Project details:
In March 2024, Bristol ESG were asked to undertake a systematic review of the evidence for the effectiveness and safety of pharmacological interventions for the treatment of cocaine use disorder. The review is funded by the NIHR Evidence Synthesis Programme (project number: NIHR165378) and is one of four projects allocated to Bristol ESG examining the effects and safety of psychosocial or pharmacological interventions for the treatment of drug use disorders.
Project status: completed
The review is registered with PROSPERO: CRD42024596434
Contact: bristol-esg@bristol.ac.uk
What is the problem?
Increasing numbers of people, especially people under 30, are using cocaine regularly and a portion of those people will develop a cocaine addiction. Unfortunately, repeated cocaine use over time can lead to issues with heart and brain health, as well as contribute to the risk of transmitting infectious diseases. Pharmacological treatments (drug therapy) can be an effective tool in helping people combat addiction. However, despite increasing research in this area, no specific drugs have been approved for the treatment of cocaine addiction.
What did we do?
We systematically searched the existing literature to find studies that have assessed pharmacological treatments for cocaine use disorder. We then assessed those treatments for effectiveness (how well they helped people reduce or stop cocaine use), acceptability (whether people tolerated the treatments) and safety (whether the treatments led to any unexpected consequences).
What did we find?
We found 163 studies involving over 14,000 people living with cocaine use disorder. Our analyses indicated that no treatment (or group of treatments) was consistently better than placebo across our twelve effectiveness outcomes. Similarly, there was no consistent evidence that any of the treatments were better (or worse) than placebo with regards to acceptability or safety. We rated most of our findings as low or very low certainty due to concerns about the appropriateness of the sample recruited and risk of bias in the individual studies. We also had concerns about the way studies analysed and reported their results and the lack of information about the people in their studies. In the future, we need to improve reporting in this research area and develop agreed outcomes that all future studies report to ensure that we can more easily compare results and find effective treatments.
