For adults with cocaine dependence or cocaine use disorder, disulfiram may result in more people achieving abstinence at the end of treatment compared with placebo or no pharmacological treatment (on average, 424 vs 269 per 1000 people; low‐certainty evidence). However, disulfiram may have little or no effect on the number of people who achieve continuous abstinence (maintained for at least three weeks following treatment completion), or on the frequency or amount of cocaine use by the end of treatment (low‐certainty evidence).

There may be little or no difference between groups in dropouts for any reason when comparing disulfiram with placebo or no pharmacological treatment (low‐certainty evidence). The evidence is very uncertain about the effect of disulfiram on adverse events or dropouts due to adverse events. Additionally, the effect of disulfiram on craving and psychological distress is unclear, with findings based on single trials with unclear risk of bias. None of the included studies assessed the effect of disulfiram on severity of dependence...