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Blocking the Path to Addiction: How a Common Beta Blocker Could Curb Cocaine Use




Anxiety is a powerful driver of drug addiction, yet many standard anti-anxiety medications are not currently used to treat substance use disorders. Our latest research explores how targeting the brain's stress systems might offer a new way to prevent and treat cocaine addiction. By using a common medication called propranolol, we found that we could not only prevent the transition into heavy cocaine use but also reduce the deep seated motivation to seek the drug.


The Question: Can Beta Blockers Stop the Downward Spiral?

We know that the brain's noradrenergic system (which handles stress and "fight or flight" responses) is heavily involved in the negative emotions and anxiety that occur during withdrawal. These states often lead to an "escalation" of drug use, where individuals take more and more of a substance to cope. We wanted to know if propranolol, a beta blocker often used for high blood pressure and performance anxiety, could interfere with this escalation process or help someone who is already in a pattern of heavy use.


The Study: Testing Prevention and Treatment

We used a well established model where rats have "extended access" (6 hours a day) to cocaine. This model mirrors the compulsive drug taking seen in humans. We tested propranolol in three ways:


  • Prevention: Giving the medication daily before escalation began.


  • Reversal: Giving it after a heavy pattern of use was already established.


    Specificity: Checking if the drug affected the drive for natural rewards, like sweet saccharin, to make sure it wasn't just making the rats less active overall.


Key Findings: A Targeted Reduction in Motivation

Our results show that propranolol has a significant impact on cocaine seeking behavior:

  • Stopping Escalation: Rats given daily propranolol did not develop the typical escalated pattern of heavy cocaine use.


  • Reducing Drive: The medication dose dependently decreased the "breakpoint" for cocaine, meaning the rats were less willing to work hard to get the drug.


  • Selective Action: Most importantly, propranolol had no effect on the consumption of saccharin. This suggests the drug specifically targets the pathways involved in drug addiction rather than general pleasure or motivation.



Why It Matters

These findings suggest that beta blockers should be seriously considered as a target for developing new treatments for cocaine use disorder. While people who have already established a very high level of use might require higher doses to see an effect, our research indicates that propranolol could be a vital tool in preventing relapse and reducing the intense motivation that keeps the cycle of addiction going. By treating the biological roots of addiction related anxiety, we may be able to help the brain move from uncontrolled use back toward stability.



Full Reference: Beldjoud H, Avelar A, Kallupi M, Sedighim S, Rizo N, Carrette LLG, Velarde N, Boomhower B, de Guglielmo G, George O. Chronic administration of a norepinephrine antagonist prevents and partially reverses escalation of cocaine self-administration. Addiction Biology. 2023;28(9):e13316.

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