A Vaccine for Cocaine

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In the city that never sleeps, 274 people died due to cocaine abuse last year, according to the New York Post. While that figure has decreased by almost half in the past four years in New York City alone, scientists are attempting to create vaccines to end the addiction for millions of people around the world.

Despite the general belief that drug addiction is a moral failure rather than a physical disease, developing and producing inexpensive vaccines for addicts can reduce the hundreds of millions of dollars spent on their medical care and incarceration. Plus, it can help turn their lives around.

After 20 years of work by a number of different scientists, a cocaine vaccine is showing promising results. A trial study by an arm of the National Institutes of Health showed the vaccine reduced cocaine use in 38 percent of vaccinated patients. It works by stimulating the immune system to produce anti-cocaine antibodies that attack cocaine molecules in the blood, preventing them from traveling to organs such as the brain. If it's not allowed in the brain, cocaine can't induce a high. Therefore, over time, the patient may have a better chance at kicking the addiction.

Cocaine works by binding to receptors that normally would receive dopamine from another neuron. That leaves excess dopamine stuck between neurons, stimulating these neurons to fire repeatedly, creating the euphoria users feel. Some scientists believe this high makes cocaine the most addictive of drugs and is the reason why behavior therapy has not been effective in helping addicts stay off the drug.

A complication in developing the vaccine was the small size of the cocaine molecule, which does not generate a good immune response and high levels of antibodies. So, the idea was to link it to a large protein molecule. Researchers focused on an unlikely partner molecule ' the cholera toxin B, a portion of cholera toxin that does not cause disease, but will stimulate the immune system to respond.

Researchers then attached this portion of the toxin to the cocaine molecule. Once the vaccine is injected, it induces production of antibodies that then circulate in the blood. When an addict uses cocaine, the antibodies bind to the molecule and prevent it from entering the brain.

The vaccine is a strict regimen of five shots over 12 weeks, a schedule that was challenging for many addicts to meet. In those that did, a third saw positive results. After two months, they needed a booster vaccine to maintain the proper level of cocaine antibodies. Researchers say the next step is to make the vaccine effective for a larger proportion of the people taking it, and to maintain the antibody level for longer than two months. It's also clear that counseling and behavior therapy is necessary to control urges since the vaccine does not affect this physical component of the addiction.

Making a cocaine vaccine available to a wide range of people in both developed and developing countries would curb the damaging toll of this drug.

More Information

Shooting Down Addiction
Overview of cocaine vaccine development, how cocaine affects the brain, and the way the vaccine disrupts the process. This article includes a firsthand view of addiction directly from an addicted person.

Cocaine vaccine for the treatment of cocaine dependence in methadone-maintained patients
A primary research paper that describes a clinical trial for a cocaine vaccine and its ability to treat cocaine dependency.

Vaccine May Treat Cocaine Addiction: Study Shows Experimental Vaccine Allows Some Cocaine Users to Reduce Their Drug Use
WebMD article about a clinical trial of a vaccine use to curb cocaine use among addicts.

University of Texas Medical Branch Center for Addiction Research
While a cocaine vaccine would be an innovative and exciting means of treating and preventing cocaine addiction, one of the primary efforts of the Center for Addiction Research at the University of Texas Medical Branch is to expand medication options, especially to suppress craving for drugs. The center is focused on identifying key biomarkers in patients to ultimately better diagnose their disorder and predict the best therapeutic combination of medication and behavioral therapy.