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Sunday, February 24, 2008

NEWSWEEK Cover: The Hunt for an Addiction Vaccine

Although the American Medical Association recognized addiction as a disease back in 1956, only now are we beginning to see treatments that target the underlying biochemistry of that disease, Newsweek reports in the March 3 cover, "The Hunt for an Addiction Vaccine" (on newsstands Monday February 25).

Health reporter Jeneen Interlandi reports that this emerging paradigm treats addiction as a
chronic, relapsing brain disorder to be managed with all the tools at medicine's disposal. The addict's brain is malfunctioning, as surely as the pancreas in someone with diabetes. In both cases, "lifestyle choices" may be contributing factors, but no one regards that as a reason to withhold insulin from a diabetic.

"We are making unprecedented advances in understanding the biology of addiction," says David Rosenblum, a public-health professor and addiction expert at Boston University. "And
that is finally starting to push the thinking from 'moral failing' to 'legitimate illness'."

Interlandi examines the science that is helping to understand how the addicted brain functions and the compounds being developed or tested by the National Institute on Drug Abuse (NIDA) that block the intoxicating effects of drugs, including vaccines that train the body's own immune system to bar them from the brain. To the extent that "willpower" is a meaningful concept
at all, the era of willpower-in-a-pill may be just over the horizon. "The future is clear," says Nora Volkow, the director of NIDA. "In 10 years we will be treating addiction as a disease, and that means with medicine."

Vaccines that would arm the immune system against addictive drugs and prevent them from making the user high are, potentially, the ultimate weapons against addiction, Interlandi explains. A cocaine vaccine is poised to enter its first large-scale clinical trial in humans this year, and vaccines against nicotine, heroin and methamphetamine are also in development.

Nabi Biopharmaceuticals, a small biotech company in Maryland, has engineered a nicotine vaccine that is in late-stage clinical trials. Earlier studies showed that it was twice as effective as a placebo in helping people quit smoking. The cocaine vaccine, developed by Thomas
Kosten of Baylor College of Medicine, could be on the market as early as 2010. It would have to be given three or four times a year, but presumably not for life, says Kosten. While the vaccine is being studied in people who are already addicted to cocaine, it could eventually be used on others.

"You could vaccinate high-risk teens until they matured to an age of better decision-making," Kosten says. He acknowledges the obvious civil-liberties issues this raises. "Lawyers certainly want to argue with us on the ethics of it," he says, "but parent groups and pediatricians have been receptive to the idea."

The revolution these new drugs promise will have a huge impact on the addiction-treatment industry (or, as it prefers to think of itself, the "recovery movement"), which runs the gamut from locked psychiatric wards in big-city hospitals to spalike mansions in the Malibu Hills of California. And the reaction there is guarded; the people who run them have seen panaceas come and go over the years, and the same addicts return with the same problems. They also, of course, have a large investment in their own programs, which typically rely on intensive therapy and counseling based on the 12-Step Model.

"We need four or five more years to see how [Vivitrol] does," says staff psychiatrist Garrett O'Conner at the Betty Ford Center, in Rancho Mirage, Calif., about the medication that prevents patients from drinking alcohol by obliterating its ability to intoxicate. "And we need to
be very cautious, because a failed treatment will set a person back." The Ford Center and the Hazelden Foundation, in Minnesota, use drugs sparingly, and mostly just in the first days or weeks of recovery, the "detox" phase.

"Hazelden will never turn its back on pharmaceutical solutions, but a pill all by itself is not the cure," says William Moyers, Hazelden's vice president of external affairs. "We're afraid that people are seeking a medical route that says treatment is the end, not the beginning."

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Monday, June 25, 2007

Vaccines Help Kick Drug Habits

A pair of new vaccines designed to combat cocaine and methamphetamine dependencies not only relieve addiction but also minimize withdrawal symptoms, according to study results presented by Baylor College of Medicine (BCM) researchers at the Annual Meeting of the College on Problems of Drug Dependence in Quebec City, Canada.

The vaccines stimulate the body to produce antibodies which then attack the drug while it is in the blood stream. This prevents the drug from reaching the brain and creating the reactions that contribute to dependency.

“These are therapeutic, not preventative, vaccines,” says lead investigator Thomas Kosten, Jay H. Waggoner Professor of Psychiatry & Behavioral Sciences at the Menninger Department of Psychiatry at BCM and research director of the Veteran Affairs national Substance Use Disorders Quality Enhancement Research Initiative. “They are meant for those who are already suffering from drug addiction.”

Kosten stresses that while the vaccines have been shown to help overcome drug addictions, they do not necessarily curb relapse.

“This is not a stand-alone treatment,” Kosten says. “There is a reason drugs were used in the first place, and that needs to be dealt with either through counseling or behavioral therapies.”
TA-CD, the cocaine vaccine, works through a series of injections over a three-month period. Study participants began to respond favorably to the vaccine after about a month. TA-CD has one more large scale human study scheduled before it is ready for the FDA approval process.

“The vaccine slowly decreases the amount of cocaine that reaches the brain,” Kosten says. “It’s a slow process, and patients do not go through any significant withdrawal symptoms.”



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Friday, April 06, 2007

Apprehensions Down 30 Percent Along Southern Border


Apprehensions through the end of the second quarter are down 30 percent compared to the sameperiod during the previous fiscal year, continuing a trend in the overall decline of border apprehensions between ports of entry, according to the US Customs and Border Protection (CBP) agency.

From Oct. 1 through March 31, CBP Border Patrol agents made 418,184 arrests along the US southern border compared to 594,142 apprehensions during the same period last year, with all southern bordersectors experiencing declines in apprehensions. The Del Rio, Texas and Yuma, Ariz., sectors experienced the greatest declines, with a decrease of 68 percent in Yuma (24,726 apprehensions) and a decrease of 57 percent in Del Rio (12,151 apprehensions), CBP says.

Apprehensions of other than Mexico nationals declined 55 percent along the southern border, which totaled 25,269 through the second quarter 2007. The decrease in other-than-Mexican apprehensions reduces the time agents spend transporting and processing and increases time spent patrolling the border, the agency adds.

Under the Secure Border Initiative, CBP continues to strengthen border security efforts through the deployment and integration of tactical infrastructure, proven technology and additional personnel. Other significant efforts include the expansion of expedited removal, thedeployment of National Guard personnel through Operation Jump Start, targeted operations within the sectors and strong federal, state, local and tribal law enforcement partnerships, CBP says.

Additionally, Border Patrol agents have seized more than 1 million pounds of marijuana (a 31 percent increase) and 7,275 pounds of cocaine (a122 percent increase) compared to same period in fiscal year 2006. Agents in the Tucson, Ariz., sector accounted for nearly 50 percent of the southern border marijuana seizures with 498,815 pounds and the Rio GrandeValley, Texas, sector accounted for 55 percent of the cocaine seizures with4,021 pounds, CBP says. The total combined estimated value of the narcotics seizedalong the southern border is more than $1.03 billion, it adds.


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Wednesday, January 17, 2007

U.S. Border Patrol Says Drop In Apprehensions Sign of Progress


U.S. Customs and Border Protection Border Patrol first quarter apprehensions are down 26 percent compared to last year along the southwest border, an indication that the Border Patrol is becoming better equipped to respond to and resolve border security threats between the ports of entry, the agency says.


During the period that began October 1, Border Patrol agents made 158,818 apprehensions along the southern U.S. border compared to 207,197 apprehensions during the same period last year, with all southern border sectors experiencing declines in apprehensions, the agency says.


The Del Rio, Texas and Yuma, Ariz. sectors experienced the greatest declines, both with a decrease of 63 percent with 4,370 and 9,320 apprehensions respectively. The number of other- than-Mexican alien apprehensions dropped 58 percent along the southern border, which totaled 12,942 through the first quarter 2007. The decrease in other-than-Mexican apprehensions reduces the time agents spend transporting and processing and increases their time spent patrollingthe border, the agency says.


Under the Secure Border Initiative, CBP continues to enhance border security through a comprehensive approach of implementing innovative programs to include the expansion of expedited removal, Operation Streamline and Operation Jump Start as well as hiring additional Border Patrol agents, up to 6,000 by the end of 2008. The continued use of cutting-edge technology, tactical infrastructure and CBP's increased ability to detain other-than-Mexicans, further augments the border security mission, CBP says.


"We are seeing positive results," says Border Patrol Chief David Aguilar. "These programs continue to enable our frontline agents to be moreeffective in our border security mission."


Additionally, Border Patrol agents have seized more than 468,879 poundsof marijuana (a 26 percent increase) and nearly 2,934 pounds of cocaine (a96 percent increase) compared to the first quarter of fiscal year 2006. Agents in the Tucson, Ariz. sector accounted for 46 percent of the southernborder marijuana seizures with 216,970 pounds and the Rio Grande Valley sector accounted for 50 percent of the cocaine seizures with 127,046 pounds. The combined estimated value of the narcotics is nearly $474 million, CBP says.


U.S. Customs and Border Protection is the border agency within the Department of Homeland Security charged with the management, controland protection of U.S. borders at and between the official ports of entry. CBP is charged with keeping terrorists and terrorist weapons out ofthe country while enforcing hundreds of U.S. laws.



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