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The two major drugs of abuse in our society –opioids (heroin) and cocaine –exert their addictive properties through two different neurotransmitter systems in the brain. Therefore, it has been assumed that pharmacologic treatments for cocaine or heroin abuse would have to be different, even though the concurrent abuse of both drugs is very common.

Opium now a medication originally developed as a pain reliever has shown great promise for the treatment of “polydrug” abuse involving both cocaine and opioids. This drug, called buprenorphine, is unusual in that it both activates and inactivates the molecules (called receptors) where opiates attach on the nerve cells in the brain. Thus, like most opioids, it effectively relieves pain but the risk for overdose is minimal.

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The Granger Collection, New York. Clinical studies found buprenorphine to be effective as a treatment for heroin addiction and to have some advantages over methadone in terms of relative safety.

However, a surprise was that buprenorphine was also found to reduce cocaine abuse in individuals who are dependent on both heroin and cocaine.

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Finding these dual effects by buprenorphine provides new insights into the mechanisms of cocaine and heroin dependence and suggests that these mechanisms may be more related than was previously thought.

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