Approaches To Developing Medications For Drug Abuse

Researchers can use the knowledge gained from animal and human studies of the effects of drugs on the brain as they develop medications for alcohol and drug dependence. Most likely, one medication will be needed to help detoxify the drug-dependent individual and a second medication to help sustain abstinence from drug use. This two-phase medication regimen is used for opiate and alcohol treatment, and it may ultimately be the approach used for countering dependency on other drugs, such as cocaine, sedatives, and nicotine. In theory, a pharmacological treatment agent or medication would block or reduce either the acute, rewarding effect of the drug or the discomfort of withdrawal. In practice, few treatment drugs have been found to be very effective in sustaining abstinence from drugs or alcohol.

Any pharmacological agent should be able to be given orally, as this is much easier than other routes of administration, such as injections. The agent itself must be medically safe and not enhance any of the health risks associated with illicit drug use, since the individual may illicitly use drugs while being maintained on the treatment agent. Finally, the pharmacological treatment agent must be acceptable to the patient. That is, if the agent causes undesirable side effects, individuals will likely not take it.

Current research with alcohol and drug effects on the brain and with treatment outcome hold great promise for effective pharmacological agents. This search process will necessarily include the animal and human laboratory studies mentioned as well as medicinal chemistry research. Medicinal chemistry research is used to develop new compounds that have similar but slightly altered chemical structures to the abused drugs or to the neuro-

transmitters that mediate the drug or alcohol effects. These new compounds are then tested in animals to see if they produce therapeutic effects. These effects include having a low potential for being another drug of abuse and attenuating the effects of the abused drug under study, preferably in a way that would lead to decreased drug abuse.

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