Effectiveness of N-Acetylcysteine (NAC) in Treating Cocaine Dependent Individuals - 1

Inclusion Criteria: * Meets DSM-IV criteria for cocaine dependence, as determined by a mini-SCID interview * Currently dependent on cocaine * Seeking treatment for cocaine abuse at the time of study entry * Currently uses cocaine by smoking, nasal, or intravenous route of administration. * Stable physical and mental health, as judged by an interview and physical examination * If female, demonstrates a negative pregnancy test and agrees to use an adequate method of contraception for the duration of the study * Lives within a 50 mile radius of the research program center and has reliable transportation Exclusion Criteria: * Meets DSM-IV criteria for dependence on any psychoactive substance other than cocaine, alcohol, nicotine, or marijuana * Physiological dependence on alcohol, which requires medical detoxification * History of significant liver, kidney, endocrine, cardiac (e.g., arrhythmia requiring medication, angina pectoris, myocardial infarction), stroke, seizure, neurological, non-drug-related psychiatric, gastrointestinal, pulmonary, hematologic, or metabolic disorders (e.g., homocystinuria) * History of an adverse reaction to cocaine, including loss of consciousness, chest pain, psychosis, or seizure * History of adverse reaction or hypersensitivity to N-acetyl cystine (NAC), or a similar drug * Significant active medical or psychiatric illness that might inhibit the ability to complete the study * Active high blood pressure, defined as a mean of three sitting blood pressure readings of 145/95 or higher within a 10-day period * History of or current asthma * Occasional or daily use of albuterol or other beta-agonist inhalers * Use of carbamazepine, phenytoin, nitrous oxide, methotrexate, 6 azauridine triacetate, or nitroglycerin within the 2 weeks prior to study entry * Use of very large doses of folate, cyanocobalamine (vitamin B12), or pyridoxine (vitamin B6) as prescribed by a health care professional; individuals taking very large doses of these vitamins on a self-initiated basis may enter the study if they are willing to stop use 14 days prior to study entry and to use a standard generic multiple vitamin instead * Pregnant or breastfeeding * Required by the court to obtain treatment for cocaine dependence * Not seeking treatment for cocaine dependence * Anticipating elective surgery or hospitalization within 20 weeks of study entry * Failure to have a consistent residence for the 4 weeks prior to study entry * History of childhood or adult seizures * Participated in cocaine treatment (clinical or research) within 30 days of study entry