Originally published in Details.
The Cure for Cocaine
An experimental new vaccine will soon make that white powder as mind-altering as air
Some guys spend $1,000 a month on dinners and drinks without blinking. Others shell out even more by adding pot or strippers to the bill. And then there are the ones like Andy, a 25-year-old actor who earns his living as a waiter at an expensive New York restaurant. For the past two years, Andy’s been dropping as much as $1,000 a week to feed his cocaine habit.
“I’ve never been the type of person to just do a couple of bumps,” he says, waving a gimlet around a Manhattan nightclub. “I wanted to do a rail and be really fucked up.” Everything in the city seemed to make it easier for him—the bar bathroom with convenient glass shelves, the trattoria where his dealer would show up with a backpack apothecary faster than you could say “spaghetti alla puttanesca.” Andy flew home to Cincinnati to detox for a month, but when he came back to New York he slipped again. Soon he was having eight-balls delivered to work, staying up on three-day benders, sleepwalking through dinner service. You’d think he’d have learned his lesson, but he still can’t refuse a pencil-thick line. “I’m kind of fed up with this lifestyle,” he admits. “But it’s also very, very hard to stop.”
Andy is one of the 3.6 million Americans who snorted their way through almost 350 tons of cocaine in 2002, the most recent year for which figures are available from the Office of National Drug Control Policy. When users get fed up and decide to walk out on their habit, they learn what Andy’s discovered: The exits are hard to find. Heroin abusers can switch to screwdrivers of orange juice and methadone or buzz-killing tablets of naltrexone, which blocks the effects of opioids. But the options for those who want to kick cocaine pretty much begin and end with will power, counseling, and the occasional 12-step meeting. Cokeheads, in other words, are a huge market waiting for a magic bullet.
That’s why Xenova, a British biotechnology firm, is banking on a new vaccine that seems to make doing coke about as much fun as sniffing lines of baking soda. TA-CD, as it’s known, trains the body to produce antibodies that fight off cocaine before it even gets to the brain, as if the drug were an infection. After you’ve been vaccinated, your antibodies remain in coke-busting mode. Xenova is now conducting clinical trials of its would-be wonder drug; thus far, about the only side effect appears to be a lot of wasted money at parties. TA-CD could be available to the public in just a few years. And if it’s successful, it may usher in an era in which drug abuse is treated as an infectious disease, and in a greater share of the population than anyone might’ve anticipated.
Dr. Campbell Bunce, the soft-spoken project leader of Xenova’s vaccine research, has forgone the customary lab coat for a starched white button-down, suggesting that for this company science is serious business. Compressors and centrifuges whir in his sunny laboratories as technicians scan plastic trays dotted with human blood serum. Bunce runs his fingertips along the spikes on a mass-spectrometer printout, explaining in his Scottish brogue how the clear liquid contained in the tiny vial before him manages to bring down one of the world’s most seductive highs.
Your brain’s neurons constantly release a steady trickle of dopamine, the neurotransmitter responsible for pleasure. After delivering its great-to-be-alive message to receptors, the dopamine returns to the neurons. But when cocaine enters your body, it bottle-rockets in seven seconds to the brain, moving into the neurons and then bolting the door behind it, so the dopamine can’t get back in. Soon it floods the receptors and you feel—and act—like Andy Dick.
The immune system, which is supposed to fend off outside invaders, just sits back and watches. What TA-CD does is teach the body to treat cocaine as a threat. So the vaccine piggybacks a cocaine molecule onto a molecule from a disease that has no trouble setting off the immune system’s alarms: cholera. After a few injections, the body develops a homeland security force of antibodies trained to recognize cocaine. The next time the user does a line, the antibodies take it down like armed DEA agents, and Saturday night starts to feel more like Monday morning.
Xenova, a company better known for developing cancer drugs, may be as desperate as any addict for these vaccines to work. Like the rest of the biotech sector, Xenova has suffered over the past few years. Its cancer drugs have yielded disappointing results, sending company stock plummeting from some $90 a share in 2000 to $1.51 this past summer. The company has a lot riding on the cocaine vaccine, and until recently it couldn’t get anyone to listen. “Three or four years ago, most people had a very high degree of skepticism,” says Xenova’s CEO, David Oxlade. “Whether you’re talking about the general population, the expert community, or the investing community, most people said ‘You guys are smoking something.’” That has already changed; Oxlade, tanned and twinkle-eyed, returned from a trip to America last year toting $39 million in checks from charmed investors.
To test the vaccine, Xenova went to people who were smoking something. In the last few years, dozens of chronic cocaine users have entered an unassuming brick building in West Haven, Connecticut, to get vaccinated. Almost 90 percent of them, in one early study, are reporting that cocaine just isn’t what it used to be. And 75 percent stayed coke-free after three months. Booster shots could extend that period indefinitely.
“One of my patients had spent $15,000 in two months on cocaine,” says Dr. Kishor Gonsai, one of the physicians in charge of the study. “He came in before he spiraled all the way down, and his response was ‘This is the best thing that ever happened to me.’” In the next leg of the study, several thousand cocaine abusers are slated to get jabbed. If all goes well, by 2007 Xenova will ask the FDA to approve TA-CD as a prescription drug.
The idea of a cocaine vaccine has been around at least since the 1970s, when scientists at the University of Chicago turned rhesus monkeys into heroin junkies, then injected them with a vaccine made from a heroin derivative. At the height of the crack epidemic in the 1980s, a pharmaceuticals company collaborated with researchers at the private nonprofit Scripps Research Institute in California to develop a drug-screening technique with Big Brother overtones: a vaccine that would produce detectable antibodies in reaction to cocaine. The vaccine was tried on rats, and a strange things happened: When the rats got their coke, it was as though they’d been scammed by their dealers. The antibodies had tackled the drug before it could reach the rats’ brains. Three thousand miles away in Massachusetts, Dr. Barbara Fox and her team at ImmuLogic discovered the same thing. The National Institute on Drug Abuse (NIDA), the government arm that funds research, gave grants to both research teams (Scripps is still working on a different cocaine-vaccine model). When one of ImmuLogic’s lead programs on allergies failed, it took the company down with it. ImmuLogic shut its doors in 1998, selling the vaccine, which changed hands again before the patent was taken over by Xenova in 2001.
If it seems odd that such a promising drug kept getting passed over like an empty Baggie, consider the financial forces at work in the pharmaceutical industry. The average cost of developing a new drug is $800 million, according to the Tufts University Center for the Study of Drug Development, and as few as one in 100 experimental drugs ever makes it to drugstore shelves. “There haven’t been many other companies that want to go down the path of immunization,” says Tom Kosten, a professor of psychiatry at Yale’s School of Medicine and the guy who’s running TA-CD’s clinical trials in Connecticut.
“There’s not much profit when it comes to cocaine.” (Though one biotech analyst puts the potential market for a cocaine vaccine at $337 million.) Unlike, say, depression and attention deficit disorder, two of the most medicated conditions of the past decade, cocaine abuse isn’t one of those nebulous labels that can be applied to almost anyone.
These free-market realities leave the government as the largest investor. This year, two-thirds of NIDA’s $32 million pharmacotherapies budget went to cocaine research. “We’ve tried all of these approaches, because cocaine is a public health problem,” says Frank Vocci, head of NIDA’s pharmacotherapies program. “For several years it’s been our primary focus.” But now, as the cocaine vaccine starts to look like a reality, private investors are beginning to sniff around. And they aren’t the only ones who are interested; so are social conservatives. But they seem somewhat more Draconian potential in the vaccine: Rather than giving TA-CD as a treatment for drug abuse, some theorists would like to see it administered to prevent drug use in the first place.
A British government think tank, Foresight, is considering mandatory vaccinations as a possible solution to England’s mounting cocaine epidemic. Since 1998, cocaine deaths have more than doubled, according to the Office of National Statistics. The Home Office estimates that there are more than half a million powder-cocaine users in the country. Professor David Nutt, a leading government adviser who sits on the Foresight committee, said that anti-drug vaccines for children will likely be one of his panel’s recommendations when it reports next March. “People could be vaccinated against drugs at birth as you are against measles,” he told the British papers in July. “You could say cocaine is more dangerous than measles.”
Here in the States, zero-tolerance advocates have some social-engineering ideas of their own for the vaccine. The Office of National Drug Control Policy, a government group in the Executive Office of the President, estimates that cocaine costs the United States $143 billion a year in health care, lost wages, law enforcement, prisons, and violence. And according to the Drug Abuse Warning Network, a watchdog group, nearly 200,000 cocaine users landed in the emergency room in 2002, a 47 percent jump from 1995. Peter Cohen, a Georgetown University adjunct professor of law who used to work for NIDA on drug policy, speculates that the American legal system could allow parents to inoculate their kids against cocaine until they reach legal age. He also can imagine mandatory shots for certain adults, such as drug offenders seeking parole. “Somebody who’s got a history of cocaine use, who’s in jail, and you let him out a few years early and all he’s got to do is come in every few months to be immunized?” Cohen asks. “Yeah, the state could probably force you.”
It all seems very farfetched and Orwellian, this rounding up of addicts for involuntary injections to alter their chemistry. And the fact is that most users, like Andy, our glassy-eyed waiter in New York, can’t be tracked because they are invisible to hospitals and jails. Andy hasn’t done any time, and he hasn’t thrown any parties that ended with a defibrillator job. But he still says he would gladly trade his habit for a shot that would render the white powder useless.
This article originally appeared in Details in October, 2004.