Are there any harm reduction programs in place for cocaine?

Readers Question Readers Question: (Name changed for privacy)
Stanton Peele Response by: Dr. Stanton Peele
Posted on July 8th, 2009 - Last updated: October 11th, 2019
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Dear Stanton:

Are there any programs for cocaine maintenance in the world. If so, do they work as well as methadone?

Can IV users of stimulants find or get an acceptable oral alternative?


This question has been asked of me by several people. Obviously, it is on many people’s minds.

Patricia Erickson, a leading expert on cocaine use patterns, recently sent me a paper which is to appear in the International Journal of Drug Policy on harm reduction for cocaine users, and which explores the range of potential cocaine harm reduction techniques.

But, in our correspondence, we both remarked on the paucity of such programs.

For example, we discussed the Swiss heroin maintenance program, which has explicitly ruled out cocaine. I asked one of the managers of this program why not include cocaine, and he said that acute reactions to the drug are too dangerous. But, of course, given that people are using the drug, its dangers are not a reason for excluding it from safety programs, but rather are a reason for including it.

So, I know of no such programs at present. Perhaps cocaine has historically been thought of as less dangerous than heroin, and this explains why so little concern has been directed towards reducing its harms.

One always thinks of needle exchange programs, for instance, in terms of heroin addicts.

Please let me know what you discover.


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Stanton Peele

Dr. Stanton Peele, recognized as one of the world's leading addiction experts, developed the Life Process Program after decades of research, writing, and treatment about and for people with addictions. Dr. Peele is the author of 14 books. His work has been published in leading professional journals and popular publications around the globe.

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