A Drug to End Drug Addiction

This article first appeared Jan. 9, 2008 on time.com
by Hilary Hylton
 
What if science made a pill to protect us from addiction — keeping us from smoking cigarettes, getting fat or abusing drugs and alcohol? According to encouraging results from several lines of study, it seems that day may be closer than we thought. Researchers in labs around the world are now developing vaccines (not a pill, but an injection) to inoculate people against dangerously addictive substances such as cocaine, heroin and methamphetamine. Within "one to 10 years, and closer to one year," says Dr. Frank Vocci, director of treatment research and development at the National Institute of Drug Abuse (NIDA), scientists may produce a vaccine against cocaine — one of the more promising areas of research — that can potentially help millions of addicts, two million in the U.S. alone.
 
One such vaccine, known as TA-CD (for "therapy for addiction — cocaine addiction"), is being developed by husband-and-wife team Dr. Thomas Kosten, a psychiatry professor, and Therese Kosten, a neuroscientist and psychologist, at Baylor College of Medicine in Texas. TA-CD has had success in early clinical trials: Now under review, a blinded, placebo-controlled study of 114 subjects showed that compared with the placebo group, people who received the vaccine were twice as likely to reduce their cocaine use by at least 50%. The Kostens are currently seeking approval from the Food and Drug Administration to go ahead with a 300-person, six-city clinical trial that may well be the final step toward federal approval of the vaccine.
 
"This is a major contribution," says Dr. Peter Cohen, a Georgetown University law professor and physician who heads up the District of Columbia Medical Society's physician health committee, which works to rehabilitate drug-addicted doctors. "Addiction is a medical problem that needs to be treated as a medical problem."
 
Unlike traditional anti-addiction approaches, such as 12-step programs, psychotherapy and older medications like methadone for heroin addicts or the nausea-inducing Antabuse for alcoholics, vaccines like TA-CD prevent the addictive substance from ever reaching the user's brain — that is, they inhibit the addictive cycle rather than respond to it. The goal is to eliminate the chemical cascade that results in the euphoric "high," which, in turn, sparks addiction — what comedian George Carlin once described this way: "What does cocaine make you feel like? It makes you feel like having more cocaine."
 
While most foreign substances in the body trigger an immune-system defense, many illegal drugs, like cocaine, fail to do so because their molecules are too small; they slip into the brain unnoticed and unchallenged. But by attaching them to larger proteins — in the case of TA-CD, an inactivated cholera protein that has been widely tested and is unlikely to cause side effects, according to researchers — the immune system is prompted to create antibodies to both the larger protein and the piggybacked drug. The next time the user takes cocaine by itself, the body mounts an automatic defense: Antibodies attach onto the cocaine molecules, which are then broken down by enzymes in the bloodstream. "It's just like a big sponge for cocaine in the bloodstream," Thomas Kosten says.
 
TA-CD has been over a decade in the making, but the science behind it goes back much further. In the 1950s, researchers developed a vaccine to block fatal overdoses of the heart drug digitalis. In the 1970s University of Chicago researchers prompted monkeys to develop antibodies to heroin by attaching molecules of the drug to a protein from cow's blood. It was this model on which Kosten, who became interested in solving addiction as a medical student at Cornell, based TA-CD. Using the cholera bacterium as a vector is a crucial tweak in design; it allows the cocaine vaccine to sidestep the potential viral syndrome associated with other vaccines, such as Cytos's experimental anti-nicotine vaccine, which is delivered via virus, Kosten says. And because cocaine addiction is most severe in Western countries where cholera is not a threat and where the cholera vaccine is not widely administered, most people do not yet have natural immunity. "Most Americans don't have antibodies to cholera," Kosten says.
 
That may be a boon to many of the 22 million drug abusers and addicts in the U.S. Although it's difficult to put a price tag on the total impact of drug abuse, NIDA estimates it costs the U.S. $484 billion a year in health care costs, lost earnings, crime and accidents. Complicating the problem, addicts tend to abuse more than one substance at a time — two-thirds of cocaine addicts also use alcohol, for example — a potentially lethal combination that may be increasing in popularity. A 2006 University of Florida study found that deaths from cocaine overdose, which often involved alcohol, increased in Florida from 150 a year in 2000 to 300 in 2005. Researchers hope that addiction vaccines may someday help to reverse those trends, not only through treatment of the addicted, but also by immunizing children from addiction early on. "Addictions," Kosten notes, "are diseases of the young."
 
TA-CD is currently designed as a therapeutic drug, however, not a preventive, says Kosten. For people struggling to overcome addiction or avoid relapse, the vaccine can reduce the rate of uptake of cocaine and slow the high. Even still, determined users can thwart the vaccine by taking more cocaine than their immune response can handle. The regimen also requires commitment, involving as many as five shots in three months, plus boosters every two months thereafter. "You have to want to quit. The addict has to want to stop" for the vaccine to work, says NIDA's Vocci.
 
Meanwhile cocaine use continues to rise in other countries, particularly in Europe, where Kosten consults on similar vaccine research. He is also working on a methamphetamine vaccine in the U.S., and a heroin vaccine in China, where increasing heroin use has been linked to skyrocketing rates of AIDS and hepatitis. Unlike the vaccine against cocaine, the heroin vaccine faces a tricky complication: It may interfere with other important treatments. If its protection extends to other opiates, for example, it would prevent patients from responding to medically necessary drugs like morphine. The same potential concern applies to nicotine vaccines that may block normal nerve transmissions involving nicotinic receptors in the brain, which play a role in muscle movement, Cohen says.
 
As complicated as the puzzle of addiction may be, Kosten believes that the 21st-century war against drug abuse can be waged as successfully as last century's global fight against infectious disease. It may not be a magic pill, but Kosten hopes the TA-CD vaccine will be the first step along the road to recovery for many addicts.
 

ONDCP Launches Initiative to Raise Public Awareness of Prescription Drug Abuse

January 24, 2008

Though overall teen drug use is down nationwide, more teens abuse prescription drugs than any other illicit drug, except marijuana — and more than cocaine, heroin, and methamphetamine combined. However, research shows that many parents are not aware of teen prescription drug abuse and are not discussing the dangers with their teens. To address this serious trend, the White House Office of National Drug Control Policy (ONDCP) today announced its first major federal effort to educate parents about teen prescription drug abuse. This national public awareness campaign will begin with advertising during this year´s Super Bowl, and includes broadcast, print, and online advertising, community outreach, and new print and online resources to help parents and communities combat the troubling trend of teen prescription drug abuse.

According to the ONDCP, every day, 2,500 kids age 12-17 abuse a prescription painkiller for the first time and more people are getting addicted to prescription drugs. Drug treatment admissions for prescription painkillers increased more than 300 percent from 1995 to 2005. Teens are abusing prescription drugs because many believe the myth that these drugs provide a “safe” high. Especially troubling is that the majority of teens who abuse prescription drugs say they are easy to get and are often free.

“Most teens who abuse prescription drugs say they get them from home, or from friends and relatives. We need parents to recognize that not all drug threats to their teens come from the street corner. Prescription drugs are in practically every home and parents can have an immediate impact on stopping teen prescription drug abuse,” said John P. Walters, Director, ONDCP.

The effort also includes the following advertising and non-advertising elements, which will unfold in the coming months and continue through May of this year, reaching over 90 percent of our target parent audience:

  • Two television ads, the first of which launches during primetime Super Bowl viewing. Both ads will run on 27 networks nationwide for more than two months;
  • An Open Letter to parents in 43 national and regional newspapers such as The New York Times, The Chicago Tribune, and The Los Angeles Times endorsed by 11 leading health, medical, prevention, and educational organizations;
  • Two Open Letter ads targeting health and school professionals in medical and educational publications running for 2 months;
  • Two print ads targeting parents in 14 national magazines and running for 4 months;
  • Online banner ads and search engine advertising for parents running for 4 months and driving to the Campaign’s Web site for parents www.TheAntiDrug.com;
  • Targeted messages on prescription information sheets for commonly abused substances in 15,000 pharmacies nationwide during February and March.
  • Featured content on ONDCP’s Web site for parents,  www.TheAntiDrug.com, including a virtual house tour showing “danger zones” in the home, as well as tips on safeguarding and disposing of prescription and OTC drugs;
  • A new, comprehensive brochure on teen prescription drug abuse for parents; and
  • A tool kit to help community groups implement local prescription drug abuse prevention efforts.


Download ONDCP’s report entitled, “Prescription for Danger: A Report on Prescription and Over-the-Counter Drug Abuse Among the Nation’s Teens” The ads can be viewed at  www.TheAntiDrug.com.


Editor’s Note:
Next month, CADCA will unveil a new publication entitled “Teen Prescription Drug Abuse: An Emerging Threat.” The publication offers strategies to effectively tackle prescription drug abuse among young people. Stay tuned for more information.



CASAC Staff & Other Drug Prevention Leaders Learn the Latest Strategies at CADCA Forum


Joining more than 2,500 alcohol and drug prevention and treatment advocates from communities across the country, Mirelle Freedman, CASAC Executive Director and Jennifer Bliska, CASAC Coalition Coordinator, brought their energy and passion to the Walter E. Washington Convention Center in Washington, D.C., Feb.11-15, for CADCA´s 18th Annual National Leadership Forum. The event provided an opportunity to learn the latest on key substance abuse issues and to hear from nationally-known experts and policymakers.

Participants included community anti-drug coalitions of all regions of the country, addiction treatment professionals, researchers, educators, law enforcement professionals, faith-based leaders, government leaders and youth.

The Forum kicked off with a riveting keynote address by Dr. Drew Pinsky, a board-certified addiction medicine specialist and host of VH-1’s Celebrity Rehab, who thanked community coalition leaders for their tireless efforts to reduce youth alcohol and drug use.

“I love CADCA, I love you, you humble me!” Dr. Pinsky told attendees. “You guys do the real work.”

Dr. Pinsky stressed the importance of addressing the rising prescription drug abuse rates, calling on coalition leaders to help educate the nation about the real dangers of abusing prescription medicines.

“I am sick of hearing of a young person dying because of a drug overdose and people saying, ‘oh well, it was doctor prescribed,’” he stressed. “It’s a major cultural problem…kids don’t perceive the harm of taking these drugs.”

Ms. Freedman had the opportunity to speak with Dr. Pinsky following his address. She related how a few years ago, prior to a presentation at Trinity College, a community person bemoaned the fact to her that there is always funding for enough beds in prison for drug users but never enough beds for treatment. Later that day at the rally at the U.S. Capitol, Dr. Pinsky reiterated Ms. Freedman’s words to loud cheers and applause.

Participants also heard some inspiring words from Acting Surgeon General Steven K. Galson, who discussed the Surgeon General’s Call to Action on Underage Drinking, and John Walters, Director of the Office of National Drug Control Policy.

In addition to hearing key leaders, attendees sharpened their skills and learned new strategies at the more than 100 workshops at the Forum, which touched on a wide range of topics—from environmental strategies to reduce youth marijuana use to the latest research on alcohol abuse prevention.

The Forum ended with an awards luncheon honoring Former Congressman Rob Portman, who was instrumental in the development and funding of the Drug-Free Communities Act. The former Director of the Office of Management and Budget recalled how the idea for the Drug-Free Communities program was born and urged coalition leaders to continue to advocate for programs like these.





Drug and alcohol use among our teens has remained a constant and often tragic problem for several generations. Using science based models and a highly successful Strategic Prevention Framework, we have seen a continued decline in overall illicit drug and alcohol use among teens since 2001. Read about this downward trend in the attached INFORMATION...foundation for good policy.

"Overall, illicit drug use by American teens continues gradual decline in 2007" is the headline for the release of the 33rd national survey in the Monitoring the Future (MTF) series conducted by scientists at the University of Michigan's Institute for Social Research. It goes on to offer even more good news: Among the youngest students surveyed – 8th graders – cumulative declines since peak levels of drug involvement in the mid-1990s are substantial.

PERCENT REPORTING PAST MONTH'S USE
Note: In 2007, 860,000 fewer youth were using illicit drugs than in 2001.

  20012007 Change as % of 2001
Any Illicit Drug
19.4% 14.8%
-24*
Marijuana16.6%
12.4%
-25*
MDMA (Ecstacy)
2.4%
1.1%
-54*
LSD
1.5%
0.6%
-60*
Amphetamines 4.7%
3.2%
-32%
Inhalents
2.8%
2.6%
-7
Methamphetamines
 1.4%0.5%
-64%
Steroids
0.9%
0.6%
-33*
Cocaine
1.5%
1.4%
-7
Heroin
0.4%
0.4%
0
Alcohol
35.5%
30.1%
-15*
Cigarettes
20.2%
13.6%
-33*
*Denotes statistically significant change from 2001.
Note: past month use is 8th, 10th, and 12th grades combined; percentage change calculated from figures having more precision than shown.
Source: 2007 Monitoring the Future (MTF) study special tabulations for 8th, 10th, and 12th graders; December 2007.


According to the latest MTF survey, long-term trends of decreasing youth drug use have continued from 2001 to 2007:
  • Use of illicit drugs dropped 21%
  • Marijuana use decreased 25%
  • Steroid us dropped by 1/3
  • Ecstacy use is less than 1/2 of what it was in 2001 (54% decline)
  • Methamphetamine use plummeted a staggering 64%
  • Alcohol use, including binge drinking, decreased by 15%
  • Cigarette smoking decreased by 33%
The drugs most responsible for this year's decline are marijuana and various stimulant drugs, including Ritalin, amphetamines, methamphetamines, and crystal meth. The only drug showing signs of an increase in use is MDMA (Ecstasy).

In the context of continuing long-term progress, these data show that there are still challenges that remain:
  • Overall youth prescription drug abuse is the second largest category of abuse, only behind marijuana.
  • Past-year use of Oxycontin increased 30% between 2002 and 2007.
  • Atittudes towards perceived risk of Ecstacy use have softened.
Challenges remain, but Connecticut is ready for the them.

To draw meaning from these national data, Connecticut's Strategic Prevention Framework is focusing resources to collect, analyze, and report data on drug use among Connecticut's youth, including alcohol, tobacco, marijuana, heroin, prescription drugs, and cocaine. This information will also be able to identify specific factors that contribute to youth drug use and find the right kinds of strategies and programs to prevent it.

For more information, please contact Dianne Harnad at 860.418.6827 or Dianne.harnad@po.state.ct.us.


CT Gov. Rell Releases Teen Safe Driving Proposals

Governor M. Jodi Rell today, April 1, 2008 released 20 new draft proposals on teen safe driving that aim to further broaden the state’s overhaul of the licensing, regulation, education of young drivers. “I am pleased to report the Teen Safe Driving Task Force continues to look at recommendations for curbing the senseless traffic fatalities involving teens,” said Governor Rell. “Frankly, these tragic accidents have sent a clear message that more needs to be done to protect teen drivers by enacting new laws and raising awareness." For more information, please visit www.ct.gov/governorrell


40% of Underage Drinkers Received Free Alcohol from Adults

A new federal report reveals that more than 40 percent of the nation's estimated 10.8 million underage drinkers obtained their alcohol from adults of legal drinking age – including their own parents. For coalition leaders, the finding are nothing new. That is why, in many communities, social host laws have been passed to stop parents from supplying alcohol to their kids.

Gwen Brown, from the Genesis Prevention Coalition in Atlanta, Ga., said the findings are not surprising. "Drinking is such a part of our culture that parents think it's okay that their teens drink," she said. "They tend to believe that it's better to serve alcohol at home to their kids, than have them go to an establishment to drink alcohol, without realizing the type of behavior that it's enforcing."

In Nebraska, local community leaders helped pass a social host ordinance in the state. The ordinance holds parent liable for serving alcohol to underage youth in their homes. That, coupled with a campaign launched around prom and graduation season, dubbed "Create Memories, Not Regrets. Celebrate Sober," is helping to educate the community about the risks of serving alcohol to underage youth.

"Parents often believe that it's okay if their teens drink while at home under their supervision. They don't realize that they're sending mixed messages. That's just telling the kid that it's okay to drink," said Amber Berliner, Substance Abuse Prevention Coordinator of Community Connections.

Underage Alcohol Use: Findings from the 2002-2006 National Surveys on Drug Use and Health.