Condition

Cocaine use disorders

Clinical trials and treatment information for Cocaine use disorders

4.1M
People Affected
50
Active Trials
204K
New Cases/Year
13K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Contingency Management
80% Effectiveness• 90% Confidence• 95% Safety• 17 trials• 15K participants
HIGH EvidenceExcellent ValueDose: Daily/weekly urine drug screens with contingent rewards
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
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95
DangerousModerateSafe

Time to Effect

1-4 weeks

Duration

12-24 weeks

Response Rate

65%

Remission Rate

45%

Number Needed to Treat (NNT)

5

Common Side Effects:

Anxiety related to performance: 5%
Mild stress: 3%

Annual Cost of Care

Drug Cost

$0

Monitoring

$2,000

Side Effects

$0

Total Annual

$4,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.5

ICER

$15,000/QALY

Cost per Remission

$8,889

Cost per Responder

$6,154

Treatment Outcomes
Primary Outcomes
Proportion of Cocaine-Negative Urine Samples25% (at treatment entry)
+140% (+35 percentage points)
Longest Duration of Continuous Cocaine Abstinence1 week (median prior to treatment)
+400% (+4 weeks)
Treatment Retention (e.g., 12-week program completion rate)35% (typical for standard treatment)
+43% (+15 percentage points)
Cocaine Craving (CCQ-Now score)CCQ-Now score: 55/70
-27% (-15 points on CCQ-Now)
Secondary Benefits
Addiction Severity Index (ASI) Drug Composite Score0.38 (range 0-1, higher is worse)
-21% (-0.08 points on ASI Drug Composite)
Depressive Symptoms (BDI-II score)BDI-II score: 28/63 (moderate depression)
-25% (-7 points on BDI-II)
Employment Rate30% (at treatment entry)
+20% (+6 percentage points)
Common Side Effects
Anxiety related to performance
+5%
Mild stress
+3%
2
Cognitive Behavioral Therapy (CBT)
75% Effectiveness• 85% Confidence• 95% Safety• 15 trials• 12K participants
HIGH EvidenceExcellent ValueDose: 60-90 minute sessions, 1-2 times per week
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
95
DangerousModerateSafe

Time to Effect

2-3 months

Duration

12-24 weeks

Response Rate

55%

Remission Rate

35%

Number Needed to Treat (NNT)

7

Common Side Effects:

Temporary discomfort during sessions: 5%
Emotional fatigue: 2%

Annual Cost of Care

Drug Cost

$0

Monitoring

$400

Side Effects

$0

Total Annual

$400

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.4

ICER

$30,000/QALY

Cost per Remission

$10,286

Cost per Responder

$6,545

Treatment Outcomes
Primary Outcomes
Days of Cocaine Use per Month18 days/month
-40% (-7 days/month)
Cocaine Craving (CCQ-NOW Score)45/70 points
-35% (-16 points)
Percentage of Cocaine-Negative Urine Screens30%
+100% (+30 percentage points)
CUDIT-R Score (Cocaine Use Disorder Identification Test - Revised)20/30 points (severe risk/dependence)
-30% (-6 points)
Secondary Benefits
Depressive Symptoms (PHQ-9 Score)15/27 points (moderate depression)
-30% (-5 points)
Anxiety Symptoms (GAD-7 Score)12/21 points (moderate anxiety)
-25% (-3 points)
Quality of Life (WHOQOL-BREF Score)50/100 points
+15% (+8 points)
Common Side Effects
Temporary discomfort during sessions
+5%
Emotional fatigue
+2%
3
Matrix Model
70% Effectiveness• 80% Confidence• 95% Safety• 50 trials• 5K participants
HIGH EvidenceGood ValueDose: Multiple group and individual sessions per week
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
95
DangerousModerateSafe

Time to Effect

3-6 months

Duration

16-24 weeks intensive, 6-12 months extended care

Response Rate

60%

Remission Rate

40%

Number Needed to Treat (NNT)

6

Common Side Effects:

Temporary discomfort: 5%

Annual Cost of Care

Drug Cost

$0

Monitoring

$400

Side Effects

$0

Total Annual

$400

Cost-Effectiveness

GOOD

QALYs Gained

0.45

ICER

$40,000/QALY

Cost per Remission

$15,000

Cost per Responder

$10,000

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+70%
Response Rate
+60%
Remission Rate
+40%
Common Side Effects
Temporary discomfort
+5%
4
Topiramate
60% Effectiveness• 70% Confidence• 58% Safety• 1 trials• 2.5K participants
MODERATE EvidenceModerate ValueDose: 50-300mg daily, titrated
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
58
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

3-6 months

Response Rate

50%

Remission Rate

25%

Number Needed to Treat (NNT)

9

Number Needed to Harm (NNH)

100

Common Side Effects:

Paresthesia (tingling): 25%
Cognitive slowing/difficulty with concentration: 15%
Nausea: 12%
Weight loss: 12%

Annual Cost of Care

Drug Cost

$400

Monitoring

$400

Side Effects

$200

Total Annual

$1,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.18

ICER

$120,000/QALY

Cost per Remission

$4,000

Cost per Responder

$2,000

Treatment Outcomes
Primary Outcomes
Cocaine Use Frequency (days/week)4.5 days/week
-40% (-1.8 days/week)
Cocaine Craving (Visual Analog Scale 0-10)7.0 (on VAS 0-10)
-30% (-2.1 points)
Cocaine-Negative Urine Samples (proportion)25% of samples
+60% (+15 percentage points (e.g., from 25% to 40%))
Longest Period of Continuous Cocaine AbstinenceMedian 5 days
+150% (+7.5 days)
Secondary Benefits
Depressive Symptoms (BDI-II score)25 (on BDI-II, range 0-63)
-25% (-6.3 points)
Clinical Global Impression - Severity (CGI-S)5 (on CGI-S, range 1-7)
-20% (-1.0 point)
Body Weight85 kg
-5% (-4.25 kg)
Common Side Effects
Paresthesia (tingling)
+25%
Cognitive slowing/difficulty with concentration
+15%
Nausea
+12%

Clinical Trial Phases:

Phase 4
5
Disulfiram
55% Effectiveness• 65% Confidence• 55% Safety• 40 trials• 3K participants
MODERATE EvidenceModerate ValueDose: 125-500mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
55
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

6-12 months

Response Rate

45%

Remission Rate

25%

Number Needed to Treat (NNT)

8

Number Needed to Harm (NNH)

100

Common Side Effects:

Headache: 15%
Fatigue/drowsiness: 10%
Metallic or garlic taste: 10%
Hepatotoxicity (elevated liver enzymes): 3%

Annual Cost of Care

Drug Cost

$800

Monitoring

$800

Side Effects

$100

Total Annual

$1,700

Cost-Effectiveness

MODERATE

QALYs Gained

0.15

ICER

$100,000/QALY

Cost per Remission

$6,800

Cost per Responder

$3,778

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+55%
Response Rate
+45%
Remission Rate
+25%
Common Side Effects
Headache
+15%
Fatigue/drowsiness
+10%
Metallic or garlic taste
+10%

Clinical Trial Phases:

Phase 4
6
Modafinil
50% Effectiveness• 60% Confidence• 65% Safety• 25 trials• 1.5K participants
LOW EvidencePoor ValueDose: 100-400mg daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

3-6 months

Response Rate

40%

Remission Rate

20%

Number Needed to Treat (NNT)

12

Number Needed to Harm (NNH)

1000

Common Side Effects:

Headache: 18%
Insomnia: 12%
Nausea: 8%
Anxiety: 5%

Annual Cost of Care

Drug Cost

$1,000

Monitoring

$100

Side Effects

$50

Total Annual

$1,150

Cost-Effectiveness

POOR

QALYs Gained

0.08

ICER

$200,000/QALY

Cost per Remission

$5,750

Cost per Responder

$2,875

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+50%
Response Rate
+40%
Remission Rate
+20%
Common Side Effects
Headache
+18%
Insomnia
+12%
Nausea
+8%

Clinical Trial Phases:

Phase 4