Effects of N-Acetylcysteine on Treatment Outcomes for Cocaine Abusers
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Background and Significance: Cocaine addiction represents a pressing and pervasive problem with social consequences. Despite advancements in the substance abuse treatment field, no pharmacotherapy has received approval for the treatment of Cocaine Use Disorder (CUD). N-acetylcysteine (NAC) has recently been identified as a novel pharmacotherapy that is well tolerated, may prolong abstinence time and lessen cravings for cocaine addicted individuals. Over the past 4 years, prescribing of NAC has become increasingly more commonplace within a regional substance abuse treatment organization. Purpose and Objectives: This project was intended to evaluate treatment outcomes in the outpatient (OP) setting for CUD diagnosed patients after having received NAC during participation in residential rehabilitation (RR) prior to OP admission. Theoretical Framework: The Cycle of Addictions was selected for its description of relapsing in terms of neurobiology. Glutamatergic dysregulation has been implicated as a contributor to relapse following sustained abstinence, and furthermore, a proposed target of NAC pharmacotherapy. Methods and Design: A retrospective cohort design was selected. De-identified OP and RR data from 193 subjects was provided by the organization. Two groups were established: those prescribed NAC in RR (n= 90) and those not (n = 98). Group comparison was conducted using chi-square, t-test, and ANOVA analyses. Results: Groups were statistically similar demographically. Subjects prescribed NAC had significantly longer episodes of treatment (MD = 8.5). Treatment with NAC in RR did not significantly influence OP appointment attendance. Finally, a composite of those prescribed NAC was deducted. Conclusion: Further research is needed into prescriber decision-making, efficacy of NAC in the OP setting, and patient perspective into NAC treatment.