It was stumbled upon by accident that buprenorphine (aka, Suboxone) can reduce cocaine use during addiction treatment. In clinical trials when the drug was being tested for its ability to help patients decrease their use of heroin, researchers noted that individuals abusing multiple drugs in addition to heroin had a significant drop in their abuse of cocaine while they were taking buprenorphine.
Unfortunately, this information could not be put to use immediately to help individuals struggling to stop using cocaine because of the risk of physical dependence and addiction. Buprenorphine is an opioid medication, which means it has the potential for abuse, especially in individuals who already have a tendency towards drug addiction. Scientists feared using the drug to help people who had a problem with just cocaine because they were concerned that there was a risk of making the problem worse rather than better.
Researchers Work to Find Two-Drug Combination to Combat Cocaine Addiction
Because researchers feel that the risks outweighed the benefits when using buprenorphine on its own, they figured they might be able to find a second drug that would negate the addictive properties in buprenorphine while still maintaining its ability to reduce dependency on cocaine. Luckily, the drug naltrexone (aka, Vivitrol) was known to block the opioid effects of buprenorphine and therefore became the perfect candidate to be the medication that could best help fight addiction to cocaine in conjunction with buprenorphine.
Why Does the Buprenorphine/Naltrexone Duo Work in Cocaine Addiction Treatment?
It turns out that buprenorphine has an effect on brain chemistry that is extremely intriguing for researchers in the addiction field. Studies have shown that the addictive process for many drugs is based upon the excess release of the feel-good chemical known as dopamine in the brain. Kappa receptors block the dopamine reward system in the brain and, therefore, stop any euphoria that a drug might normally be able to produce. In essence, there is no reason to keep taking the drug because it doesn’t have any positive emotional or physical effects.
On the other hand, buprenorphine also activates mu receptors, which drive addiction by producing opioid effects. As a result, it:
- Eliminates physical pain
- Reduces emotional distress
- Decreases anxiety
Researchers knew that in order to make buprenorphine safe for cocaine addicts, they had to maintain the drugs activation of kappa receptors while preventing stimulation of the mu receptors. A team at the Scripps Institute in California recently tested the hypothesis that adding naltrexone in combination with buprenorphine would decrease mu receptor activation in rodents and was found effective. Now the first clinical trials are underway on humans. Since the FDA already approves both drugs for use, if the study goes well, the prescription combo will be able to be utilized quickly.
What do you think about the use of Suboxone during drug and alcohol rehab? Do you think abstinence is key to recovery, or do you think weaning off an addiction is an effective way to reach long-term sobriety? Tell us your thoughts below.