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Journal Article 
Treatment of Cocaine Addiction 
Gorelick, DA; , 
Springer Milan 
Textbook of Addiction Treatment: International Perspectives 
Cocaine use disorders represent a substantial clinical and public health burden in many countries, yet there are no well-proven and broadly effective treatments available, and no medication approved for this indication by any national regulatory authority. Psychosocial treatments are the mainstay of care, guided by the general principles of prompt engagement in treatment; minimum duration of 3 months; strict monitoring of cocaine use with consistent consequences for lapses; and engagement of the patient’s social network. Contingency management (i.e., reinforcement for abstinence [cocaine-free urine samples] with vouchers or prizes) and cognitive behavior therapy (CBT) have the strongest evidence for efficacy in controlled clinical trials, often doubling the abstinence rate over standard drug counseling. Other interventions with mixed evidence include community reinforcement, motivational enhancement or interviewing, and participation in Cocaine Anonymous. Medications with efficacy in more than one controlled clinical trial include disulfiram, oral stimulants in sustained-release formulation, and the anticonvulsant tiagabine. New treatments currently undergoing clinical study include anti-cocaine vaccines and repetitive transcranial magnetic stimulation (rTMS).