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Researchers at Weill Cornell Medical College received approval earlier this year to begin human trials on a cocaine vaccination. Authorization for Phase 1 of the trials, which are expected to last about three years, came after researchers demonstrated that their drug intercepts the powerful stimulant in the bloodstream, before it reaches the brain, effectively stopping the dopamine induced “high.”
For people struggling with cocaine addiction, a vaccination could be a critical first step in the process of a long-term recovery.
What is the History of Cocaine Addiction?
Despite its portrayal in cinema, cocaine use is not a modern phenomenon that came to popularity during the disco craze of the 1970s. The coca plant is among the oldest and strongest stimulants known to mankind. Ancient Incans chewed the plant’s leaves because it increased their rate heart rate and blood flow and made life in the high altitudes of the Andes Mountains more bearable.
A German physicist in the mid 1800s was the first to extract cocaine from the plant. Shortly thereafter, cocaine garnered a reputation among notables like Sigmund Freud for its “medical” benefits.
Abuse of the drug has ebbed and flowed since that time. Eight years ago, however, it became the second most trafficked illegal drug in the world. Regions of North, South and Central America are beset with violence as warring cartels fight for one the largest market in the world, the United States.
“Cocaine addiction is a huge problem that affects more than 2 million people in the United States,” said lead investigator on the vaccine, Dr. Ronald Crystal. “It results in more than 500,000 annual visits to the emergency room.”
How Does the Cocaine Vaccination Work?
The vaccine, called dad5GNE, uses a unique approach of creating antibodies that stop cocaine before it crosses the blood-brain barrier:
- The vaccine works by linking GNE, a cocaine-like molecule, to an inactive adenovirus, the kind that causes symptoms of a cold and makes the body’s immune system produce antibodies
- Signaled by the adenovirus, the immune system releases antibodies to fight off infection and, as a result, is programmed to see the attached cocaine molecules as a virus
- Thereafter, the immune system is encoded to see cocaine as an invader and release antibodies that destroy it in milliseconds, before it gets to the brain and creates excess of dopamine that causes feelings of euphoria
Treatment for Cocaine Addiction
Unlike other addictive drugs with therapeutic treatments, such as methadone or buprenorphine for heroin, there have been no therapeutics for cocaine until now, notes Dr. Crystal. If effective, the vaccine will be an important aspect of the overall treatment for cocaine addiction. It will not be however, the sole approach to recovery for people suffering from the disease of cocaine addiction.
In addition to addressing the physical addiction, treatment must also deal with the underlying psychological damage brought about by dependency. On its website, the National Institute on Drug Abuse (NIDA), which provided some of the funding for the vaccination trials, points out that “…behavioral therapies are the only available and effective treatments for many drug problems, including stimulant addiction.”
These are evidence-based approaches, such as cognitive behavioral therapy (CBT), where a person develops an understanding between their emotional state, thought processes and behaviors. Over time, people learn to adapt their thinking, avoid triggers that might lead to relapse, and recognize how depression or anxiety can distort their thoughts and decisions.
A vaccination for cocaine addiction in combination with behavioral therapy is a promising treatment that will likely be available in the not too distant future. If effective, it could spark new areas of research that take a biological approach to the disease of addiction.
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