Immunization with an experimental anti-cocaine vaccine resulted in a substantial reduction in cocaine use in 38 percent of vaccinated patients in a clinical trial supported by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health. The study, published in the October issue of the Archives of General Psychiatry, is the first successful, placebo-controlled demonstration of a vaccine against an illicit drug of abuse."The results of this study represent a promising step toward an effective medical treatment for cocaine addiction," said NIDA Director Dr. Nora Volkow. "Provided that larger follow-up studies confirm its safety and efficacy, this vaccine would offer a valuable new approach to treating cocaine addiction, for which no FDA-approved medication is currently available."Like vaccines against infectious diseases such as measles and influenza, the anti-cocaine vaccine stimulates the immune system to produce antibodies. Unlike antibodies against infectious diseases, which destroy or deactivate the disease-causing agents, anti-cocaine antibodies attach themselves to cocaine molecules in the blood, preventing them from passing through the blood-brain barrier. By preventing the drug's entry into the brain, the vaccine inhibits or blocks the cocaine-induced euphoria.This study included 115 patients from a methadone maintenance program who were randomly assigned to receive the anti-cocaine vaccine or a placebo (inactive) vaccine. Participants were recruited from a methadone maintenance program because their retention rates are substantially better than programs focused primarily on treatment for cocaine abuse. Participants in both groups received five vaccinations over a 12-week period and were followed for an additional 12 weeks. All participants also took part in weekly relapse-prevention therapy sessions with a trained substance abuse counselor, had their blood tested for antibodies to cocaine, and had their urine tested three times a week for the presence of opioids and cocaine.Participants differed in the levels of antibodies generated in response to vaccination. Thirty-eight percent attained blood levels of anti-cocaine antibodies thought to be sufficient to block cocaine's euphoric effects. During weeks 9 to 16 (when antibody levels peaked), these participants had significantly more cocaine-free urines than those who received the placebo or those with active vaccine but low levels of anti-cocaine antibodies. Participants with the highest antibody levels had the greatest reductions in cocaine use. No serious adverse effects were associated with vaccine treatment."Fifty-three percent of participants in the high-antibody group were abstinent from cocaine more than half the time during weeks 8 to 20, compared with only 23 percent of participants with lower levels of antibodies," said Thomas Kosten, M.D., of Baylor College of Medicine in Houston, the study's principal investigator.
"In this study immunization did not achieve complete abstinence from cocaine use," added Dr. Kosten. "Previous research has shown, however, that a reduction in use is associated with a significant improvement in cocaine abusers' social functioning and thus is therapeutically meaningful."Dr. Kosten led the study in collaboration with colleagues from Yale University School of Medicine, the Connecticut Veterans Administration (VA) Healthcare System, Baylor College of Medicine, and the Michael E. DeBakey VA Medical Center.
On-duty NHS specialists are set to join a hi-tech government crackdown on the smuggling of class A drugs into the UK
On-duty NHS specialists are set to join a hi-tech government crackdown on the smuggling of class A drugs into the UK by scrutinising live x-rays
where exactly do the authorities get their heroin from?
The government is considering whether legal, injectable heroin might be one way to tackle the effects of drug abuse, but where exactly do the authorities get their heroin from?After a trial reported success in tackling use of street drugs and crime, Justice Secretary Jack Straw has suggested that prescribing heroin on the NHS may be the only way to deal with some users. Most people probably think of opium poppies coming from Taliban-controlled fields in Afghanistan or from the Far East's Golden Triangle, but it is perfectly possible to produce opium in the UK.
Diamorphine for the addict treatment trial is produced in the UK
The UK has one diamorphine producerPoppies are grown in Hampshire, Wiltshire and elsewhere in the south of EnglandIndeed, all of the diamorphine - equivalent to heroin - used in the UK's addict treatment trial is produced in the country. Opiates firm Macfarlan Smith, a subsidiary of Johnson Matthey, is the country's sole diamorphine producer.
It holds contracts with farmers in the south of England - including Hampshire and Wiltshire - to grow crops of poppies, says Ian Godwin, communications director for Johnson Matthey. The firm takes the harvest and processes the poppies into what is called "active pharmaceutical ingredient" (API). This API is then passed on to a UK pharmaceuticals firm to be turned into doses. The processing of opium poppies is done under government licence in "extremely secure" conditions.
The heroin prescription trial in the UK, which is being run at the National Addiction Centre, initially used diamorphine imported specially from Switzerland and distinct from the NHS's own stockpile. It moved to using British diamorphine when that became a cheap enough option. The cost of a year's diamorphine treatment for an addict is about £15,000, although this includes administering and supervising the injections. There have been similar trials involving pharmaceutical heroin in the Netherlands, Switzerland, Germany and Canada. But the UK also has another use for diamorphine. It continues to be used in palliative care, to relieve pain in terminally ill people. A recent problem with supply led to many doctors using other opioids, says Dr Bill Noble, president of the Association for Palliative Medicine. "It is virtually the same as using morphine. The only difference is that diamorphine is much more soluble than morphine, which means you can have much lower volume injections."A regular part of the BBC News Magazine, Who, What, Why? aims to answer some of the questions behind the headlines
It is also used as part of the treatment for some patients with acute heart failure.
Diamorphine does not tend to be used in other countries for palliative purposes simply because it is illegal, says Dr Noble.
Diamorphine for the addict treatment trial is produced in the UK
The UK has one diamorphine producerPoppies are grown in Hampshire, Wiltshire and elsewhere in the south of EnglandIndeed, all of the diamorphine - equivalent to heroin - used in the UK's addict treatment trial is produced in the country. Opiates firm Macfarlan Smith, a subsidiary of Johnson Matthey, is the country's sole diamorphine producer.
It holds contracts with farmers in the south of England - including Hampshire and Wiltshire - to grow crops of poppies, says Ian Godwin, communications director for Johnson Matthey. The firm takes the harvest and processes the poppies into what is called "active pharmaceutical ingredient" (API). This API is then passed on to a UK pharmaceuticals firm to be turned into doses. The processing of opium poppies is done under government licence in "extremely secure" conditions.
The world's pharmaceutical firms get their poppies from everywhere from Spain to India, but the biggest producer is Tasmania in Australia. In Tasmania, a thousand farmers grow poppies across about 13,000 acres and it is one of the island's major exports.The growing of poppies there can only be done under licence and there are strict controls on access to the field. Possession of opium poppies is a crime. Heroin is not just for addicts but also for other medical uses
The heroin prescription trial in the UK, which is being run at the National Addiction Centre, initially used diamorphine imported specially from Switzerland and distinct from the NHS's own stockpile. It moved to using British diamorphine when that became a cheap enough option. The cost of a year's diamorphine treatment for an addict is about £15,000, although this includes administering and supervising the injections. There have been similar trials involving pharmaceutical heroin in the Netherlands, Switzerland, Germany and Canada. But the UK also has another use for diamorphine. It continues to be used in palliative care, to relieve pain in terminally ill people. A recent problem with supply led to many doctors using other opioids, says Dr Bill Noble, president of the Association for Palliative Medicine. "It is virtually the same as using morphine. The only difference is that diamorphine is much more soluble than morphine, which means you can have much lower volume injections."A regular part of the BBC News Magazine, Who, What, Why? aims to answer some of the questions behind the headlines
It is also used as part of the treatment for some patients with acute heart failure.
Diamorphine does not tend to be used in other countries for palliative purposes simply because it is illegal, says Dr Noble.
Health officials have stepped up their efforts to call attention to health risks caused by cocaine laced with levamisole
Health officials have stepped up their efforts to call attention to health risks caused by cocaine laced with levamisole, a veterinary anti-parasitic drug. The Substance Abuse and Mental Health Services Administration (SAMHSA) has issued a nationwide health alert to medical professionals, substance abuse treatment centers and other public health authorities.
In humans, levamisole can cause agranulocytosis, a serious, sometimes fatal blood disorder. Ingesting cocaine mixed with levamisole can seriously reduce a person's white blood cells, suppressing immune function and the body's ability to fight off even minor infections, according to SAMHSA. People who use crack or powdered cocaine laced with levamisole can experience overwhelming, rapidly-developing, life-threatening infections, the agency said in a news release.Other serious side effects can also occur. If you use cocaine watch out for:
High fever, chills, or weakness.
Swollen glands,Painful sores (mouth, anal)
Infections that won't go away or gets worse very fast
Skin infections, abscesses
Thrush (white coating of the mouth, tongue, or throat)
Pneumonia (fever, cough, shortness of breath)
"SAMHSA and other public health authorities are working together to inform everyone of this serious potential public health risk and what measures are being taken to address it," said SAMHSA Acting Administrator Eric Broderick.
The number of reported cases of agranulocytosis due to tainted cocaine use is expected to increase as information about levamisole is disseminated through the medical community. Thus far, 20 known cases and two deaths have been confirmed.According to the U.S. Drug Enforcement Administration, Columbia cocaine producers are lacing their product with the medication to give it an extra kick.
In humans, levamisole can cause agranulocytosis, a serious, sometimes fatal blood disorder. Ingesting cocaine mixed with levamisole can seriously reduce a person's white blood cells, suppressing immune function and the body's ability to fight off even minor infections, according to SAMHSA. People who use crack or powdered cocaine laced with levamisole can experience overwhelming, rapidly-developing, life-threatening infections, the agency said in a news release.Other serious side effects can also occur. If you use cocaine watch out for:
High fever, chills, or weakness.
Swollen glands,Painful sores (mouth, anal)
Infections that won't go away or gets worse very fast
Skin infections, abscesses
Thrush (white coating of the mouth, tongue, or throat)
Pneumonia (fever, cough, shortness of breath)
"SAMHSA and other public health authorities are working together to inform everyone of this serious potential public health risk and what measures are being taken to address it," said SAMHSA Acting Administrator Eric Broderick.
The number of reported cases of agranulocytosis due to tainted cocaine use is expected to increase as information about levamisole is disseminated through the medical community. Thus far, 20 known cases and two deaths have been confirmed.According to the U.S. Drug Enforcement Administration, Columbia cocaine producers are lacing their product with the medication to give it an extra kick.
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