U.S. Backs Vaccines For Drug, Nicotine Addiction

Reuters

Hooked on cocaine or cigarettes? The U.S. government wants drug companies to make a vaccine for that.

Convinced of the need for new and better treatments for addiction, the government is focusing its efforts on vaccine development as a new way to treat and possibly prevent addiction to a range of addictive substances.

"It's a perspective that is very different from what we've operated on in the past," Dr. Nora Volkow, director of the National Institute on Drug Abuse told reporters this week at the Society for Neuroscience meeting in Chicago.

Volkow said the agency intends to piggyback on the frenetic investment by drug companies in vaccine development, spurred by the need for new products and the runaway success of products like Merck's Gardasil vaccine to prevent the virus that causes cervical cancer.

"There is an enormous amount of research and development in vaccines for cancers and a wide variety of disorders," she said. "We can take advantage of those developments."

But first Volkow has to tempt drug companies to develop the vaccines by funding costly clinical trials.

Earlier this month, her agency, part of the National Institutes of Health, awarded Nabi Biopharmaceuticals a $10 million grant -- the agency's largest ever -- for a late-stage clinical trial of Nabi's vaccine for nicotine addiction called NicVAX.

Volkow said she did her homework before backing the Nabi vaccine to ensure it was significantly different from other products. "Nonetheless, when you are investing in something at this level, it can be very risky," she said.

The vaccine is meant to stimulate the immune system to make antibodies against nicotine, blocking its rewarding effects and helping to prevent relapse in smokers trying to quit.

TOUGH MARKET

A similar anti-smoking vaccine by Cytos Biotechnology and Swiss drugmaker Novartis last week missed its main goal in a midstage study, leading some analysts to question whether it can make it to market.

"They are still looking at it but it has been very problematic," said Robert Wasserman, director of investment research at the investment banking firm Dawson James in Florida.

"Vaccines are really tough," he said. "It's not for the faint of heart."

Still, if it works, a nicotine vaccine could have a huge impact, Volkow said. "It's an international problem that kills 5 million individuals every year across the world," she said.

The global market for smoking cessation is expected to reach $4.6 billion by 2016, and vaccines could account for $2 billion in sales, according to independent market research firm Datamonitor.

Volkow said the same methods for making a nicotine vaccine could be used for other illicit substances.

Her agency backed a study released this month of an anti-cocaine vaccine that helped block the high felt by 38 percent of addicts who took it.

The vaccine was developed by Dr. Thomas Kosten of Baylor College of Medicine in Houston, who used a similar approach to make a nicotine vaccine now being tested in Europe by private equity firm Celtic Pharma.

Volkow said drumming up drug company interest in vaccines for illicit drugs is a harder sell because of liability concerns, and the fact that drug abusers are stigmatized.

"Unfortunately, when it comes to cocaine addiction treatment ... most of the investment goes to the government," she said.

Eminem Seeks Addiction Help From Elton John

Detroit Examiner

Legendary singer/pianist Elton John is an unlikely confidant for oft troubled Detroit rapper Eminem, but Elton John says he's been helping Eminem kick drugs.

"I've been helping Eminem over the last 18 months and he's doing brilliantly," John told BBC Radio, without divulging details. The interview was taped over the holidays and broadcast today.

While John didn't discuss details, and host Danny Baker, did not pry, Eminem's drug problems are common knowledge.

"It's no secret I had a drug problem," Eminem told Vibe magazine, after he entered rehab in 2005 for addiction to sleeping pills before taking a three-year sabbatical.

    If I was to give you a number of Vicodin I would actually take in a day? Anywhere between 10 to 20. Valium, Ambien ... the numbers got so high I don't even know what I was taking.

When the rapper decided it was time to get help, he called Elton for support.

    He had a substance-abuse problem in the past. So when I first wanted to get sober, I called him, because he's somebody in the business who can relate to the lifestyle and how hectic things can be. He understands, like, the pressure and any other reasons that you wanna come up with for doing drugs.

Sir Elton John is no stranger to drug and alcohol abuse after his own battle with drugs and booze earlier in his legendary career. "To be honest with you, I don't know how I survived," John confessed. He acknowledges the problem is as rampant as it ever was.

    When you give it up, you tend to think everybody else has given it up, but of course it is just as prevalent as it ever was. And nowadays pills, such as downers, are even more damaging.

John has counseled other celebrity addicts over the years, including the late Michael Jackson, but says he doesn't force his advice on anyone. "I'm there if people want my help,"

"If people ask for help, you tell them where to go, but there's no point advising people if they don't want to do it."

Not everybody is interested in help or counsel. John has tried to help singer George Michael in the past only to be rebuffed. Elton holds no ill will though saying, "People used to tell me 'Oh, for Godsake, clean your act up." And I didn't want to know. I didn't want anyone's help. I used to get annoyed."

You can watch the entire interview here. (The Eminem conversation is at approximately 18-19 minutes in).

At the 2001 Grammy Awards, John and Eminem performed a memorable duet of the hip-hop star's hit song, "Stan." At the time, Eminem was under fire from gay rights groups because of his lyrics, but he later said he didn't know John was gay when he asked him to sing with him.

L.A. Gangs Seek Profit In Peace

The Wall Street Journal

LOS ANGELES -- After nearly two decades fighting gangs, Los Angeles County Sheriff's Detective Robert Lyons thought he had seen it all. Until he saw members of the Bloods and the Crips -- rival gangs that spent years in brutal conflict -- meeting amiably in a restaurant.

"They were talking. There was hugging and high-fiving. It was unbelievable," Mr. Lyons said. He has heard a refrain from gang members: Red (the Bloods) and blue (the Crips) make green (money).

Gangs that were once bloody rivals now are cooperating to wring profits from the sale of illegal drugs and weapons, law-enforcement officials and gang experts say. In some cases, gangs that investigators believed to be sworn enemies share neighborhoods and strike business deals. The collaboration even crosses racial lines, remarkable in a gang world where racial divisions are sharp and clashes are often racially motivated.

"You see African-Americans dealing with Hispanics on obtaining narcotics and weapons. We're seeing Hispanic gang members involved with the Eastern European criminal figures," said Robert W. Clark, acting special agent in charge of the criminal division of the Los Angeles field office of the Federal Bureau of Investigation. "Where they see opportunities to collaborate, they do."

Gang activity has been one of the most intractable crime problems facing Southern California for decades, terrorizing communities, claiming hundreds of lives a year in some periods and also breeding a nexus of criminal activity that has been exported to other communities. Los Angeles, along with Chicago, has long been considered one of the centers of gang activity in the U.S.

But gang-related violence is at a 30-year low in Los Angeles, according to experts. Gang-related homicides in Los Angeles totaled 128 in through October of this year, compared with 312 in all of 2002. All reported gang-related crimes, including rape, assault and robberies, totaled 4,899 through October, compared with 7,432 in 2002.

The sharp drop is undoubtedly a landmark success for law-enforcement officials and policy makers, who have used aggressive policing and rehabilitation programs to tackle the problem. But the reports of alliances between formerly warring gangs potentially offers a different explanation: Gangs are committing less violence because they are partnering on criminal activity, creating new challenges for law enforcement.

"Now, instead of having 200 guys that are arch-enemies with 200 other guys, you have 400 guys working together against law enforcement," said the sheriff's detective, Mr. Lyons.

There are still plenty of rivalries and violence. One Los Angeles-area Latino gang, Barrio Hawaiian Gardens, was charged this spring with hate crimes against African-Americans -- including targeted shootings.

Tracking the number of gang members is notoriously tricky, and membership is fluid. But a November report from the California Gang Node Advisory Committee, which attempts to track gang membership, put the number of gang members at 85,832 in Los Angeles County, up slightly from recent years.

And the number of gang members has been on the upswing nationally. There were about one million gang members in the U.S. in 2008, up from 800,000 in 2005, according to the National Gang Threat Assessment, compiled by the National Gang Intelligence Center and the National Drug Intelligence Center.

Some regions of the country -- like New England, with 640 gangs -- are seeing an increase in violence and substance abuse as gangs grow and fight for control of neighborhoods and the drug trade, the report said. But there is cohesion in other regions, like Washington and Oregon, where "alliances between gangs may result in the expansion of criminal networks and increased criminal activity in the Northwest Region," the report says.

In Los Angeles, federal and local law-enforcement agencies have launched massive investigations and raids against gangs. In 2009, law-enforcement officials arrested more than 650 gang members in Southern California, according to the FBI.

City officials also credit gang-prevention and rehabilitation programs for the drop in crime. Gang intervention workers -- often former gang members -- work alongside police to prevent retaliatory shootings. Homeboy Industries, a privately funded gang-rehabilitation program in Los Angeles, serves around 12,000 people a year who have left gangs, providing job training, counseling and laser tattoo removal. And the mayor's office has sponsored activities like basketball games and picnics among neighborhoods that are home to feuding gangs.

But intensifying pressure from police has also prompted gangs to work together, said Jorja Leap, a University of California, Los Angeles professor and gang expert. "They really are united against what they perceive to be a common enemy -- law enforcement," said Ms. Leap, who now advises Los Angeles County Sheriff Leroy Baca on gangs.

Ms. Leap said gangs form links to survive -- and to maximize profits. "The market is tougher and they're consolidating," she said.

Los Angeles Police Chief Charlie Beck said gangs are "treating their activities more like businesses than before. In business, you work with whoever you have to."

This collaboration can make tracking gang crime and dismantling gangs more complicated. Members of street gangs are showing up unexpectedly in health-care and credit-card fraud investigations, which have traditionally been run by Eastern European crime rings.

During a two-year investigation of the Athens Park Bloods, an African-American gang entrenched in south Los Angeles, investigators learned the members had formed a pact with a Hispanic gang called Barrio 13. Eventually, 22 people were charged -- 20 African-Americans and two Hispanics.

"They shared the same guns, the same narcotics, the same neighborhood," said Mr. Lyons, the sheriff's detective.

Cocaine Chic Linked To Rise In Young Addicts

London Times Online

The number of children being treated for cocaine addiction has nearly doubled in four years, NHS figures show, with the drug’s “glamorous” image being blamed for the rise.

Young adults are increasingly requiring treatment for addiction to cocaine, often after developing a habit in their teens or twenties.

Last year 745 under-18s in England sought help from the National Treatment Agency after abusing the Class A drug, up from 453 in 2005-06.

Among those reporting addictions last year was a small group of very young children, including at least 15 children who were under 12, the latest figures show. Fourteen children aged 12 to 14 and 169 children aged between 14 and 16 also needed help to stop using cocaine, although fewer teenagers were seeking treatment for crack and heroin dependencies.

Experts said that children who started to use Class A drugs so young were likely to be using them as a “coping mechanism” to hide other problems, copying parents or other family members who were already abusing the substances.

Overall, nearly 24,053 under 18s needed addiction treatment for misusing illegal drugs and alcohol last year, 150 more than the total three years ago.

The number of individuals treated for cannabis was 12,642 and alcohol 8,799, accounting for almost nine out of 10 of all young people receiving support last year.

Last year the agency treated 657 crack and heroin users who were under 18, down from 1,081 in 2005-06.

Three quarters of young people treated had psychosocial therapies such as counselling, but others required support for the breakdown of family relationships, poor school attendance or emotional and physical harms.

Harry Shapiro, director of communications at the charity Drugscope, said that a shift in use away from heroin and crack towards cocaine reflected a general trend among all age groups.

“If young people are in a particularly risky or dysfunctional environment, alcohol or cannabis abuse is going to be more likely, and that makes them more likely to try other drugs.

“Cannabis has gone down since 2002, the general trends might be flat or dipping, but there is a minority of young people trying drugs as a coping mechanism.

“If you are in an environment where the house is used as a dealing hub or there are users regularly coming round to score, or if they come into contact with Class A substances through family members who are using them, then clearly that is an issue.

“Although they are coming forward for treatment, it’s likely that their drug use is symptomatic of other problems that are going on at home or school.

“I don’t think it’s a question of children and teenagers hanging round street corners, buying off dealers, but that could be their future if they don’t get treatment.”

Figures published this month show that the number of people under 35 entering treatment for cocaine addiction has increased by 75 per cent among men and 60 per cent for women in the past four years. The average age to start using the drug was 21.

Norman Lamb, the Liberal Democrats’ health spokesman, said: “There is a real problem with young people receiving mixed messages because of the alleged glamour associated with drugs such as cocaine.

“We need to get the message across about the dangers of experimenting with a massively addictive drug such as cocaine.

“The Government has been obsessed with trying to look tough on drugs while slashing funding for information services and refusing to listen to scientific opinion. Ministers must do a lot more to make people aware of the serious damage that drug use can do to your long-term health.”

Rosanna O’Connor, director of delivery at the NTA, said that the latest figures indicated that the heroin “epidemic” had peaked.

She said: “Most young people receiving substance misuse interventions cannot be described as addicts in the same way as adults in cocaine addiction treatment programs.

“Addiction is normally the result of regular, consistent use of substances over time; most under-18s who have problems have not pursued drug-taking long enough to result in dependency.”

John Mallalieu, of the charity Turning Point, said that there was no conclusive answer as to why fewer young people were receiving crack or heroin addiction treatment, “but it seems they may now be more aware of the potential consequences of using these drugs than previous generations were”.

He added: “The fact that more young people are drinking tells us that similar cultural messages for alcohol are not sinking in. In 2008 heroin was responsible for around 900 deaths, whereas alcohol was attributed to nearly 8,500.

“Quite simply, greater resource is needed to ensure that England’s next generation of drinkers are taught of the dangers of alcohol, and change their behaviour before it is too late.”

Alcohol Abuse Leads To Increased Risk Of HIV

Namibia Economist

Excessive alcohol abuse amongst Namibians is one of the main causes fuelling the spread of HIV and AIDS, according to a 2008 report on the behavioural and contextual factors driving the epidemic in Namibia.

“A recent study on alcohol consumption, sexual partners and HIV transmission in Namibia concludes that Namibians are not socialised to drink in moderation and also don’t recognise the difference between abstention and responsible drinking. In regard to HIV and AIDS, alcohol abuse becomes a dangerous trap by making the individual more vulnerable to engage in risky sexual behaviour such as unprotected sex and multiple concurrent partnerships,” said Stefan Sckell, Counsellor for Development Cooperation at the German embassy.

He said, although inconsistent condom use and multiple concurrent partnerships were also identified as drivers of the HIV and AIDS epidemic in the country, alcohol abuse presents an underlying and reinforcing factor.

Namibia has made significant strides in the fight against HIV, as the prevalence rate has declined from 22% in 2002 to 17.8% in 2008.

And according to Prime Minister, Nahas Angula, there has been a rapid and comprehensive roll-out of anti-retroviral treatment (ART) as 75% of people living with HIV receive treatment. An increase in the distribution and use of condoms has also been reported.

“During last year’s National Testing Day over 30 000 Namibians went and got tested. This year, people were even more responsive so that almost 85 000 of our fellow country women and men came for an HIV test over the course of the National Testing Day campaign. Furthermore, mobile testing services are becoming more and more popular. We are also seeing an encouraging increase in the distribution and use of condoms,” said Angula.

He further said more emphasis should be placed on prevention programmes and alcohol addiction treatment programs which are relevant and responsive to the particular risks present in a given community.

“We must also intesify our prevention efforts for our most productive age groups and those who are working for the economic progress of our nation. Let us ensure that all workplaces put in place effective HIV/AIDS prevention programmes as part of broader employee wellness services,” Angula said.

Treatment Program Gives Addicts Hope

Baltimore Sun

When Heather Spiker graduated recently, there was no cap and gown, no pomp and circumstance. But for the first time in her adult life, Spiker said, there was hope.

Spiker, 37, was one of nine people to complete Howard County's drug and DUI court program during a ceremony in District Court. The program was set up in 2004 to give nonviolent repeat offenders a chance to rehabilitate themselves rather than go - or return - to jail.

"We see them when they're sick, down and out," said Bobbie Fine, a former defense attorney and prosecutor who has coordinated the program since its inception. "This program saves the state money [in terms of incarcerations] and it's given these people a life, self-worth."

According to Fine, Spiker is one of the program's biggest successes.

It has given the Baltimore native an opportunity "at life" after years of what she described as an addiction to alcohol and drugs - including heroin - that resulted in nearly two dozen arrests since 2000 and as many incarcerations of varying lengths in detention centers throughout the state.

Asked when she was in jail, Spiker said, "When wasn't I in jail?"

Through court order, Spiker said, she spent 15 months in drug treatment programs, first at the Shoemaker Center in Sykesville and later at The W House, a Hagerstown residential halfway house for women in the early stages of drug-addiction recovery.

She has reunited with her two sons, ages 18 and 14, whom she said she hadn't seen in five years because of her addiction.

The celebrations of Thanksgiving and Christmas this year have special meaning to Spiker, who spent many previous holidays either in jail or homeless.

"Holidays and having family around, and friends and a network and being on the way to recovery, that's a pretty special thing," she said. "You're really in touch with reality and spirituality and just with life. When you get all of that back, and you have time for love, it's a pretty special thing."

Though Spiker twice relapsed after starting the program after an arrest in Howard County in 2007 for possession of heroin, she said that the difference between this program and others she had been at came from the compassion she felt from District Court Judge Neil David Axel and the support she received from Fine and others involved.

"It wasn't just to lock me up and throw away the key," Spiker said. "I would get arrested and there was no help available, at least not through any kind of court. When I reached this program, it was like they had faith in me way before I had faith in myself. This is a hard program to go through, especially for an addict. Structure is what I needed."

The drug rehab programs are set up to take a year, but Fine acknowledge that many, including Spiker, take longer because of their continuing battle with drugs and alcohol.

"It's very difficult to say to somebody, 'From this day on, you'll never use [drugs or alcohol],' " Fine said. "You won't say they will [relapse], but there's a good chance they may. We don't throw them out the first or second time if they're doing everything else that we require of them."

As for Spiker, who was chosen as the heroin addiction treatment program participant to speak at the graduation ceremony, Fine said, "We knew how hard Heather was trying, and she proved us right. We had faith in her, we thought she could do it. She had been doing so well, when she did relapse. But she had the determination. We didn't want to give up on her."

Spiker said that her problems with addiction began shortly after graduating from high school in Woodstock, Va., where she had gone for her senior year after leaving Catonsville because her mother was having her own problems with an addiction that would eventually kill her.

"She died in my arms when she was 44," Spiker said.

Returning to Baltimore, Spiker got a job doing clerical work, but to earn extra money, began bartending on The Block. Spiker said that the bartending job led to her becoming an exotic dancer and later a prostitute. Her first arrest came when she tried to buy drugs while she was a prostitute.

"The last 10 years were pretty crazy," she said. "I lived on the streets in Baltimore. I worked Wilkens Avenue, Washington Boulevard, all those areas, for years. I lived in abandoned houses, in alleys in the summer, wherever I could. I was going in and out of jails and institutions."

Kerri Robinson, the lead addiction counselor at The W House, said that Spiker had "hit rock-bottom" when she arrived and was "ready to surrender, knowing that she was totally powerless to overcome her addiction by herself."

Since her graduation, Spiker has moved to Jersey City, N.J. She starts a new job in New York on Dec. 15.

She knows her battles aren't over, but she is confident that she will not relapse. Spiker knows what the alternative is. "There's no going back. If I go back, I will die," she said.

Cutting Treatment Costs More Than It Saves

from the Times Union

The Times Union's outstanding series, "Poppy's story: A face of addiction," coincides with a state fiscal crisis that will tempt lawmakers to enact across-the-board budget cuts to alcohol addiction treatment, prevention and recovery services.

They should reject this path, because in many instances broad-based cuts to these vital programs would actually cost the state money. Lawmakers must understand that dealing with the fallout from addiction is more costly than treating the problem.

Addiction to alcohol and other drugs is a chronic disease. Dealing with the consequences significantly drives up spending in areas such as health care, social service, criminal justice and child welfare. Unfortunately, New York historically has failed to treat addiction and instead has spent billions on its effects. During these times of economic distress, we must rethink our approach.

A study by the National Center on Addiction and Substance Abuse at Columbia University found that alcohol abuse and other drug problems drive 70 percent of spending on child welfare, 77 percent on criminal justice, 66 percent on juvenile justice, 25 percent on health, 51 percent on mental health and 9 percent of developmental disabilities expenditures in state agency budgets.

So it would be penny-wise and pound-foolish to cut funding on addiction services -- investments that could reduce the amount the state spends in these other areas.

This is especially true in juvenile justice. Adolescents addicted to alcohol and other drugs frequently wind up in state-run facilities that cost taxpayers between $150,000 and $200,000 a year for each teen -- often with very poor results. Most of these youths then land in our state prisons as adults. Adolescent chemical dependence treatment programs cost half as much and are far more successful at treating our children and returning them to school and their families.

The health care problems of severely addicted people like Poppy often consume huge amounts of Medicaid dollars as well. However, there are programs to manage these cases, and if done properly, significant savings occur.

The Managed Addiction Treatment Services program saves more than $18 million annually in New York City alone. Offering residential treatment as an alternative to incarceration saves at least $10,000 a year for every addicted person.

Instead of cutting services, Gov. David Paterson and the Legislature should expand these programs so they return bigger savings to New York's taxpayers.

Closing costly juvenile detention centers and investing in chemical and alcohol dependence treatment programs can save millions. Lawmakers should also consider imposing an additional tax on alcoholic beverages and dedicating the revenues to fund treatment services.

By treating the disease instead of the consequences, we can save the state significant amounts of money. That will mean fewer New Yorkers like Poppy struggling to survive on our streets -- which will help taxpayers and addicts alike.

John Coppola is executive director of the New York State Association of Alcoholism and Substance Abuse Providers.