REDUCE

Each year, approximately 15,000 people seek care due to problems with cocaine use. Agonist ("substitute") medications are very effective in treating heroin and nicotine addiction, such as methadone for heroin addiction and nictoine replacement therapy for smokers. However, there are no "proven effective" medications for treating cocaine addiction. Dexamphetamine is an agonist medication that might be effective in treating cocaine addiction. 

In 2016, we published the results of the CATCH study in The Lancet, a proof-of-principle study investigating the efficacy of sustained-release dexamphetamine in the treatment of cocaine addiction in 73 people who were participating in 'heroin-assisted treatment' for their comorbid heroin addiction. The results showed that SR-dexamphetamine was effective and significantly reduced cocaine use. Moreover, the participants' health also seemed to improve. A commentary on the Lancet article referred to it as "a milestone."

In the REDUCE study, we will investigate the efficacy and safety of sustained-release dexamphetamine compared to placebo in patients with moderate or severe cocaine use disorder. The study will be conducted at three major addiction treatment centers. A total of 204 patients will participate, all of whom are enrolled in a methadone program for their comorbid heroin addiction. Participants will be randomly assigned to receive either sustained-release dexamphetamine or placebo for 24 weeks. This will be followed by a six-week period to study the consequences of discontinuation of the medication. The effects of the treatment on cocaine use, overall health, and quality of life will be evaluated during treatment, at the end of treatment, and at a 52-week follow-up.

collaborations

This study is being conducted in collaboration with Antes, Brijder, GGD Amsterdam, and Stichting Het Zwarte Gat.

Funding

This research project is funded by ZonMw (Goed Gebruik Geneesmiddelen – Rediscovery program).