Nicotine and Cocaine Vaccines Move Forward
NICOTINE: A vaccine to prevent nicotine addiction demonstrated a good safety profile in a recent clinical trial with 68 healthy smokers. Dr. Dorothy Hatsukami of the University of Minnesota and colleagues found NicVAX to be safe and well tolerated, with side effects comparable to those of placebo. Overall, the reported side effects—most commonly general discomfort, headache, and muscle pain—were mild to moderate in severity. The vaccine triggers the production of antibodies that bind nicotine in the blood and keep it from reaching the brain. Nevertheless, healthy smokers who received the vaccine did not experience craving or withdrawal symptoms, nor did they increase the number of cigarettes smoked during a 38-week study and followup. Pharmacodynamics and Drug Action 78(5):456-467, 2005.
COCAINE: An investigational medication designed to induce the 's natural defenses to inactivate cocaine before it reaches the brain has cleared an important human trials hurdle. Dr. Bridget Martell, Dr. Thomas Kosten, and their colleagues at Yale University tested the compound, now designated TA-CD, in an open-label study involving 18 cocaine-addicted participants who took it for either 8 or 12 weeks. No participant reported adverse effects, and all still had cocaine-specific antibodies in their bloodstream 6 months after their first injection. At the 6-month followup, participants reported exposure to the drug produced only mild euphoric effects, even though blood tests showed waning concentrations of the antibodies. Biological Psychiatry 58(2):158- 164, 2005.
No-Smoking Policy Did Not Deter Enrollment In Addiction Programs
New Jersey's requirement that residential addiction programs establish completely smoke-free environments and help drug abusers quit smoking does not deter smokers from entering treatment for other addictions or increase the number of early discharges. Dr. Jill Williams, Dr. Douglas Ziedonis, and their colleagues at the University of Medicine and Dentistry of New Jersey found that half of the programs had tobacco-free facilities and grounds 1 year after the State implemented the new licensure standards. More than 90 percent of residential programs provided assessment, counseling, or education programs and materials for nicotine-dependence treatment, compared with 37 to 53 percent the year before. Most patients (77 percent) smoked and most smokers (65 percent) wanted to quit or cut back. To assist patients in smoking cessation, the State offered a free 8-week course of nicotine-replacement therapy and special staff training. Journal of Substance Abuse Treatment 28(4):331-340, 2005.
GVG Shows Promise In Early Human Trials
A potential medication for treatment of drug abuse and addiction—gamma-vinyl GABA (GVG)—has taken an important step in the medication development process. Having previously shown promise in tests with laboratory animals, it now has proven to be safe in a small clinical trial with cocaine and methamphetamine abusers. GVG also proved effective: 16 of 18 patients in treatment for addiction to cocaine, methamphetamine, or both tested negative for the drugs throughout the last 6 weeks of the open-label trial. What's next? A larger, randomized double-blind study. Synapse 55:122-125, 2005.
Methamphetamine Disrupts Focus
Methamphetamine abuse disrupts one aspect of attentional control more profoundly than others—the ability to ignore distractions. Dr. Ruth Salo and her colleagues at the University of California, Davis and Stanford University found that 34 methamphetamine abusers who had been abstinent for at least 4 weeks made more mistakes (17 percent) than did control subjects (13 percent) on tests requiring that they focus on a task and ignore distraction. No difference was found in error rates on tests requiring the participants to switch attention from one task to another. Deficits in the ability to pay attention undermine a patient's effective engagement in cognitive-behavioral therapy, Dr. Salo says, and it is therefore important to identify specific cognitive problems associated with methamphetamine abuse. Biological Psychiatry 57:310-313, 2005.