Disulfiram versus placebo for cocaine dependence in buprenorphine-maintained subjects: a preliminary trial.
BACKGROUND
We examined the effects of disulfiram versus placebo on cocaine dependence in buprenorphine-maintained subjects.


METHODS
Opioid and cocaine dependent subjects (n = 20) were induced onto buprenorphine maintenance, then randomized to disulfiram (250 mg q.d. ; n = 11) or placebo (n = 9) treatment for 12 weeks.


RESULTS
Groups were comparable at baseline on demographic measures and on baseline measures of drug-use severity. Fifteen subjects completed the study, including 8 subjects randomized to disulfiram (72.7%) and 7 subjects randomized to placebo (77.8%). The total number of weeks abstinent from cocaine was significantly greater on disulfiram versus placebo (mean +/- SD: 7.8 +/- 2.6 vs. 3.3 +/- 0.5, p <.05) and the number of days to achieving 3 weeks (24.6 +/- 15.1 vs. 57.8 +/- 7.7, p <.01) of continuous cocaine abstinence was significantly lower in disulfiram compared with placebo. The number of cocaine-negative urine tests during the trial were also higher on disulfiram (14.7) than on placebo (8.6); furthermore, subjects in the disulfiram group achieved consistently higher rates of cocaine-negative urine tests in each 3-week interval and the increase over time was faster in the disulfiram compared with placebo.


CONCLUSIONS
This preliminary study suggests the potential efficacy of disulfiram versus placebo for treatment of cocaine dependence in buprenorphine-maintained patients.
George
T P
TP
Department of Psychiatry, Yale University, School of Medicine, New Haven, CT 06508, USA.
Chawarski
M C
MC
Pakes
J
J
Carroll
K M
KM
Kosten
T R
TR
Schottenfeld
R S
RS
D000328:Adult; D000427:Alcohol Deterrents / Q000009:adverse effects / Q000627:therapeutic use*; D002047:Buprenorphine / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D004221:Disulfiram / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D015813:Substance Abuse Detection; D013997:Time Factors
D000427:Alcohol Deterrents; D009292:Narcotic Antagonists; D002047:Buprenorphine; D004221:Disulfiram