Dr. Thomas Kosten, a professor of psychiatry and neuroscience at Baylor College of Medicine, has spent the last 20 years of his career working on breakthrough vaccines.

Not vaccinations for H1N1, or even the common cold. No, Dr. Kosten is working to create vaccinations for a far more sinister disease — drug dependence.

Kosten's vaccines aren't meant to be preventative as, say, a chicken pox vaccine is. Instead, they're intended as therapeutic treatments for people who are drug-dependent or who have suffered damage from drug abuse.

Although Kosten concedes that his vaccines could be used preventatively, say in patients with a high risk of addiction, "the more sensible use is to prevent relapse."

"Immunotherapy is really the better word, but it uses the vaccine mechanism," Kosten says.

Kosten's cure for cocaine addiction

Although Kosten has vaccines for several types of dependencies in the works, we found his work on a vaccine for cocaine addiction the most fascinating.

Kosten's cocaine vaccine works by preventing the cocaine from getting into the brain and activating the receptors that produce the drug's desired effect — an artificial sense of euphoria caused by dopamine. Preventing the desired effect also acts to detox the abuser as they're vaccinated, effectively weaning the abuser off the drug.

Kosten says there are an estimated 3 million cocaine abusers in the United States alone, and he envisions the main candidates for the vaccine as being high-risk adolescents and pregnant women.

The vaccine's effectiveness in pregnant women with a history of cocaine abuse is particularly impressive — if the mother relapses while pregnant, the vaccine keeps the cocaine from reaching the fetus. And if the drug has already reached the womb, the vaccine can actually act to extract it.

How it works

Most drug particles are so tiny that the human body has trouble producing antibodies to fight them. Kosten's vaccines work by attaching the drug of abuse to a carrier protein — for example, inactivated cholera toxin — and injecting it into the patient, causing the patient's immune system to produce antibodies to both the protein and the drug.

Some vaccines produce more antibodies than others, and the cocaine vaccination takes approximately five rounds of treatment over several months to produce the desired number of antibodies. The antibodies then remain in the body for approximately three months before the patient needs a booster shot.

For those initial three months, the vaccine produces extremely high affinities of antibodies. People in treatment, Kosten says, could be administered 10 times the lethal dose of cocaine without experiencing its effects.

And what about risk of overdose? If a patient finds himself or herself three-months-immune, is there a chance the patient could relapse and accidentally O.D.?

Kosten says drugs of abuse are usually ingested in such a manner that the abuser knows immediately whether they're getting an effect. In other words, unless a drug user is actively trying to kill themselves, the vaccine puts them at no greater risk of overdose.

What's next

The cocaine vaccine is now in its second large phase II study and is currently being shopped to American manufacturers. "The U.S. and Europe are the places that cocaine is a huge problem," Kosten says, and adds that if he can't find a manufacturer here, he may simply produce the vaccine in China and export it to the States.

He foresees interested buyers in governments (to vaccinate indigents), insurance companies, law enforcement agencies and concerned family members looking to stage an intervention.

A nicotine vaccine, for which there is obviously a vast American market, is in in phase III — the last stop before FDA approval.

It seems that vaccinating drug abusers is not a cause that's necessarily personal to Kosten, but rather attractive.

"I thought it was a good idea, and not a lot of people were working on it," he says. (Kosten is also working on vaccines for morphine and methamphetamine addiction, although he is developing those in China due to that nation's more advantageous relationship with its pharmaceutical companies.)

"That's how science works," Kosten says. "If you're lucky, it is a good idea. And if you have one good idea during your career, you're a great success."