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Heroin Addiction and Related Clinical Problems: 2007, 09, 2 (pages: 11 - 16)

Buprenorphine for Dual Dependency: Cocaine, Alcohol and Opiates

Gardner T., Kosten T.

Summary: Dual-drug dependency is common in Europe and America and represents a complex management and treatment challenge. Most heroin addicts abuse stimulants or alcohol in addition to opiates. Cocaine pharmacotherapy remains a challenge, but there has been some success with Buprenorphine, Disulfiram, Modafinil and GABA agonists. A promising cocaine vaccine is also under development. Triple-dependency with alcohol or benzodiazepines is also common and can lead to serious dependence requiring detoxification. In addition to regular monitoring following alcohol detoxification, relapse prevention pharmacotherapy is essential. The following review will briefly describe concurrent-drug abuse with cocaine and opiates as well as describe current pharmacotherapies for multi-drug dependence. In addition, we will briefly discuss the implications for combining behavioral therapies with medications to improve treatment efficacy.