Effects of buprenorphine and an alternative nondrug reinforcer, alone and in combination on smoked cocaine self-administration in monkeys.

The abuse of smoked cocaine base, also known as 'crack', continues to be a major public health problem and to date the success of pharmacological or behavioral interventions has been limited. The purpose of this study was to evaluate the efficacy of a behavioral (alternative reinforcer-saccharin) and pharmacological (0.01 mg/kg buprenorphine) treatment alone and in combination. Five adult male rhesus monkeys self-administered cocaine base (1.0 mg/kg/delivery) via the smoking/inhalation route. Each day ten smoke deliveries were available contingent upon completion of a chained FR (lever press), FR (inhalation response) response schedule during 4 hr sessions. The data were analyzed using a behavioral economic framework in which the lever press response requirements were varied from 64 to 1024 to generate a demand function (consumption x FR) for cocaine under the following conditions: (1) buprenorphine pretreatment alone (0.01 mg/kg, i.m., 30 min presession); (2) concurrent access to saccharin alone (0.03% wt/vol); and (3) buprenorphine pretreatment in the presence of concurrent access to saccharin. Under all conditions, increases in the lever FR resulted in significant decreases in smoked cocaine base deliveries. Neither buprenorphine pretreatment alone nor concurrent saccharin alone produced significant decreases in smoked cocaine deliveries; however, the combination of buprenorphine pretreatment and concurrent saccharin significantly decreased the mean number of smoked cocaine deliveries from the no treatment baseline and from the buprenorphine alone condition. These data suggest that the combination of pharmacotherapy and alternative reinforcers may be an effective treatment strategy to alter smoked cocaine self-administration.