TMS and Cocaine Addiction – The Evidence
Cocaine is one of the most popular illegal drugs in the UK. Around 2.6% of the population (aged 16-59) took powdered cocaine during 2017-18, which amounts to over 1million people. The drug alters the brain chemistry, which causes addiction. It is a stimulant that causes excessive amounts of dopamine, which typically produces happiness and pleasure in the body. Feelings of euphoria fade quickly and as time goes on, the body needs larger amounts of the stimulant to feel the same extreme highs.
What is the evidence for TMS treatment for cocaine addiction?
A number of studies have shown that TMS is effective in reducing cravings. Therefore, TMS also reduces the average consumption of the drug because the urge to use it is less intense.
Camprodon (2007) recognised that cocaine cravings reduced temporarily after only two TMS sessions. This research was continued by Politi in 2008, who again saw reductions in cravings, this time treating each cocaine addicted patient with 10 sessions. These studies combined demonstrated the vital role the pre-frontal cortex plays in modulating the cravings felt by patients with addiction problems.
In 2016, research continued further and used a control group, who received medication, to be compared to the group receiving TMS treatment. A higher number of cocaine-free urine samples were given in the TMS group and the average cocaine craving scale score was much lower, too. At the end of the study, those patients who were in the control group were switched onto TMS and saw a significant improvement in their cravings.
The pre-frontal cortex is targeted to enhance the brain activity, improve behaviour control and, in turn, reduce drug usage. The clinically beneficial side effects of TMS over the pre-frontal cortex is supported by all evidence. It’s demonstrated by the enhanced dopamine activity in the mid-brain, which is usually depressed when suffering from addiction.
What other treatment is available for cocaine addiction?
Addiction is complex disease of the body as well as the brain and withdrawals can be intense, although not life threatening. The difficult withdrawal is usually the reason for most patients to relapse after a short time. The relapse rate for cocaine addiction is around 75%. You won’t need to take alternative drugs (as you may need to when withdrawing from heroin), but there has been no FDA (Food and Drug Administration in the USA) nor NICE (National Institute for Health and Care Excellence in the UK) approval for treatment. A number of medications, including Risperidone (antipsychotic medication), Topiramate (an anticonvulsant), Disulfiram (used to treat alcoholism) and Modanifil (a stimulant used to treat narcolepsy) have been trialed but none have been established as effective and have their own side effects.
Psychological therapies, like cognitive behavioural therapy (CBT) and contingency management (rewarding patients who remain substance free), can be used in combination. They are likely to be needed for a minimum of 6 months to make any impact, however.
What’s the verdict? Does TMS work for cocaine addiction?
At Smart TMS, we have reviewed all available research and have concluded that TMS is more effective and safer than using psychotropic drugs.
In our own experience, we have found that after one week of treatment, cravings for cocaine are either greatly reduced or non-existent altogether. This is vital when treating cocaine addiction, as the cravings are the reason a large majority of relapses occur. Subsequent treatment maximises the chance of staying clean.
We recommend signing up to one of our aftercare programmes following your treatment. This will allow you to have monthly “top-up” sessions of TMS to prevent a relapse and keep you feeling your best. A course of CBT and/or contingency management is also recommended following a successful course of TMS treatment, or at very least regular attendance at Narcotics Anonymous, to future-proof your success.
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As you may have experienced when trying to quit cocaine yourself, the addictive cravings are very tricky to combat. With 75% of cocaine users relapsing due to the cravings, you’re not alone if you have tried to give up but been unsuccessful. Our friendly, knowledgeable team of patient advisors will talk you through TMS and the response/remission rates we have seen since offering treatment for cocaine addiction to help you make the best decision for you.