addiction treatment center on the use of change-oriented behavioral therapies that seek to eliminate the underlying motivations for cocaine consumption. One approach, called contingency management, is commonly used to help people in treatment establish abstinence and comply with the guidelines of program participation. Another approach, called cognitive behavioral therapy, helps cocaine programs reduce the risk for relapse. Additional approaches to the non-medication-based treatment of cocaine addiction include 12-step program participation and enrollment in long-term residential communities known as therapeutic communities.
Development of an Antidote
In the study published in The Journal of Biological Chemistry, researchers focused on the brain chemical dopamine as a potential source of a cocaine addiction antidote. More specifically, the researchers focused on the chemical pathways that allow the brain to remove dopamine from circulation and regulate the production of euphoria inside the pleasure center. Under normal circumstances, cocaine blocks the chemical pathways responsible for dopamine removal and thereby keeps the pleasure center’s dopamine levels artificially elevated. The researchers wanted to know if it’s possible to stop cocaine from performing this blocking action and keep dopamine removal going at a normal rate. Through laboratory experiments on rats, the researchers identified two substances that essentially “bump” cocaine from its place inside the brain. When administered to the rats, these substances (which don’t produce a mind-altering effect) stopped cocaine from triggering an increase in the pleasure center’s dopamine levels. Effectively, this means that the substances disrupted cocaine’s ability to support the changes in brain chemistry that make cocaine addiction a possibility. On a detailed level, the study’s authors don’t fully understand why the chemical substitutes they used during their animal experiments had a blocking effect on cocaine’s normal brain impact. If future efforts can increase understanding in this area, pharmaceutical researchers may one day be able to develop a specifically targeted medical antidote for people dealing with cocaine addiction. These findings mirror the findings of other groups of researchers currently working on the development of a cocaine vaccine that preemptively stops cocaine from producing a drug effect inside the brain.