Pubdate: Mon, 28 Apr 2003
Source: U.S. News & World Report (US)
Copyright: 2003 U.S. News & World Report
Contact:  http://www.usnews.com/
Details: http://www.mapinc.org/media/464
Author: Nell Boyce

'NO' IN A NEEDLE

New Vaccines Meant To Block Drug Highs Could Help Break A Habit Or Keep One 
 From Starting

When Charles Schuster developed a vaccine that made monkeys immune to a 
heroin high, he hoped the work might someday help recovering addicts. But 
Schuster, now at Wayne State University, wasn't prepared for what happened 
next. "I began to get calls and plaintive letters from parents all over the 
world saying please won't you immunize my child so that they won't become a 
heroin addict," he recalls. The idea of using a vaccine to prevent rather 
than just treat addiction made Schuster "leery," and he dropped the research.

That was three decades ago. Now vaccines against vice are back, thanks to 
biotech firms that have spent years and millions in federal grant money 
pursuing them. Vaccines against cocaine and nicotine have just entered 
clinical trials, and ethicists wonder what will happen if they work. While 
traditional vaccines protect against diseases that no one wants to get, 
vice vaccines would fight pleasures that many people cherish in spite of 
their dangers. The shots might appeal not just to addicts trying to break a 
habit but also to parents, schools, and governments, raising issues of 
personal choice and social benefit so knotty that the National Academy of 
Sciences will hold a meeting this week to consider them.

Blocking the buzz. The vaccines would work by spurring the body to create 
antibodies against the drug. The immune system normally ignores small 
molecules like nicotine or cocaine, so developers have to link the drug 
molecule to a larger one. Once the immune system makes antibodies to the 
combination, it will later recognize the naked drug, binding to it and 
keeping it from reaching the brain, where it would generate a high.

Biotech firms Nabi Biopharmaceuticals and Xenova have already finished 
initial safety studies of nicotine vaccines and are launching larger 
trials. In its new safety trial, Nabi will also study how its vaccine 
alters smokers' habits. Xenova has developed an anticocaine vaccine, which 
Thomas Kosten of Yale University has tested in dozens of recovering 
addicts. He says some who used cocaine afterward reported that it seemed 
less exciting.

So far, scientists haven't been able to see firsthand how the vaccines 
change a person's response to a drug, because it's unethical to give 
nicotine or cocaine to a recovering addict. Not so if the test subjects are 
users who don't want to quit, says John St Clair Roberts of Xenova. Last 
week, Xenova said it was vaccinating 10 volunteers with its anticocaine 
shot, then giving them the drug to see if the vaccine blocks its effect on 
mood, heart rate, and blood pressure.

Even if these trials pan out, it will be several years before vice vaccines 
hit the market. But eventually, say ethicists, institutions struggling with 
drug abuse, from prisons to schools, might embrace them, and healthcare 
workers might urge them on pregnant women. Parents also might want to get 
their children vaccinated as a preventive measure. Nabi's Robert Naso is 
upfront about the company's interest in someday marketing an antinicotine 
vaccine to the parents of teens. "They'll still want to smoke at a party on 
Saturday night and look cool," Naso says. "But hopefully it will prevent 
them from becoming a two-pack-a-day addicted smoker." A cocaine vaccine 
might hold a similar appeal. "Imagine your kid is growing up in a rough 
neighborhood in Baltimore, where you have drug dealers all over," says 
Thomas Murray, a bioethicist at the Hastings Center. "Wouldn't you be tempted?"

Xenova's St Clair Roberts says that his company currently has no plans to 
market its cocaine vaccine for prevention. "I see that as being a 
nightmare," he says. Scientists working in the field are "absolutely" aware 
of all the tricky social issues their new vaccines might create, adds Paul 
Pentel of the University of Minnesota, who has studied Nabi's antinicotine 
vaccine. But they also see the shots as a potentially huge boon for 
treating addiction.

Treatment rather than prevention is what today's vaccines would most likely 
be best at in any case. The vaccines raise antibodies that last only 
months, requiring frequent booster shots. And they don't totally block 
drugs' effects; higher doses could overwhelm the antibody response.

But scientists are working to make the vaccines last longer and be 
stronger. And they're making progress toward shots for other drugs, like 
PCP and methamphetamine. So while the current vaccines can't guarantee 
clean living, they might just represent a step toward a future when people 
end up as slaves to virtue, rather than vice.
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MAP posted-by: Larry Stevens