About this Research Topic
Over the last 10 years great strides have been made in translational research on cocaine addiction. Animal paradigms of cocaine self-administration and cocaine related behaviors, such as impulsivity have provided insights into the basic neurobiology of cocaine addiction. New research on basic neurobiology of drug addiction has shown that the etiology of cocaine addiction is more complicated than simple drug related reward. Novel studies have shown the potential for interactions between neurotransmitters at the receptor level to affect drug related behaviors.
Brain imaging studies in humans have extended these findings, showing the importance of a striato-thalamo-cortical network in cocaine addiction. PET and fMRI studies are using these findings to develop brain imaging as a biomarker of treatment response and as a tool for medication development.
Human behavioral research has shown that cocaine addiction is not merely driven by drug related reward, but is also heavily influenced by cue reactivity and behavioral inhibition. These behavioral targets have become a focus of treatment research in cocaine addiction.
Lastly, a number of clinical trials for cocaine addiction have taken place, which have shown some evidence that pharmacotherapy can reduce cocaine use. Although the majority of double blind, placebo controlled, clinical trials for cocaine addiction have not shown a reduction in cocaine use as measured by cocaine positive urines, more recent research combining pharmacotherapy with effective behavioral therapies has shown that cocaine use can be reduced in placebo controlled trials.
However, a number of challenges remain to move the basic science of cocaine addiction to the bedside treatment of cocaine-addicted individuals. Several important differences exist between animal models and human cocaine use, besides the differences in brain structure and behavior across species. Further, clinical endpoints for FDA approval for pharmacotherapy for cocaine addiction remain difficult to achieve.
The purpose of this research topic is to provide new information on research on cocaine addiction from the bench to the bedside, highlighting research successes and discussing hurdles that remain to produce effective treatments for cocaine addiction.
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