Currently there are no medications approved by the FDA to specifically treat cocaine addiction. But researchers continue to study natural brain chemicals to help restore the imbalance caused by long-term cocaine use.
Several medications developed to treat other disorders are used to reduce cocaine use. These include:
- Disulfiram, used to treat alcohol dependency
- Baclofen, a muscle relaxant
- NAC, an amino acid that curb cravings
- Modafinil, improves sleep after you are drug-free
What They Do
- Curb cravings
- Reduce withdrawal symptoms such as trouble sleeping and daytime sleepiness
- Ease anxiety
- Help prevent relapse
Do They Work?
There are a limited number of recent studies on medications for cocaine use disorder. The most effective ones so far work on the natural brain chemical dopamine (such as Modafinil) or GABA (such as Topiramate). Combination drugs are especially promising.
Scientific reviews do show that modafinil, bupropion, topiramate or disulfiram used with counseling and group support such as 12-step programs are better than either approach on its own.
NOTE: Even when taking medications it is vital to receive support from a peer group program like Cocaine Anonymous and treatments such as counseling or therapy. These help you see what role your thoughts, feelings and attitudes play in addiction – so you feel stronger and more able to handle your life.
BACLOFEN (Gablofen®; Lioresal®)
What it does: This muscle relaxant curbs cocaine cravings, especially in long term and heavy users, and lessens withdrawal symptoms.
How it works: Increases the amount of GABA in the brain, a natural chemical that has a calming and relaxing effect.
Side effects: Drowsiness, dizziness, weakness, fatigue, nausea, headache, constipation.
** Using baclofen for more than a couple of months may cause dependence. Withdrawal can cause agitation, insomnia, and confusion. Do not stop using it suddenly – gradually lower the dose with the help of your doctor.
For a more complete list of side effects click here.
Availability: Physician prescription
More information on Baclofen
Research Studies
Research Studies
Baclofen was shown to help prevent relapse in cocaine-dependent men. It blocks the brain’s early response to drug triggers that can lead to relapse. Young KA 2014.
Baclofen decreased cocaine use in people seeking treatment for cocaine dependence. It does not appear to be effective in cocaine users who are also using opioids, such as those on methadone. Haney M 2006.
Baclofen plus substance abuse counseling significantly reduced cocaine use in people recovering from cocaine addiction. Shoptaw 2003.
DISULFIRAM (ANTABUSE)
What it does: Makes drinking alcohol or using cocaine very unpleasant. It is used to reduce cocaine use and relapse, especially when caused by stress.
How it works: Blunts cocaine cravings or changes the “high”. It may need to be used longer or at a higher dose to reduce the effects of cocaine that keep people using.
Side effects: Nausea, vomiting (sometimes very severe, if any alcohol or cocaine is used), difficulty breathing, confusion and fainting. May also cause anxiety, paranoia and restlessness.
For a more complete list of side effects click here.
Availability: Physician prescription
Research Studies
Research Studies
Disulfiram was shown to be effective in six studies for treating cocaine dependence but is rarely prescribed because of safety concerns. If patients are screened for medical and psychiatric stability and are evaluated for drug interactions, disulfiram can be safely used for the treatment of cocaine dependence with or without alcohol dependence. Malcolm R. 2008.
Research suggests that disulfiram (also known as Antabuse), a medication used to treat alcohol addiction, is also effective in reducing cocaine abuse, especially when combined with cognitive behavioral therapy. Carroll KM 2004.
For more information: https://medlineplus.gov/druginfo/meds/a682602.html
Gabapentin, Topiramate and Vigabatrin
What it does: Eases anxiety and agitation during recovery.
How it works: Reduces cravings and help you feel more relaxed by increasing the natural brain chemical GABA.
Side effects: tiredness, dizziness, headache, nervousness, joint or muscle pain, memory problems.
For a complete list of side effects click here. Under Browse by generic or brand name click on the first letter of the drug you’re looking up, such as G to find Gabapentin, T to find Topiramate and V to find Vigabatrin.
Availability: Physician prescription
Research Studies
Research Studies
This review of 6 studies showed that topiramate plus behavioral therapy increased the number of days with no cocaine use and the number of people who stopped using cocaine for 3 weeks in a row. Prince V 2018.
Thirty people with cocaine dependence took part in an 8-week study of 1,200 mg a day of gabapentin in divided doses. Cravings decreased from 78% to 25% by the 8th week. Positive urine drug screens decreased from 86% to 29% at the 4th and 8th week. Myrick H 2001.
MODAFINIL (PROVIGIL)
What it does: Improves sleep during cocaine withdrawal and reduces cravings.
How it works: Increases the natural brain chemicals dopamine and glutamate which is used up by cocaine use. This may work at the core of the craving for cocaine.
Side effects: Anxiety, depression, diarrhea, dizziness, dry mouth, headache. DO NOT USE Modafinil if you have certain types of heart disease such as mitral valve prolapse.
For a more complete list of side effects click here.
Availability: Physician prescription
Research Studies
Research Studies
As people stop using cocaine, their sleep can worsen. Modafinil taken in the morning can help you sleep longer and get to sleep faster after 3 weeks of abstinence from cocaine. Morgan PT, 2010.
In a study of 219 patients dependent on cocaine, Modafinil plus behavioral therapy increased abstinence in people who were not also dependent on alcohol and reduced cocaine craving. Anderson AL. 2009.
Patients treated with Modafinil were more likely to remain abstinent from cocaine for a longer time. This study provided early evidence that Modafinil improves outcomes when combined with psychological treatment for cocaine dependence. Dackis CA 2005.
For more information: https://medlineplus.gov/druginfo/meds/a602016.html
N-ACETYLCYSTEINE (NAC)
What it does: This amino acid curbs cocaine cravings and may repair damage in the brain caused by cocaine use.
How it works: Restores the natural brain chemical glutamate to normal levels. Glutamate helps make GABA which calms anxiety, stress and fear.
Side effects: diarrhea, nausea, vomiting, fatigue, skin rash
Availability: Over the counter
For specific suggestions of other amino acids that can lessen cravings see our Nutrition page in the Holistic section
More information on N-Acetylcysteine
Research Studies
Research Studies
NAC may help decrease cravings and the compulsion to use drugs. It may be especially useful in preventing relapse. It seems to work best in adults with cocaine use disorders who have already begun their recovery and are not currently using cocaine. Tomko, 2018