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NIDA-Funded Research May Stop Cocaine Addiction

A study by SmithKline Beecham released in 1995 shows that 21 percent of workers testing positive for drugs are using cocaine. Research undertaken at the Yale University School of Medicine in New Haven, has shown that it may be possible to suppress cocaine seeking in animals by increasing the feeling of satiety or satisfaction. Yale university’s Dr. David Self -- a member of the research team funded by the National Institute on Drug Abuse -- says, “Cocaine develops a psychological dependency which the medication alone will not directly address. Rather, it will block cravings for cocaine within a month or two. In that time a user will need reinforcing therapy to substitute positive values in their lives and create lifestyle changes.”

Mark Perrino, President of the American Methadone Treatment Association sees parrallels between the development of heroin treatment and any upcoming “cure” for cocaine. He is optimistic about the NIDA-funded research but cautions against overselling a cure for cocaine. Any medication developed must be seen as part of a treatment regimen, he says. “Addiction is a very complex issue which goes beyond a biochemical problem that a medication can cure,” says Perrino. “Treatment of cocaine addiction should also include treating the underlying problems of employment, HIV and crime.” Perrino says the ideal medication would be one with the least possibility of addiction itself. This is important in assuring the widest possible treatment sources.

Previous research had focused on blocking some of cocaine’s reinforcing properties, that is, the craving for the drug. In the new study, researchers allowed rats to self-administer cocaine for two hours and then switched them to saline for two hours. During this time, the self-administration behavior diminished; the saline did not interest the rats as much as the cocaine. Researchers then gave the animals a small priming dose of cocaine and found that it had no effect on those who were pre-treated with a D1-like agonist (which mimics the effects of cocaine but with less euphoric effect). This indicated that the medication could at least suppress the physical cravings for cocaine.

The research has shown that, “by removing the cravings for cocaine, you can extinguish the memory of the drug’s excitement,” says Dr. Self. This raises the possibility of finding a cure for the physical aspects of cocaine addiction in the near future.

The Yale team now faces the long process of FDA trials. “Fortunately,” Dr. Self says, “D1-like agonists are already undergoing tests for treatment of Parkinson’s Disease.” He adds, “We hope to get clinical trials started at Yale next year and we are optimistic because the Parkinson team has already completed some 50 percent of the toxicology work.”

Alan Leshner, Ph.D., director of NIDA, says the development of a cocaine treatment medicine is NIDA’s top priority. He is hopeful that one of the compounds the research team is developing will not have any stimulatory effects, which would simplify its delivery system. “We are seeking the least necessary level of regulation that will ensure public safety,” says Leshner.

Employees Can Beat Urinalysis But Probably Not Hair Testing

Hair testing is the least popular method of testing for substance abuse in the workplace, yet it may be the most accurate. . Employers who realize that their workers can beat urine testing by abstaining from cocaine use for 72 hours may want to examine the benefits of hair testing, which tracks drug use 90 days prior to testing.

In Search of Accuracy

Tom Hendershot, director of health and safety at Steelcase Corporation says he is very satisfied with the accuracy of hair testing. The company first tried hair testing and urine testing in parallel for 784 prospective employees. “We were shocked to find that the urine test showed 2.7 percent positives while the hair test showed 18 percent,” says Hendershot. He says the better screening results more than make up for the excess cost of hair testing. Blockbuster Entertainment has been using hair tests in employee drug screening since 1990. Wally Knief, Blockbuster’s corporate communications manager, says the hair test is a better screen than urinalysis. The company uses the testing method on all prospective hires and for random testing of employees. Knief says the test is more accurate. “You can tell if testers have been using drugs over a longer period of time,” he explains.

Is it Worth the Additional Cost?

Hair testing is roughly twice the average cost of urinalysis. But Ray Kubacki, president and C.E.O. of Psychmedics, a Cambridge Mass. company that has held a patent for hair testing since 1988, says it’s worth the expense. “Hair testing costs more initially, but the superior detection rate, thus the potential for avoiding accidents at the workplace, makes hair testing more economical in the long run.” His company uses a sliding scale of charges. If you run a small outfit with under 100 employee tests per year, expect to pay $55 per test; figure $50 each for companies with 1,000 employee tests per year; and $40 per test for 20,000 and above.

Kubacki says the hair test has a superior detection rate to urinalysis because of the way it works. He explains that hair detects trace amounts of substances deposited in hair through the blood stream for at least 90 days of hair growth. He offers five reasons why hair testing is better than urine testing:

Hair testing looks back 90 days whereas urinalysis can be beaten after three to four days of abstinence;
The hair test can’t be beaten by substituting some one else’s sample. Hair samples are taken from the back of the head by management personnel;
It is a less demeaning method of testing, particularly for women;
Hair testing is more precise because it can tell the difference between heavy, moderate and low drug use;
If an employee claims the tested sample was not his, employers can retest and be assured of virtually the same result; and
Hair testing can be used as a qualifier in a return-to-work case. It can prove that an employee has been off drugs for 90 days.

Ethnic Bias Concerns

Some detractors of hair testing contend that hair testing research suggests dark hair accumulates cocaine deposits at a higher rate than light hair. Dr. Tom Mieczkowski, professor of criminology at University of South Florida, has studied testing procedures in criminal justice populations for several years. “Provided the laboratory methodology is correct, there is no difference in results because of hair color,” he says. Mieczkowski’s studies show that hair tests and urine tests provide the same positive results but hair testing can also differentiate intensity and length of drug use. “Where a worker can beat a urine test by abstaining for 72 hours, hair testing will look back 90 days,” says Dr. Mieczkowski.

Ray Kubacki says correct hair testing procedures should eliminate the melanin factor -- which creates the difference in hair color -- in a sample before the testing is done. “I think it is an important safety factor although you must remember that urine has melanin, yet nobody has ever worried about that.” A hair testing bill before the Florida State Legislature is likely to contain procedures for compensating for hair color.

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NIDA-Funded Research May Stop Cocaine Addiction

Employees Can Beat Urinalysis But Probably Not Hair Testing

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