Abstinence from cocaine at the end of a 9-week trial was nearly four times as common among cocaine-dependent patients taking vigabatrin as among those taking placebo. Vigabatrin is an antiepileptic medication used outside the United States. It elevates concentrations of γ-aminobutyric acid (GABA) and blunts cocaine-induced increases in extracellular dopamine in animals. In the randomized, double-blind trial by Brodie et al. (p. 1269), the rates of abstinence in 103 Mexican parolees after treatment with vigabatrin or placebo were 28.0% and 7.5%, respectively. During 4 weeks of follow-up, abstinence continued for 12 of the 14 patients taking vigabatrin who were abstinent at the end of treatment. In addition, among participants who used alcohol at baseline, 43.5% of those taking vigabatrin reported alcohol abstinence at the end of treatment, compared to 6.3% for placebo. Dr. Kathleen Brady highlights ethical issues in an editorial on p. 1209.