Pharmacological treatment of substance dependence from a neuroscientific perspective (I): opiates and cocaine

Abstract

In this review paper it is intended to analyze the most recent publications on pharmacological treatment of drug dependences from a neuroscientific perspective. It has been divided into two parts, the first one focuses on the treatment of illegal substance dependence, specifically opiates and cocaine; and the second part deals with the pharmacological treatments of three substances, two legal drugs such as alcohol and tobacco, and a group of medications with abuse potential, benzodiazepines. In this first part the neuroscientific aspects (genetic, neurochemistry, circuits involved, neuroimaging and neuropsychological deficits) relevant to understanding the pharmacological treatment of the main drug addictions are summarized. The pharmacotherapies of opiate dependence, both for detoxification and for dehabituation, are then discussed. Finally, the main medications that have been proposed to treat cocaine dependence are also reviewed.