Sustained Release Dexamfetamine Reduced Cocaine Use in Crack Addicts Interview with:

Mascha Nuijten MSc Researcher/ PhD candidate Brijder Research (PARC) The Hague The Netherlands

Mascha Nuijten

Mascha Nuijten MSc
Researcher/ PhD candidate
Brijder Research (PARC)
The Hague
The Netherlands What is the background for this study? What are the main findings?

Response: Crack-cocaine dependence is a complex disorder, for which no proven effective pharmacotherapy is yet available. Prior to our study, sustained-release dexamfetamine was found to be a promising treatment for cocaine dependence in several studies, but no studies so far had shown a convincing benefit in terms of substantial cocaine use reductions. Therefore, we investigated the efficacy of sustained-release (SR) dexamphetamine in a robust dose of 60 mg/day in chronic crack-cocaine dependent patients.

We found that the number of days of cocaine use decreased with almost 40% in the dexamfetamine group, compared with 9% in the matched placebo group. In addition, the number of cocaine self-administrations on days that patients used crack-cocaine decreased with 43% in the dexamfetamine group and with 7% in the placebo group. Thus, SR dexamfetamine both contributed to cocaine abstinence and to cocaine use reductions. What should clinicians and patients take away from your report?

Response: The study results are an important step in the search for an effective pharmacotherapy in cocaine dependence, and agonist treatment with SR dexamfetamine should be considered for chronic cocaine dependent patients for whom harm reduction rather than total abstinence is a feasible treatment goal. In addition, we found 60 mg/day SR dexamphetamine to be safe and a tolerable medication, with mostly transient and mild side-effects. What recommendations do you have for future research as a result of this study?

Response: Our study included chronic crack-cocaine dependent patients with comorbid heroin dependence who participated in heroin-assisted treatment. In particular, we recommend to investigate the efficacy of SR dexamfetamine in chronic cocaine dependent patients in more routine treatment settings, for instance in cocaine/ heroin dependent outpatients in methadone maintenance treatment or in cocaine dependent outpatients without comorbid opiate dependence.

Future research should also investigate the efficacy of SR dexamphetamine in patients with other stimulant addictions. Is there anything else you would like to add?

Response: We are encouraged by these results and hope to be able to replicate them in future research, in order to contribute to a new pharmacological treatment for cocaine dependent patients. Thank you for your contribution to the community.


Sustained-release dexamfetamine in the treatment of chronic cocaine-dependent patients on heroin-assisted treatment: a randomised, double-blind, placebo-controlled trial

Nuijten, Mascha et al.

The Lancet , Volume 0 , Issue 0 ,
Published Online:22 March 2016

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Mascha Nuijten MSc (2016). Sustained Release Dexamfetamine Reduced Cocaine Use in Crack Addicts

Last Updated on March 30, 2016 by Marie Benz MD FAAD