title: [Cocaine addiction: current data for the clinician].
abstract: Cocaine remains the second most commonly used illicit drug worldwide after cannabis. Observed levels of cocaine use among countries considerably vary. An increased cocaine use is recorded in the general European population. Cocaine addiction is a worldwide public health problem, which has somatic, psychiatric, socio-economic and judicial complications. It is a multifactorial disorder variable in its clinical manifestations and heritable. Compared to the general population, there is a high prevalence of somatic and psychiatric disorders among cocaine-dependent patients. There are predictable dose-related effects of pharmacological action of cocaine and effects which are uncommon, unrelated to dose and occur randomly in this population. The number of patients entering drug treatment for primary cocaine use has been increasing in Europe for several years. However, there is no specific pharmacotherapy with established efficacy for the treatment of cocaine addiction, nor is any medication approved by regulatory authorities for such treatment. Recent controlled clinical studies and laboratory studies have highlighted some very promising medications. The perfect therapeutic platform for abstinence initiation and relapse prevention of cocaine addiction is a combination of pharmacological treatments and behavioral treatments. Targeting somatic and psychiatric comorbidity is another way to use pharmacological treatments in addictions.
authors.affiliation: Université Paris Sud-11, AP-HP, Hôpital universitaire Paul-Brousse, Centre d'enseignement, de recherche et de traitement des addictions, CEA-Inserm U1000, Villejuif, France. Electronic address: laurent.karila@pbr.aphp.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Karila
authors.affiliation: Université Paris Sud-11, AP-HP, Hôpital universitaire Paul-Brousse, Centre d'enseignement, de recherche et de traitement des addictions, CEA-Inserm U669, Villejuif, France.
authors.forename: Rim
authors.initials: R
authors.lastname: Zarmdini
authors.affiliation: Université Paris-7, AP-HP, Hôpital Bichat, Service de psychiatrie et d'addictologie, Villejuif, France.
authors.forename: Aymeric
authors.initials: A
authors.lastname: Petit
authors.affiliation: Université Paris Sud-11, AP-HP, Hôpital universitaire Paul-Brousse, Centre d'enseignement, de recherche et de traitement des addictions, CEA-Inserm U669, Villejuif, France.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Lafaye
authors.affiliation: SOS Addictions, 75016 Paris, France.
authors.forename: William
authors.initials: W
authors.lastname: Lowenstein
authors.affiliation: Université Paris Sud-11, AP-HP, Hôpital universitaire Paul-Brousse, Centre d'enseignement, de recherche et de traitement des addictions, CEA-Inserm U669, Villejuif, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Reynaud
mesh_terms: D019970:Cocaine-Related Disorders / Q000453:epidemiology* / Q000209:etiology / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy; D004358:Drug Therapy; D006801:Humans; D012008:Recurrence