четверг, 19 июня 2008 г.

Are Vaccines the Answer to Addiction?

A vaccine that would teach the immune system to attack and destroy cocaine before the drug reached the brain is poised to enter its first large-scale clinical trial in humans. The shot is still years away from FDA approval, but the underlying concept--inoculating those at risk of addiction--is attracting increased interest.

Besides cocaine, researchers are developing vaccines against such highly addictive substances as nicotine, heroin and methamphetamine. NicVax, a nicotine vaccine by Nabi Biopharmaceuticals, is the furthest along in development. In November, one year into a phase-two clinical trial, the company reported that twice as many people taking the vaccine had quit smoking as those taking a placebo.

Addiction vaccines work the same way as the traditional vaccines used to treat infectious diseases such as measles and meningitis. Basically, they marshal the body's defense system. But instead of targeting bacteria and viruses, these new vaccines zero in on addictive chemicals that people snort, shoot or swallow.

If the new treatments make it to market, experts hope they will overcome one big hurdle that existing anti-addiction medications have failed to clear--widespread resistance to the idea of treating addicts with drugs. "Vaccines are nowhere near as stigmatized as giving drug therapy to the addicted," says Baylor College of Medicine psychiatrist Thomas Kosten, who is leading research on the cocaine vaccine. " 'Vaccine' sounds more wholesome than 'drug'."

Despite a growing body of evidence that addiction, like so many other diseases, is rooted in a person's genes, it is often seen as a personal weakness, not a medical condition to be treated or cured. That impression, some experts say, has stymied research into potential treatments for the estimated 20 million Americans who struggle with alcohol and drug addiction. "It's easy to interest the scientists, but not so easy to interest the marketing people," says Kosten.

Each of the proposed vaccines employs a similar biochemical strategy. Because the addictive-drug molecules are small enough to evade the body's immune system, they can slip undetected from the lungs and bloodstream into the central nervous system, where they disrupt brain chemistry and turn on addiction pathways that can be difficult to shut off. But when attached to a larger molecule, the addictive substances can't hide. To make the cocaine vaccine, Kosten attached the cocaine molecule to a protein made by cholera-causing bacteria. When injected, the vaccine triggers the immune system to develop antibodies. The next time the drug is ingested, the thinking goes, these antibodies will latch onto it and prevent it from crossing the blood-brain barrier.

Current anti-addiction medications do not prevent addictive drugs from entering the brain. Instead, these treatments block the drugs' neural targets, so that when a drug reaches the brain it has no place to go. Such medications --known as small-molecule therapies--have met with only limited success so far. For example, methadone, a medication used to treat heroin addicts, has itself been associated with addiction and overdose, because in addition to blocking heroin's entrance to brain cells, methadone also mimics the narcotic, producing its own, milder high. Drugs that treat alcohol and nicotine addiction have been effective only in small subsets of patients and have produced severe side effects in some cases. "With these types of drugs, the brain's receptors are still being manipulated, albeit by a replacement drug," explains Nora Volkow, director of the National Institute on Drug Abuse, which funds research on the addiction vaccines. In theory, she says, the vaccines would circumvent some of these problems by neutralizing the addictive substance before it reached the nervous system.

One day, anti-addiction vaccines could be used to prevent substance abuse as well as treat it. "It would be great if we could give kids a vaccine that would make them impervious to the effects of hard drugs," says Volkow. "In reality, we are still many years away from that."

For the cocaine vaccine to succeed, researchers will have to solve several technical problems. In early studies, for example, not all of the subjects developed antibodies against the cocaine-cholera molecule, and some developed much stronger responses than others. "This is not like an antibiotic, which is directed against the invading microbe and has roughly the same effect on everyone," says Volkow. "Here, we are stimulating the immune system, which can react differently depending on the individual."

Another concern is that a serious drug user could overwhelm the immune response by simply ingesting more cocaine than the immune system could handle. He could also switch to another drug, which the vaccine would be powerless to protect against. The determination and desperation of drug addicts notwithstanding, however, vaccines have an extraordinary track record. They could prove to be the solution to one of our most enduring public-health problems.

'I Can't Believe How Far I've Come'

She's now 26. She's a wife, and seven weeks ago she became a first-time mom. Jodie Sweetin, who played spunky middle child Stephanie on Full House from age 5 to 13, is clearly all grown up-and all tuckered out. Apologizing to her guest as she stifles a yawn, Sweetin smiles at her new baby girl, Zoie, who's happily snoozing on Dad's shoulder. "Sometimes I just look at her and go, 'You're so perfect,'" she says. "You look at your baby and think, 'Wow, I did that.' It's really amazing."

Lately life has been just that for Sweetin and her husband of 10 months, Cody Herpin. "Zoie first smiled a couple weeks ago," says Herpin, 31, relaxing with his wife in their Corona, Calif., home. "And her little facial expressions are the cutest thing." As for Sweetin, "I'm still like, 'Oh, wow, I'm a mom,'" she says. "It's the most overwhelming, exciting thing I've ever done."

It's also a far cry from what the actress has been through over the past few years: An addiction to crystal meth took over her life and wrecked her first marriage before she entered rehab in 2005. Sweetin was about 22, a college student married to Los Angeles police officer Shaun Holguin and taking a break from acting when she first tried the drug. It was popular among some friends she'd met in high school. "It wasn't so much the allure of it, but the people I was hanging out with," recalls the Southern California native. "They didn't look like the people in commercials with no teeth. They looked normal and had what I thought were normal lives. It didn't seem scary."

Soon it would become terrifying. Six months after first trying meth, she said it became a crippling daily habit. "Everything revolved around my addiction. On a typical day I'd wake up and feel terrible because I hadn't done any. You're either trying to get it, doing it or worrying about when you're going to get it next. You don't even realize that it's taken over so quickly." Sweetin's parents, once an integral part of her life, became strangers. "They lived pretty close, but I'd go for weeks not speaking to them. I didn't want anybody around." She kept the secret from her husband too-even as he watched her dwindle from 130 lbs. to a gaunt 100. "He had no idea," she recalls. "It was the elephant in the room. Something was wrong, but it wasn't talked about."

Then in 2005 Sweetin was hospitalized after a night of partying. But her "scariest, most upsetting moment" came next: Realizing she had hit bottom, she admitted her addiction to her family. "Going to my parents' house and telling them what I had been doing," she says, taking a deep breath, "was hard. I looked them in the eye and said this is the big secret I've been keeping from you … and I need help."

Six weeks of inpatient treatment followed, and after a few weeks of detox so did a breakthrough: "I started realizing I can laugh again," Sweetin recalls. "I can enjoy myself without this drug. I think I'm going to make it…. Each day that you put together, you get yourself distance. I'm very lucky to have made it through to the other side." Now, she says, "there are days that I don't think about it at all. It's always there, but it's not looming over my head like it was."

Sweetin and her first husband decided to divorce after she left treatment, while she was spending six months in sober living with people from rehab. "I had damaged the relationship so much that we couldn't fix it," she says. When she met Herpin, a film transportation coordinator, through friends, "I felt a lot stronger," she says. The couple began dating in May 2007, and wed just two months later. "From the time we met, we've been inseparable. I'd been through so much and he didn't judge anything in my past-that was important and really special." And when their whirlwind romance was quickly followed by a pregnancy, says Sweetin, "it was a blessing."

Speaking publicly also has helped her recover. Says the new mom: "I could dodge the subject, but I thought, 'Maybe I have an opportunity here.'" And she seized it, talking about her struggle at colleges. "I don't think she realizes how many people she's helped," says Herpin. "We get e-mails that say, 'Thank you so much. You saved my life.'" Adds the actress: "These students grew up watching Full House, and many of them have been through this or have family members who did, so they're grateful."

Sweetin is too. "I was really fortunate that I didn't have any residual effects. A lot of people don't come through this in one piece," she says, adding that she still has some of her Full House earnings in savings (she also used the money to buy a home, attend college and go to rehab). The actress's family and Full House costars were, and continue to be, a support system. While she was in the hospital about to give birth to Zoie, "Bob [Saget] and I texted back and forth about 15 times," says Herpin. "He left messages: 'I hope everything's okay!' He's really sweet," adds Sweetin, who's closest to Saget and Candace Cameron Bure. (She hasn't talked to the Olsens in a while but says, "I wish them nothing but the best.")

While she nests at home with Zoie this summer, Sweetin is also prepping to get back to work-reading pilots and hoping for a bid from her favorite show. "I'm begging to be on Dancing with the Stars. I've danced my whole life." But for now Sweetin is thrilled to just watch her daughter. "Cody and I will look at her and go, 'Her head grew!' or 'She didn't make that noise yesterday!'" And Sweetin's looking forward to the simple things-like Zoie's first words ("I can't wait to hear what her little voice sounds like!"), princess dresses and tea parties-something she couldn't imagine just three years ago. "I can't believe how far I've come," says Sweetin. "It's amazing to think about how different my life is now."

Tatum O'Neal BUSTED FOR DRUGS

In her 2004 memoir A Paper Life, actress Tatum O'Neal chronicled her battle with cocaine and heroin. "I've triumphed over addiction," she wrote. Sadly, her battle may not be over. On June 1, police arrested O'Neal, 44, for allegedly purchasing two bags of cocaine from a dealer near her Manhattan home. Charged with criminal possession of a controlled substance, O'Neal faces a maximum of one year in jail. But at her arraignment the next day, the District Attorney's office recommended she attend a drug awareness program. She's expected back in court July 28. "There's no excuse for what I did," O'Neal told the New York Post after spending a night in jail. Thanking police for keeping her "sober," she explained that three weeks earlier, "I lost my Scottish Terrier, Lena. That seemed to set me off…I have the disease of alcoholism. It's lifelong."

Friends were surprised by the news. "She said she wasn't using," says Peter Bogdanovich, who directed O'Neal in 1973's Paper Moon, for which she won an Oscar at age 10. "She seemed like she was in good shape." The eldest child of actors Ryan O'Neal and Joanna Moore (who died in 1997), O'Neal has said she suffered emotional and physical abuse during her childhood. A rocky marriage and bitter divorce from tennis star John McEnroe followed. In 1995, O'Neal lost custody of their kids, Kevin, now 22, Sean, 20, and Emily, 17, due to her drug use. After numerous trips to rehab, she won joint custody. Now those close to O'Neal-who appears on the FX drama Rescue Me-are hoping the troubled star can bounce back once again. "She's had some tough breaks," says Bogdanovich. "I'm sure she can recover. She's a good girl."

SECOND LIFE

DOREEN MOTTON SAYS SHE KNOWS HOW IT FEELS TO hit rock bottom: It hurts. Feelings of inadequacy helped fuel a 20-year alcohol and drug addiction. "To hide and suppress my feelings, I'd go to the bar or indulge in substances," admits Morton, who decided in 1996 that enough was enough. "I realized the only thing holding me back was me. I decided to rebuild my life."

Today, with nearly 11 years of sobriety under her belt, Morton is a newly christened entrepreneur. Of course, the 52-year-old stresses that her transformation did not happen overnight.

Morton says she had a lifetime struggle to quiet an inner belief stemming from childhood that she "just wasn't good enough." She turned to drugs and alcohol in college to cope, but recreational use developed into a lengthy battle, with her life slowly spiraling out of control. "I always had a job, traveled the world, and I was good at communicating with people," says Morton on hiding her indiscretions. "As a user you learn how to become very manipulative." But once close family members discovered her addiction, Morton says she felt "it was almost a relief." "Those were extremely dark times in my life. It's only by the grace of God that I'm still here." she adds.

In April of 1997, Morton checked herself into a rehabilitation center, and after a year of intense therapy, she emerged with a new perspective.

By 2001, the 30-year sales and marketing veteran, had landed what appeared to be a dream job as a vice president of marketing at a major financial services firm in New York But the demands of the position left the single mom feeling besieged and unhappy. "I felt robotic and mechanical," she says. "I didn't really feel that I had a purpose. And after all that I had been through in my life, there had to be a deeper meaning for me." Morton left her lucrative financial career in early 2007 and with $10,000 in personal savings launched Neero & Ana Inc.

(www.neero-ana.com)--named in part after her 16-year-old son, Dana. The New York-based company [started in 2004 as a part-time venture) specializes in organic satin products for men and women, including a line of signature satin pillowcases--a favorite of actresses Kerry Washington and Kimberly Elise. "Taking the risk to own a business was nothing compared to the risk that I took with my addiction," Morton admits. Last year, the company saw gross revenues of nearly $400,000, and expects partnerships with hotel chains, dermatologists, cosmetic surgeons, and charitable organizations to help revenues swell to more than $1 million this year. "This solidifies what I think of myself," Morton says, "that I am valuable and that I can be everything that I want to be."

Children's prescription drug deaths are focus of ad campaign

Tammy Pasanella sobbed as she stood in front of a wall of television cameras and reporters on Friday and recalled how her son, Chandler Valley Christian High School football player Danny Pasanella, slipped into a prescription drug addiction and, ultimately, death.

It was a dramatic turnaround from the days just after her son died in September when, she said, she shunned the media because they were obsessively focusing on Danny's overdose death.

Now Tammy Pasanella is embracing the attention.

She and four other mothers helped launch an ad campaign Friday that will use TV, radio, billboard and print ads to warn other parents about the dangers of prescription drugs.

"The pain that we go through is unbearable and indescribable," Pasanella said at an afternoon news conference at the Maricopa County Attorney's Office in downtown Phoenix. Her son overdosed on a combination of OxyContin, Vicodin, and heroin.

More frequently than ever before, teens are turning to their parents' medicine cabinets to get high on painkillers, the mothers said.

The pattern, as the women showed, can lead to tragedy.

Debbie DiVello said her son, Shaun, became addicted to Methadone after a dirt biking accident.

"Little by little, he was able to 'doctor shop' and get all these prescriptions," she said.

Then on Feb. 3, it killed him. "I lost my son," she said.

One after another, DiVello, Pasanella and the other moms: Cindy Sierzchula, Patte Bielman and Karen Black told similar stories.

"For me, I really felt that something good needed to come out of the loss of my son," said Black, whose son Jacob overdosed on OxyContin a year ago. "If this is the good, then that's the way I have to look at it.

The five were brought together by the Drug Free AZ campaign of the Maricopa County Attorney's Office, which is organizing the local media blitz.

"Prescription drug overdoses by their children have caused great tragedy in their families," said County Attorney Andrew Thomas at the event. "I want to applaud the courage and strength of these mothers."

The campaign will cost nearly $700,000, which includes $60,000 to produce three television ads featuring the mothers which will begin airing on local television soon.

Area legislator proposes medical marijuana study: Similar bills have languished in the legislature

Rep. Earl Jones, D-Guilford, has never been one to shy away from controversy, and he's showing that trait again with a bill he introduced to study the medicinal use of marijuana in North Carolina.

Jones, who represents parts of High Point in the N.C. General Assembly, introduced House Bill 2405 this week. The bill would allow the Legislative Research Commission to study the potential benefits of letting marijuana be used for medicinal purposes.

Jones said he envisions the study debunking myths and presenting medical evidence about the benefits of medicinal marijuana for patients suffering conditions such as cancer and glaucoma.

"What bothers me is we're missing an opportunity as a state and nation on advancements in science and the opportunity to relieve pain and suffering," said Jones, who's also been an advocate for stem-cell research in the state.

A leader of the N.C. Family Policy Council said his group objects to Jones' proposal and that it will facewide opposition. "Our concern is that the intent of it is to promote the potential legalization of marijuana in North Carolina. Even if that's done for medical purposes, it can create some significant problems," said John Rustin, vice president with the council in Raleigh.

Easier access to marijuana could promote drug addiction, Rustin said.

Jones, a three-term legislator and former Greensboro City Council member, said he thinks his proposal for a study has a reasonable chance of passing, if the study is perceived as gathering curate information. Rustin said similar bills introduced in the past on marijuana legalization have languished in the General Assembly, and he would be surprised if House Bill 2405 didn't face a similar fate.

Jones gained notice earlier this year when he was amonga handful of legislators to vote against expelling disgraced Democratic legislator Thomas Wright of Wilmington. Wright was expelled from the House just before being convicted of political corruption in office. Jones voted against the expulsion because he said it shouldn't have happenedbefore Wright's court case played out.

Jones won't face any immediate political fallout from his medicinal marijuana bill. He's unopposed for another two-year term in the fall generalelection.

Ex-drug addict, droput earns academic honors

Not long ago, Candace Small of Thomasville was a high school dropout and drug addict few would have considered for academic honors.

But after a stellar turnaround at Guilford Technical Community College, the 29-year-old mother of three graduated this month as Outstanding College Transfer Graduate. GTCC President Don Cameron also gave her the scholarship that bears his name to cover University of North Carolina at Greensboro tuition and fees for two years.

Small, who became a math whiz at GTCC, wants to become a math teacher.

Small's troubles started when at age 10 she became caregiver for two siblings. Three years later, she was diagnosed with chronic depression, post traumatic stress and obsessive compulsive disorders and left home and school. Hanging out with the wrong crowd and developing some bad habits led to drug addiction, Small said.

"Between the age of 18 and 24, I was on and off of drugs," she said. "I've been clean now for five years."

Small decided to enroll at GTCC in2005 while her then-soldier husband Joe was in Iraq with the National Guard.

"Once my husband returned, I decided I wanted to go back to school and do something else with my life in addition to being a mother and a wife," Small said.

Small also worked part time as a supplemental instruction teacher to earn extra money.

"She is a true leader in every sense of the word," said Susan Barbitta, a developmental education math instructor. "Being a student herself afforded her leverage with the math students."

Small said Barbitta's guidance encouraged her.

"I want to do algebra. It lays the foundation students will need later," Small said.

While scholarships will pay school fees, Small will have to work to earn money to cover child care expenses.

"It probably will take me three years to finish," Small said.