Could an anti-cocaine vaccine help prevent HIV in the process?

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(Photo illustration courtesy of Pixabay)

When I first began to write about PrEP, the HIV prevention pill, I remember someone saying, “Back in my day, we would have been lining up around the block for a pill to prevent HIV. But today’s gay men aren’t.”

Another quipped that gay men “are more interested in ecstasy than a pill to prevent HIV.”

True or not, a brand new medical development raises similar questions. In some ways, it too could be a new tool in HIV prevention. Weill Cornell Medicine and New York-Presbyterian hospitals are now enrolling volunteers for a phase I clinical trial for a cocaine vaccine. That’s right – a vaccine that would prevent you from getting high on cocaine. You could toot up as much as you’d like, but you wouldn’t get high.

Cocaine use among gay men often fuels intense sexual sessions where HIV transmission can become more likely.

“Cocaine addiction is a huge problem that affects more than 2 million people in the United States, and results in more than 500,000 annual visits to emergency rooms,” principal investigator Dr. Ronald Crystal said in a Weill Cornell Medical College news release. “While there are drugs like methadone designed to treat heroin, there aren’t any therapeutics available to treat cocaine addiction. We hope that our vaccine will change that.”

Good cocaine is hard to put down

When I moved back to the Quad-Cities in 2002 to get away from Los Angeles and a raging methamphetamine addiction, and also to care for my dad, for a long time all I did was smoke pot. But when I got back into the bar scene, and was introduced to “good” coke, that became a problem for me too. At one point, most of my paycheck was going to the coke dealer.

At some point in 2012 or 2013, those of us in the coke crowd began to say, “Hey wait a minute. This stuff isn’t coke.”

While dealers often doled out baggies of Calumet, what finally got a lot of us to quit the “coke” wasn’t so much getting ripped off with total crap (as addicts, we were still dumb enough to buy it). Most of us quit using it when it began to keep us up all night, cause us to break down, and generally feel extremely unwell.

It now appears due to certain arrests in the past year or so that we probably were being dealt meth and being told it was coke. Had that good coke continued to flow, I’m not sure I ever would have been able to give it up, and then finally give up cigarettes, alcohol, and marijuana, in that order.

So yay for a potential cocaine vaccine.

How would a cocaine vaccine work?

“While most drugs that target addiction are designed to disrupt some process in the brain, this vaccine, called dAd5GNE, is meant to absorb cocaine in the bloodstream – well before it has had a chance to pass the blood-brain barrier and later produce a dopamine-induced high,” according to the Cornell news release.

The vaccine works by attaching GNE, a cocaine-like molecule, to an inactive virus for the common cold. When the body recognizes the virus and unleashes antibodies, it also will learn to attack cocaine as an enemy, the reasoning goes. The body will respond with a flood of anti-cocaine antibodies, each meant to gobble up cocaine like a Pac-Man, Dr. Crystal said.

While the vaccine has been proven effective on animals, now investigators are looking to enroll 30 active cocaine users. The study is funded by the National Institutes of Health and the National Institute on Drug Abuse.

Before getting the vax, each subject will have to abstain from cocaine for at least 30 days (hard for an addict to do). They’ll be dropped regularly to make sure they are clean during that period.

They’ll get their first vaccine shot in the shoulder, with additional boosters given every four weeks until everyone has had six shots. After the final booster, monitoring will continue for three more months.

“Most people who become cocaine addicts want to give it up, but struggle to kick the habit in the long-term,” Dr. Crystal said. “If this vaccine works, it could represent a lifetime therapeutic for addicts.”

Participants will get $25 per visit – up to $2,400 for those who complete the study. To enroll or for information, contact Aileen Orphilla at 646-962-2672 or email anticocaine@med.cornell.edu.

Pfizer cancer drug may block cocaine memories

Meanwhile, another experimental cocaine addiction treatment recently made headlines. Researchers have found that a drug used in cancer therapy trials treats cocaine addiction “by inhibiting memories responsible for cravings,” according to a Cardiff University news release.

“We have demonstrated that a single administration of a trial drug from the pharmacompany Pfizer can completely obliterate cocaine associated memories and significantly accelerate the end of drug seeking behavior in animals,” said professor Ricardo Brambilla of Cardiff University’s School of Biosciences. “With this drug currently being used in cancer trials, it could be easily repositioned for treatment of cocaine addiction and other drugs of abuse.”

According to the news release, the drug kept mice from progressing to compulsive cocaine users by blocking the creation of long-term memories.

“With drug use recently on the rise, new treatments for breaking addiction are much needed,” said Dr. Stefania Fasano of Cardiff. “The availability of a powerful drug from Pfizer, already validated in humans, could speed up the clinical development of our findings.”

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