By Kermit B. Fernander, Guardian Lifestyles Reporter, kermit@nasguard.com -

For a decade, researchers have been developing and fine-tuning a vaccine that they hope will one day alleviate the suffering of persons addicted to cocaine. It now appears that success may be imminent once the United States Food and Drug Administration (FDA) grants approval for clinical trials to commence.

Dr. Tom Kosten, a psychiatry professor, and his wife, Therese Kosten, a psychologist and neuroscientist, researchers at Baylor College of Medicine in Houston, Texas, have been diligently working on a vaccine that may be the first ever to help people hooked on cocaine.

This is exciting ground-breaking research, but the task facing the Kosten's is enormously challenging. "For people who have a desire to stop using, the vaccine should be very useful. At some point, most users will give in to temptation and relapse, but those for whom the vaccine is effective [they] won't get high, and will lose interest," said Dr. Tom Kosten.

And therein lies the problem of addiction. The high that cocaine produces in the brain is so intensely pleasurable that users will literally do anything to attain that state, and this is precisely why they are generally prepared to risk all in order to indulge their habit. Contrary to what many lay persons believe, addicts are powerless to help themselves. In fact, powerlessness is the crux of their problem.

How the vaccine works.

According to Dr. Tom Kosten, the molecules of cocaine and other drugs are so small that they cannot be recognized by our immune system. This means that our immune system cannot form antibodies to

attack these molecules. However, to help the immune system recognize the drug, Dr. Kosten attached inactivated cocaine to the outside of inactivated cholera proteins.

It was a brilliant move!

The immune system responded favorably by making antibodies to this combination, which is harmless, but also recognizes the naked drug when ingested. The antibodies bind to the cocaine and prevent it from reaching the brain. As a result, the user fails to experience the usual explosive highs that are so terribly addictive.

"It's a very clever idea," said David Eagleman, another Baylor neuroscientist, who praised the vaccine.

"Scientists have spent the last few decades figuring out reward pathways in the brain and how drugs like cocaine hijack the system. It turns out those pathways are difficult to rewire once they've seen the drug. But the vaccine just circumvents all that."

Dr. David Gorelick, a senior investigator at the National Institute on Drug Abuse, is more guarded in his response to the vaccine. "Addiction vaccines are a promising advance, but it's unlikely any treatment in this field will work for everyone. Still, if they prove successful, they will give those working in drug addiction an important option," he said.

Last December, Kosten requested that the FDA approve a multi-institutional trial he hopes will begin in the spring. He awaits their response. If approval is granted, it is possible that the treatment of cocaine addiction will change dramatically. At the moment, treatment options are limited to psychiatric counseling and 12-step programs.

One of the toughest and most prevalent of all illnesses is that of addiction, whether it's to alcohol or to a powerful recreational drug like cocaine. The problem with addiction is that many addicts remain stubbornly in denial of their illness. They lose their sense of judgment, and truly believe they don't have a problem because, to their mind, they can cease drinking or "using" any time they wish. Now, for the first time in history, there may be help on the horizon for cocaine addicts who wish to stop using.