Pubdate: Sun, 25 Aug 2002
Source: Star-Ledger (NJ)
Copyright: 2002 Newark Morning Ledger Co
Contact:  http://www.nj.com/starledger/
Details: http://www.mapinc.org/media/424

SCIENTIST LEADS THE CHARGE IN LEARNING HOW DRUGS AFFECT THE BRAIN

As a 10-year-old, Francis Vocci was struck by the story of indigenous South 
Americans who used the skins of poison frogs to advantage, rubbing their 
blowgun darts on frog backs before hunting. When hit, even the largest of 
animals, he read with amazement, were killed or immobilized by a smidgen of 
poison.

Now 53, Vocci is one of the country's leading experts in neuropharmacology, 
the study of how drugs affect the brain. And he is out to harness nature's 
chemical bonanza, for the best of reasons: to fell the specter of addiction 
in America.

Over the past decade, developing drugs to treat drug addiction has become a 
major research focus at the National Institute of Drug Abuse in Bethesda, 
Md., where Vocci guides the pharmacological onslaught against addiction 
from a fourth-floor corner office.

There are now more than 60 experimental compounds in the institute's 
research pipeline. When Vocci joined the agency in 1989, there were zero.

He had been working at the Food and Drug Administration then, screening 
drugs that affect the central nervous system, when he was wooed away to 
join the institute and head its medications division. He started with $10 
million and 10 people. Now the division has 40 staffers and oversees about 
$100 million in grants to researchers both within the agency and at 
universities and research centers across the country.

 From the beginning, Vocci had his work cut out for him. The pharmaceutical 
industry shunned addiction drugs, fearful that the stigma of drug addiction 
would taint the reputation of its best- selling products, though some were 
likely "dual-use" candidates.

The drug companies also were concerned about using addicts in experimental 
clinical trials. Addicts might not take their medicines reliably and might 
not show up consistently, company executives worried. They might develop 
nasty side effects that would slow the acceptance of the drug by federal 
authorities.

Vocci got creative.

To entice the manufacturers to investigate addiction drugs, he promised 
them that their trade secrets would stay secret. To executives he offered 
access to the government's vast array of medication-screening capabilities 
and clinical beds. He extracted a promise from his colleagues at the FDA to 
give special attention to medications for drug addiction.

He modeled the division after the National Cancer Institute, where 
scientists in the 1970s reached out to industry and created a phalanx of 
clinical trial centers to encourage the creation of new cancer treatments 
and to encourage their adoption across the country.

"I had one guy from the South tell me -- and I had never heard this 
expression before -- 'You are in high cotton.' It means you really can't 
see very far and you are going to get lost quickly," he remembered.

The "disbelieving" pharmaceutical industry, he said, wished his agency 
luck: "They felt we were really in a maze and that we were really going to 
have a difficult time."

Vocci and others, like the outspoken NIDA chief at the time, Alan Leshner, 
argued that there was enough science to go on.

"Initially, people thought I was being ridiculous when I raised the 
possibility that addiction was a brain disease, and that includes people 
who approached the issue from a moralistic point of view and even some in 
the drug addiction treatment community who focused solely on personal 
responsibility," said Leshner, now chief executive officer of the American 
Association for the Advancement of Science, in Washington, D.C.

"I have to say that, over time, science won out."

Vocci agreed that the fact that the science has "ripened" has helped his 
cause. "What was said then, no one would say now," Vocci said. "We really 
do have molecular targets in the brain that we can address in a systematic 
way to develop medications. I have put this forth to multiple 
pharmaceutical industry people and no one has said, 'You're wrong.' They've 
all said, 'Agreed.' That's a major change."

With every new story of a celebrity telling all about his addiction, Vocci 
said, addiction becomes a little less stigmatized. "It's not so much an 
us-vs.-them problem anymore," he said.

Small biotechs still lead the field in terms of private addiction research, 
he said. Though still hush-hush, several major pharmaceutical companies are 
investigating drugs to treat addiction, he said.

"I sat down with my boss one day and said a paradigm shift will have 
occurred when companies come to see us rather than us seeing them," Vocci 
said. "And that has happened."
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