Predicting Response to Disulfiram for Cocaine Use Disorder

Disulfiram promotes abstinence in individuals with alcohol use disorder (AUD) via negative reinforcement (it causes nausea and other distressing symptoms by inhibiting an enzyme involved in alcohol metabolism). In several studies, disulfiram has also reduced cocaine use in individuals with cocaine use disorder (CUD), but the mechanism is not clear. One theory is that disulfiram inhibits the enzyme dopamine βhydroxylase, thus increasing the dopamine available for signaling in the brain. Increasing synaptic dopamine could reduce cocaine craving and impulsivity. These researchers studied whether two polymorphisms in the SLC6A3 (DAT1) gene —encoding the dopamine transporter (DAT), which is responsible for dopamine clearance from the synapse — …