Human Lab Model of Behavioral/ Pharmacological Treatment for Cocaine Dependence

Cocaine dependence continues to be a significant public health concern. Data from the National Survey on Drug Use and Health indicate that the number of Americans who had used cocaine in the past month has remained relatively stable since 2002 and cocaine remains the most frequently mentioned drug in emergency-room admissions according to the Drug Abuse Warning Network. Despite intense research efforts, a widely accepted medication for cocaine dependence has not yet been identified. A number of non-pharmacological treatments for cocaine dependence have also been examined. Specifically, behavioral treatments for cocaine dependence seek to reinforce non-drug related behaviors. For example, contingency management uses monetary incentives to decrease cocaine use and is associated with high rates of prolonged cocaine abstinence. Given the effectiveness, but also high relative cost, of behavioral treatments for cocaine dependence, some have theorized that pharmacotherapies may be able to enhance the effectiveness of behavioral therapies and decrease costs associated with delivery of these therapies. Indeed, pharmacotherapies (i.e.,desipramine and bupropion) have been shown to enhance the effectiveness of behavioral therapies for cocaine dependence. The purpose of the experiments proposed in this application is to "reverse engineer" a human laboratory model of combined pharmacological and behavioral treatments for cocaine dependence using an already existing and validated model of contingency management, the cocaine versus money choice paradigm. The research proposed in this application has one specific aim. The specific aim is to validate the cocaine versus money choice paradigm as a model of combined pharmacological treatment and contingency management. We will accomplish this aim with two experiments. In Experiment 1, eight non-treatment seeking cocaine dependent subjects will choose between a range of doses of intranasal cocaine and monetary values following maintenance for seven days on placebo or 300 mg bupropion. In Experiment 2, eight non-treatment seeking cocaine dependent subjects will choose between the same range of doses of intranasal cocaine and monetary values in Experiment 1 following maintenance for ten days on placebo or 20 mg citalopram. The research proposed in this application will serve to develop an efficient and valid human laboratory screen of medications for cocaine dependence.