Cocaine consumption broke a new record. According to United Nations calculations, around the world, around 22 million people consumed the substance, which is extracted from the leaves of the coca bush, in 2021. This number is greater than the sum of inhabitants of the cities of São Paulo and Rio de Janeiro. In Europe, cocaine is the second most common illegal drug, after marijuana.
The drug is highly addictive and damages vital organs. Consumption pushes the circulatory system to its limits – an effect comparable to a marathon. Abstinence, in turn, is associated with great physical and mental stress. Now, in Brazil, researchers are developing a vaccine to help combat addiction.
How does cocaine work?
Most users inhale powder cocaine through the nose. Alternatively, it is smoked in a pipe, like crack, which is nothing more than a type of drug produced from cocaine. The substance reaches the brain through the blood. There, the drug stimulates the body to release several messenger substances, including dopamine. The predominant sensation is that of intense euphoria.
The body becomes hyperactive. The heart beats at its maximum capacity while the arteries contract. Blood pressure increases, as does body temperature. Needs such as hunger and thirst are no longer important. In the worst case scenario, cocaine use can cause convulsions and even respiratory and cardiac arrest.
The effect lasts from five to 30 minutes. “It’s as if all the traffic lights are green,” says Hanspeter Eckert, a therapist at a Berlin association who works with drug therapy. “The brain memorizes: that was intense and great, I want it again! The body stores consumption as essential for survival,” he adds.
The desire for more cocaine dominates thoughts. The internal voices that warn about the consequences become quieter. Health, social contacts and work are neglected. An addiction develops.
Vaccination as a solution against addiction?
A cocaine vaccine can help treat addiction. After vaccination, antibodies form in the blood. These antibodies specifically bind to cocaine. Therefore, the substance is too large to pass through the blood-brain barrier. This means that the brain cannot be stimulated, so there is no sensation caused by the substance.
Brain reactions that normally trigger cravings for the drug are suppressed. As a result, the patient perceives the drug differently, says Frederico Garcia, from the Federal University of Minas Gerais (UFMG), who is developing a vaccine against cocaine called Calixcoca. The vaccine has already been tested on rats.
Garcia believes that results from animal tests can be transferred to humans. This would be the first cocaine vaccine in the world to be used to treat addiction. Other research teams in the US are also working on similar vaccines. Human clinical trials are still pending and therefore it is uncertain when and if a vaccine for cocaine addiction will actually be available.
For therapists, vaccination does not rule out therapy
In principle, therapist Eckert is in favor of vaccine research: “If there is no inebriation, the mind can rest. The body can free itself from constant irritation. People can have positive experiences and realize that the good feeling is due to themselves and not the drug.”
However, Eckert is skeptical if the vaccine alone will do the trick, as therapy is hard work. It takes at least a year for addicts to learn to understand their body and psyche. Through this process, they gain more control over their lives, explains Eckert.
Vaccination is not intended as a preventative measure or for occasional users. Eckert warns that there is a risk of overdose among those vaccinated because the vaccine blocks inebriation. Thus, the user may seek a higher dose, which may overload the circulation – the result may be cardiac and respiratory arrest.
Marica Ferri, from the European Monitoring Center for Drugs and Drug Addiction (EMCDDA), has other considerations. “The substance itself is not an isolated problem. All problems are not automatically resolved by stopping cocaine use. Physical damage needs to be healed, as does mental health. Therapy also involves working on the psyche and social environment. This takes time,” she points out.
She strives for more comprehensive solutions. As a public health specialist, the specialist advocates expanding the number of places offering therapy. Vaccination is suitable for a small proportion of users who are already on therapy, says Ferri.