Brand-new medical treatment for cocaine addiction

Cocaine is an extremely addictive substance, and once you’re addicted, anxiety, depression and, in some cases, psychosis can often follow.
What’s more, cocaine – an illegal drug – is so expensive that addiction to it would lead to financial ruin for most of us.

‘Although there are many good reasons to kick a cocaine habit, it’s very difficult to do. So, it would be good if we could offer some kind of medical treatment for cocaine addiction – in addition to psychotherapy, which is the standard treatment today,’ says Professor Claus Juul Løland from the Department of Neuroscience at the University of Copenhagen.

Medical treatment of this kind is not yet available. However, Professor Løland, who is an expert in the biochemical mechanisms behind narcotic drugs, is working with colleagues from the prestigious American National Institute on Drug Abuse to design one.

The research group has identified a drug able to inhibit the narcotic effect of cocaine. Studies have shown that when this drug is given to mice, cocaine has no stimulant effect. ‘And we expect to see the same result in humans – the widely reported “rush” will simply not happen,’ Løland explains.

This substance developed by Professor Løland and the American research group now needs to be refined and its safety tested in animal trials before it can be used to treat cocaine addiction.
The process is now under way and the aim is to develop an actual drug.

Claus Juul Løland has recently received funding from the Lundbeck Foundation in the form of an Ascending Investigators research grant worth DKK 5 million. If everything turns out as the Danish-American research group hopes, the drug should be on the market within the foreseeable future:

‘This drug will probably not eliminate the craving for cocaine on its own. But it will have an effect like antabuse, a common anti-alcohol drug, and will give the addict the chance to feel what it’s like to be drug-free – because they won’t experience the high they get from taking cocaine. The drug will be a motivating factor and provide an element of support as part of an overall course of treatment to help people kick their cocaine habit.’

DIFFERENT DRUGS – SAME EFFECT

The drug Professor Løland and his research partners from the National Institute on Drug Abuse are working to develop is a variant of modafinil.

Modafinil is a drug used to treat the neurological disorder narcolepsy, which presents with overwhelming sleep attacks and sudden muscle weakness.

On the face of it, modafinil has nothing to do with treating cocaine addiction. However, there is one highly unusual aspect that makes the researchers believe that the drug could have great potential in this field:

Modafinil and cocaine – which are two independent and, in many ways, quite different chemical substances – have one thing in common: they can throw a spanner in the works of dopamine, which is a neurotransmitter produced in the brain and linked to the brain’s reward system.

When the brain sends signals about reward and motivation through its nervous system, dopamine helps ensure that the signal is transmitted between neurons. And one of the key elements of this process is that dopamine is not allowed to lie around in the space between two brain cells: once the neurotransmitter has done its job, it withdraws to the cell that discharged it. It is then released again when it is needed to transmit a new signal.

It is this withdrawal that cocaine inhibits, and the result is an accumulation of dopamine which then releases a huge reward in the form of a brief narcotic episode.

Professor Løland explains that a distinctive feature of modafinil is that, like cocaine, it is able to inhibit withdrawal of dopamine – but without in any way inducing a “high”:

‘When we discovered this back in 2012, we began exploring modafinil’s chemical structure. Based on this, we constructed the drug we now plan to refine further. This is what I’ll be spending my Lundbeck Foundation grant on.’

The studies seek to investigate at atomic level why cocaine and modafinil trigger completely different reactions to euphoria:

‘This is rather remarkable when you think of the many pharmacological features the two drugs have in common. Once we have a better understanding of the underlying causes, it will be easier to tailor the active substance in the drug to treat cocaine addiction – and this is our ultimate goal,’ says Claus Juul Løland.

While the Danish-American research team is refining the active substance, it will be tested in animals. They will then apply for permission to test the drug in clinical trials – on addicts who want to kick their cocaine habit.

 

YOUNGER GENERATION EXPERIMENTS WITH COCAINE

• Around 4% of all Danes between 16 and 34 have tried cocaine within the past year. (6.8% of men and 1.9% of women. Source: Danish Health Authority, “Denmark, Country Drug Report 2017”.)
• In 2019, 190 kg of cocaine was seized in Denmark, in 5,447 separate actions. The two largest resulted in seizure of 58 kg of cocaine. (Source: “Drug crime, drug seizures and the drug market”, Danish Health Authority, 2020.)