Abstract
New pharmacotherapies have been developed for acute withdrawal and maintenance treatments of alcohol and opioid dependence but not for cocaine dependence. High-dose, long-acting benzodiazepines, beta-blockers, and two antiseizure agents-carbamazepine and valproate-are being used for alcohol withdrawal. For maintenance treatment, opioid antagonists and various serotonergic agents, such as fluoxetine and ondansetron, show promise. For opioid dependence, clonidine-naltrexone detoxification appears quite cost-effective, and buprenorpbine and LAAM (levo-alpha-acetylmethadol) show promise for both detoxification and maintenance. More work is needed, however, to discover an effective agent for target populations of cocaine abusers.