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MONDAY, March 1 (HealthDayNews) -- A combination of the drug disulfiram -- which helps some people with alcohol disorders stay sober -- and cognitive behavioral therapy helps cut cocaine use, especially among users who are not dependent on alcohol.

So says a study in the March issue of the Archives of General Psychiatry.

The study notes that alcohol is a powerful "cue" for cocaine use and adds that alcohol impairs judgment and lowers a person's resistance to cravings for cocaine. It's been hypothesized that using disulfiram to reduce alcohol use may reduce the likelihood of cocaine abuse by users.

This Yale University School of Medicine study included 121 cocaine-dependent adults who were randomly assigned to receive either disulfiram or placebo for 12 weeks. They were also randomly assigned to take part in either cognitive behavioral therapy (CBT) or interpersonal psychotherapy (IPT), which is a less-structured form of behavioral therapy.

"Participants assigned to disulfiram reduced their cocaine use significantly more than those assigned to placebo, and those assigned to CBT reduced their cocaine use significantly more than those assigned to IPT," the authors write.

The study found the benefits of the drug and CBT were most evident in those who weren't alcohol-dependent and who did not drink during the study.

"This is the first placebo-controlled trial, to our knowledge, to demonstrate that disulfiram therapy is effective in nonalcoholic cocaine-dependent outpatients. Moreover, these findings suggest that disulfiram is especially effective for nonalcoholic cocaine users, as the effects of disulfiram treatment were most pronounced in participants who did not meet the criteria for current alcohol abuse or dependence and in those who abstained from alcohol during the trail," the authors write.

More information

The American Medical Association has more about cocaine abuse.

(SOURCE: JAMA/Archives, news release, March 1, 2004)

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