The small size and uncertainty of the market for cocaine pharmacotherapies constitutes a critical barrier to development of a cocaine abuse pharmacotherapy. Although all of our interviewees agreed that the total number of cocaine users is large, they recognized that the market for a cocaine abuse treatment is likely to be much smaller than the absolute number of people that use cocaine. Representatives of one pharmaceutical company said that they used a conservative estimate of the market size for cocaine treatment that was about half of the generally accepted 2 million heavy users.
Uncertain market penetration was another reason for the skepticism of the market. Interviewees from two of the companies stressed that potential patient compliance problems and limited access to patients (i.e., given the need for many substance abusers to obtain pharmacotherapy under controlled settings) made them uncertain about the true market size for cocaine treatment. Representatives of two pharmaceutical companies noted that many publicly-funded treatment centers were managed by non-physicians who tended to oppose the use of drugs to treat substance abuse, which such staff regarded as "behavioral" conditions, thereby further restricting the potential sale of these drugs.