NEWSWEEK Cover: The Hunt for an Addicti...(the director of NIDA. In 10 years wewil...),Health

Vaccines that would arm the immune system against addictive drugs and prevent them from making the user high are, potentially, the ultimate weapons against addiction, Interlandi explains. A cocaine vaccine is poised to enter its first large-scale clinical trial in humans this year, and vaccines against nicotine, heroin and methamphetamine are also in development.

Nabi Biopharmaceuticals, a small biotech company in Maryland, has engineered a nicotine vaccine that is in late-stage clinical trials. Earlier studies showed that it was twice as effective as a placebo in helping people quit smoking. The cocaine vaccine, developed by Thomas Kosten of Baylor College of Medicine, could be on the market as early as 2010. It would have to be given three or four times a year, but presumably not for life, says Kosten. While the vaccine is being studied in people who are already addicted to cocaine, it could eventually be used on others. "You could vaccinate high-risk teens until they matured to an age of better decision-making," Kosten says. He acknowledges the obvious civil-liberties issues this raises. "Lawyers certainly want to argue with us on the ethics of it," he says, "but parent groups and pediatricians have been receptive to the idea."

The revolution these new drugs promise will have a huge impact on the addiction-treatment industry (or, as it prefers to think of itself, the "recovery movement"), which runs the gamut from locked psychiatric wards in big-city hospitals to spalike mansions in the Malibu Hills of California. And the reaction there is guarded; the people who run them have seen panaceas come and go over the years, and the same addicts return with the same problems. They also, of course, have a large investment in their own programs, which typically rely on intensive therapy and counseling based on the 12-Step Model. "We need four
'/>"/>