Disulfiram versus placebo for cocaine dependence in buprenorphine-maintained subjects: a preliminary trial

• Published in: Biological psychiatry (1969) Vol. 47; no. 12; pp. 1080 - 1086
• Main Authors: George, Tony P, Chawarski, Marek C, Pakes, Juliana, Carroll, Kathleen M, Kosten, Thomas R, Schottenfeld, Richard S
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15-06-2000; Elsevier Science
• Subjects: Adult; Alcohol Deterrents - adverse effects; Alcohol Deterrents - therapeutic use; Biological and medical sciences; buprenorphine; Buprenorphine - therapeutic use; Chi-Square Distribution; clinical trial; cocaine; Cocaine-Related Disorders - psychology; Cocaine-Related Disorders - rehabilitation; Disulfiram; Disulfiram - adverse effects; Disulfiram - therapeutic use; Drug addictions; Female; Heroin Dependence - psychology; Heroin Dependence - rehabilitation; Humans; Male; Medical sciences; Narcotic Antagonists - therapeutic use; opioids; Substance Abuse Detection; Time Factors; Toxicology; clinical trial; Disulfiram; buprenorphine; cocaine; opioids; Human; Drug addiction; Replacement therapy; Treatment efficiency; Opiates; Ester; Chemotherapy; Association; Buprenorphine; Dependence; Clinical trial; Cocaine
• ISSN: 0006-3223; 1873-2402
• DOI: 10.1016/S0006-3223(99)00310-8

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.