Immunized against addiction

Can a simple vaccine kill the appetite for cocaine? Researchers may soon find out.

By Dawn MacKeen

Apr 26, 2000 | The 10 years of hardcore drug use are a blur to Janet -- the weeks she barely ate or slept, the many times she avoided seeing her parents, the ways she went about getting crystal meth and coke. But one thing is clear: On a summer morning two years ago, she woke up and quit. And then she left every reminder of her old life, including her husband, her job, her town.

"I did the coke to be more outgoing," says the 30-year-old, who asked that her real name not be used. "The first high of it was positive, but then you start to lose that and you want more, and if you can't get it, you kind of crash out of society."

Doctors have long been baffled why some people, like Janet, can quit drugs on their own and others can't, even with the help of toll-free hot lines, counselors and countless 12-step programs. But a new form of treatment for addicts could help when other attempts fail -- and change the way we look at addiction.

Researchers at Yale University recently completed the first human tests of a cocaine vaccine. Scientists also are experimenting with immunizations against addiction to methamphetamine, PCP and nicotine. It's unlikely such vaccines would ever be added to the list of routine inoculations, like the polio vaccines given to all kids. But if anti-drug vaccines proved effective, it might trigger a hunt for other biochemical approaches to addiction.

"I think it's one of the most promising treatments," says Alan Leshner, director of the National Institute on Drug Abuse. "If it is done well and we figure out all the issues, it will be an important addition to the clinical toolbox."

In the Yale study, psychiatrist Thomas Kosten found that the cocaine vaccine caused no major side effects. Now he is testing its effectiveness on cocaine addicts at an outpatient clinic. Called TA-CD, the vaccine is being developed by England-based Cantab Pharmaceuticals. It would be administered every six to nine months, Kosten says.

The implications of a vaccine to prevent abuse of a drug like cocaine are tremendous. Medical historians point to the possibility of court-ordered shots for drug abusers. And the availability of a medical approach like a vaccine might persuade the public that addiction is actually a disease, not the mark of bad behavior that should be punished.

"People should recognize that the use of cocaine that first time was something that was purely a matter of volition, but once cocaine is being used, the drive to use it again is part of your normal biology," says Donald Landry, an associate professor of medicine at Columbia University who is doing research in this field. "It's all well and good to say they should solve it with willpower, but it is an insidious mechanism that is designed to imprint behavior on an individual."

Vaccines, of course, are not the first medical approach to addiction. Methadone, used to treat heroin abuse, is effective -- but also happens to be addictive. Critics have undercut its value by deeming it a drug swap. (And obviously, methadone has not eliminated heroin addiction.) While vaccines can escape that accusation, they do come with baggage. Increasingly, they have come under attack because of safety concerns.

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