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Tagged In:  Drugs

The Medical Research Council (MRC) is awash with fascinating insights into future treatments, but one particular article on cocaine addiction caught our attention. 




Dr Karen Ersche, from the University of Cambridge, has found that cocaine addicts are more likely to change their behaviour if they know the consequences of their actions. Crucially, she talks in detail about how those findings could impact treatment options. 

Relevance to offender healthcare professionals


For those working in substance misuse within prisons, the research is of direct interest. After all, the latest data from HM Inspectorate of Prisons shows that whilst heroin and cannabis are the two most cited primary drugs prisoners are addicted to, crack cocaine is not far behind. 

Different habit forming behaviours in addicts


The research suggests that people who are addicted to cocaine form habits that are not typically seen in non-addicts and that understanding this could have significant implications for treatment. 

Dr Ersche mentions how those who are addicted are much more prone to “developing habits for actions that are rewarded”, whereas non-addicts form habits largely based around repetition and that if the situation requires, they can break the habit. It’s far more complex for cocaine users though, as those working in offender health will know all too well. 

The study involved training 125 participants (72 addicts and 53 non-addicts) to perform two tasks of pairing various cards. In the first task, when the respondents got the answer correct they were rewarded with points, and on the second task they received a small electric shock for an incorrect answer. 

The results from the two groups were interesting. In the rewards based task, those addicted to cocaine improved over time, but they did not improve at all in the task involving electric shocks. 

What does this tell us about cocaine addiction?


This is all very interesting, but what does this tell us about cocaine addiction? Dr Ersche suggests that interventions that use rewards are most likely to be effective, as is training users to replace drug-taking habits with alternative less harmful habits. 

What’s the wider impact?


Well, those in favour of reward-recovery activities known as ‘contingency management’ are likely to be very interested in the results. However, rewarding people with addiction as part of a controlled recovery programme is not commonplace in Britain. There is little evidence of its use over here due to a combination of factors, including investment needed in drug testing, tight project management requirements, and  not to mention the perceived controversy of ‘rewarding drug users’.

However, we may be edging closer to more rewards-based techniques. After all, the Advisory Council on the Misuse of Drugs (ACMD) in a 2015 report into drug treatment and recovery systems, notes that “there is strong evidence for the use of contingency management in reducing cocaine or crack and heroin use among those in OST”. For now though, the research remains a talking point amongst professionals. 

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