ABSTRACT
The Ultimate Vaccine to End Addiction
By Jenny Meier
Cocaine is one of the top three most addictive drugs and is especially a problem in
America and other Western countries. Millions of people who suffer from cocaine
addiction have trouble stopping the drug due to its addictive qualities. There are various
treatment programs and plans to help those struggling, but many abusers continue to
relapse. For the past couple of decades doctors and researchers have been working on a
medical vaccine to “cure” cocaine addiction. This vaccine has gone through many trials
and transformations in order to become more effective. Recent forms of the vaccine has
proven to be effective in decreasing the amount of anti-cocaine anti-bodies, along with
decreasing the amount of cocaine found in urine samples. However, these results weren’t
consistent throughout all subjects since the vaccine had little effect on a portion of the
examined group. Furthermore, all forms of the vaccine haven’t been able to significantly
decrease subject’s desire to abuse cocaine. New forms of the vaccine are still in the
works, and are expected to be perfected within the next ten years. Although anti-cocaine
vaccines can significantly help addicts struggling to quit abusing, other drug treatment
programs should be used with the vaccine.
Keywords: addiction, cocaine, TA-CD, anti-cocaine vaccine, drugs, treatment, drug
abuse, dopamine, Dr. Janda, Dr. Kosten, 12-step programs, self-help groups
Multimedia
How Cocaine Affects the Brain: http://www.youtube.com/watch?v=4OS2C4NemJI
The Ultimate Vaccine to End Addiction
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Comedian George Carlin once asked, “What does cocaine make you feel like? It
makes you feel like having more cocaine” (1). The issue of addiction has always been a
concern, however more Americans are becoming worried about the use of “harder drugs”
like cocaine. Cocaine is most prominent throughout Western countries and is known as
one of the top 3 most addictive drugs (2). In 2007 the National Institute of Health
reported that 2.5 million people were addicted to cocaine in the United States, but only
809,000 of them were actually treated (3). Even with treatment programs, self-help
groups, and one-on-one therapy, many people still struggle with sobriety. Various
vaccines and pills have been developing to treat specific types of drug dependencies, and
doctors continue to create more. For the past 50 years researchers have been working on
an anti-cocaine vaccine. Although vaccines can’t replace other treatment programs,
researchers are coming close in finding a vaccine that helps prevent addicts from desiring
cocaine. This type of invention of a vaccine can provide significant help to the abuser.
While people are aware of addiction, many don’t understand its complexity.
Addiction is most commonly explained as a chronic compulsion or obsession to a certain
vice so strong that the abuser loses control of his or her life. Medical News Today writes
about cocaine dependency, warning, “People who are addicted may eventually prefer
taking cocaine to any other activity – their lifestyles may alter completely as the addiction
takes hold more firmly. There have been cases of mothers selling their child,
professionals spending thousand of dollars on binges costing from $20,000 to $50,000”
(4). Substance abuse can lead to health problems, loss of relationships, unemployment,
problems with the law, disease, and death (5). Addiction doesn’t only have negative
consequences for individuals, but for society as well. The National Institute on Drug
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Abuse estimates over $600 billion annually is wasted due to productivity, health, and
crime related costs (6). Even with these negative consequences once dependent, it’s hard
for an abuser to stop using their drug of choice.
Addiction can be triggered by a variety of reasons. Some people are more prone
to addiction than others due to social pressure, stress, depression, age of user, and even
genetic predisposition. For example, those who are younger become addicted faster due
to lack of brain development, and those who live in an unhealthy environment are more
likely to rely on drugs as an escape. Many people are beginning to look at addiction as a
disease. Just as asthma targets the immune system, addiction targets the brain. Unlike
diseases though, drug dependency isn’t “a mere physiological problem; it’s psychic, too.
Even if you can cancel the effects of drugs, can you make us not want to take them?” (7).
Unlike other diseases drug dependency is partially about desire and control, which is
completely psychological and therefore can only be changed if the person’s mindset
changes. With cocaine and many other substances, it’s hard to control one’s mind due to
how the drug affects the brain.
Cocaine contains chemicals that “fool” the brain into reacting a certain way.
When something pleasurable happens – a promotion, sex, delicious food, a funny joke –
dopamine is released into the nucleus recognizing that activity as enjoyable. It is
estimated that “addictive drugs…can release two to 10 times the amount of dopamine
that natural rewards do, and they do it more quickly and more reliably” (2). Using
cocaine releases extreme amounts of dopamine, making the user feel euphoric, sociable,
confident, and energized. The brain becomes so over stimulated, it stops releasing
dopamine, allowing the body to calm down to normal levels. SEE FIGURE 1. When
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dopamine is released naturally from a rewarding activity it stays in the body and gets
“recycled.” Every time someone uses cocaine however, that dopamine can not be reused
in the body. Therefore, normal pleasurable activities aren’t as pleasurable since less
dopamine is being produced. In order to go back to a euphoric state more drugs are taken
and the abuser begins to rely on cocaine and eventually becomes addicted (2). Continued
abuse of cocaine also increases one’s tolerance to the drug continues to increase making
it more likely for one to have extremely negative consequences, like severe impairment,
overdosing, and even death.
FIGURE 1
http://37.media.tumblr.com/be308170d713c051e43e5654b3d8c811/tumblr_mmw6y9aUwd1qb6etto1_500.jpg
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To help prevent these negative consequences, researchers have been trying to find
a viable anti-cocaine vaccine. Normally when a virus, disease, or bacteria enters the
body, a person’s immune system elicits a response to fight
FIGURE 2 – NIDA (8)
the bacteria. Cocaine molecules are so small however, that
when it enters the body the immune system doesn’t
recognize it, so the coke goes into the bloodstream to the
brain. To prevent this, scientists realized they needed two
elements in the vaccine: an immunogenic protein and a
hapten. SEE FIGURE 2. Immunogenic proteins are bacteria
or viruses that enter the body and, if not fought off properly by one’s immune system, can
make people sick. The vaccine however won’t have enough bacteria to make a person ill;
it will have just enough to elicit antibodies that stop cocaine molecules from going to the
brain. A hapten “is a molecule that shares some
key structural features with the target drug” (8). It
allows body to recognize cocaine so the
immunogenic protein can attach itself and produce
antibodies. One researcher describes the vaccines
as “a big sponge for cocaine in the bloodstream”
(1). SEE FIGURE 3. By “soaking up” the cocaine
molecules, preventing it from entering the brain,
the person vaccinated won’t be able to feel the
psychoactive effects of the drug. Therefore it is
FIGURE 3 – From NIDA (10)
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theorized that the abuser won’t crave coke anymore since it’s hard to get high.
Using this logic, various vaccines have been created, trialed, and altered. Dr. Kim
Janda created the first credible anti-cocaine vaccine in 1995. After trying the vaccine out
on rats, Dr. Janda found that vaccinated rats showcased less hyperactivity and lower
levels of cocaine found in the brain (8). Year later Dr. Janda worked with another doctor
to improve the vaccine’s formula using an immunogenic protein found in the common
cold. As before, when they tested their vaccine on rats the vaccinated rats showed less
behavioral responses. They also found that the vaccinated rats reported higher levels of
anti-bodies in their blood. More surprisingly, Janda and Crystal found the vaccinated rats
were less inclined to seek cocaine than the control rats. Currently, the Doctors are slightly
altering the vaccine so it’s better matched for humans, and when tweaked properly, they
plan to do a clinical trial with people.
Janda and Crystal’s biggest rival is Dr. Thomas Kosten, who is working on an
anti-cocaine vaccine called TA-CD. The TA-CD vaccine uses cholera agents to trigger an
immune response. In 2009 Dr. Kosten ran a 24-week clinical trial with 115 cocaineaddicted participants. He gave half the subjects the TA-CD vaccine and the other half a
placebo vaccine. Using urine and blood samples Dr. Kosten measured the participants’
anti-body levels and found similar results as Dr. Janda found years earlier when testing
her vaccine on rats. Dr. Kosten found those injected with TA-CD had more antibodies,
which translated to less urine tests that read positive for drugs. SEE FIGURE 4. He also
found that those who were vaccinated showcased less psychoactive effects than those in
the placebo group (9). Dr. Kosten’s trial has been the most successful one to date and is
known to be groundbreaking.
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FIGURE 4 – NIDA (10)
Although TA-CD was a huge breakthrough, much still needs to be done. Only
38% of vaccinated subjects had 43 mg/ml of antibodies, and by week 16 there was no
difference in antibody level between groups (3). SEE FIGURE 4. Furthermore, there was
a large variety in how subjects responded to the injection; the scale varied from no
antibody response to an extremely high one (9). Also, a main objective of the vaccine is
to prevent addicts from craving the euphoric high. Although the serum blocked cocaine’s
effect on the brain, subjects still desired to use. Since TA-CD prevents user from feeling
coke’s effect, “some users took ten times more cocaine, and several went broke in hopes
of finding the elusive buzz” (7). Most experts, including Kosten, don’t view the vaccine
as a solution to addiction, but instead see it as an additional method to help fight
dependency. They stress the importance of being ready to quit so addicts don’t have the
same relapse experience as some of the subjects in the TA-CD trial. Addicts are
encouraged, and in all clinical trials were required, to continue using other anti-addiction
methods, as in 12-step programs and support groups.
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Kosten, Janda, Crystal, and many other researchers continue to look for a highly
effective anti-cocaine vaccine to help minimize abuse. Within the next five years more
clinical trials will be done, including the biggest one yet with 300 subjects (1). Once the
vaccine is perfected, doctors plan on giving it to children. The hope is if a child can’t get
high and doesn’t feel cocaine’s effects, then he or she won’t become addicted. However,
there are many ethical concerns about giving this vaccine to children. Some people
believe that it should be the person’s choice if he or she wants the vaccine or not, and that
many parents won’t want to inject their child with the vaccine. Opponents argue that
addiction is extremely hard to overcome and since so many people are struggling, the
vaccine could be a solution for cocaine dependency. A main fear for researchers is that
addicts will view the vaccine as a cure and stop other programs ignoring the
psychological factors behind dependency. Though there have been many scientific
breakthroughs, dilemmas such as these explain why researchers believe it will be another
decade or longer before reaching a true solution to cocaine addiction.
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