ADDICTS PARTICIPATE IN TRIAL OF NEW COCAINE 'VACCINE'

BRIDGEPORT, Conn. -- When young drug addicts Sam and Pasquale pushed up
their sleeves, they knew the cocaine-laced injections they were poised to
receive would not make them high.

The shots, given by a nurse in a Newtown drug treatment facility earlier
this year, were designed to do the exact opposite: block the effects of cocaine.

"I'm doing this so, hopefully, people won't have to go through the same
turmoil I did," said Sam, a 23-year-old from New Haven County who asked that
his real name not be used.

Sam and Pasquale, 23, who also asked to be anonymous, are among 34
inpatients at the Daytop drug abuse treatment center in Newtown who received
a first-of-its-kind vaccine in a study currently under way.

If the vaccine proves as potent in people as it did in animal tests, it
could alter cocaine treatment programs worldwide and give addicts a better
shot at freedom from the drug, said Dr. Thomas Kosten, chief of psychiatry
at the Veterans Affairs Medical Center in West Haven.

Kosten helped chemists at ImmuLogic Pharmaceuticals in Waltham, Mass.,
develop the vaccine in 1996. He is now in charge of the first human trials.

Volunteers at Daytop were injected with the new vaccine -- and two "booster"
shots -- over the past year. The final participant received his shots in April.

"If it works, it will be very exciting," said Kosten, whose treatment was
featured in an article in the June issue of Discover magazine.

Kosten is also expected to testify before Congress about the vaccine.

For the next year, Kosten and VA nurse Ellen Mitchell will question and test
the blood of those vaccinated to gauge how long the vaccine lasts in humans,
and assure there are no serious side effects.

"It was well-tolerated by all who were vaccinated" at Daytop, said Mitchell.
No side effects have been reported so far, she added.

And of 24 patients who've since been released into the community from their
treatment programs at Daytop, "none have been using cocaine -- that's what
they've told me," she added.

Verifying those claims is not a focus at the moment. The researchers are
concentrating on tracking vaccine side effects and measuring levels of
antibodies produced in the patients' blood in reaction to the vaccine.

The antibodies are what researchers believe block cocaine's effects. Kosten
expects an additional 200 cocaine addicts, mostly outpatients including some
from the West Haven VA center, will be vaccinated starting this fall or winter.

The addicts were recruited at various treatment programs and are not being
paid for participating in the trial.

The vaccine, Kosten said, "is relatively simple." The body's immune system
does not attack cocaine molecules because they are so small they are
undetectable. The vaccine binds a large protein molecule to a cocaine
molecule so the immune system can "see" the drug.

The immune system then attacks the "invader," rendering it ineffective.

When the vaccine was tested on addicted rats, the rodents lost interest in
the drug. Before being injected with the vaccine, the rats had pushed a
lever to self-inject cocaine, "sometimes hundreds of times" a day, said Kosten.

"We don't know, entirely" if the same result will be seen in people, he added.

Initial tests show the vaccine likely remains effective six to 12 months
before "booster" shots are needed.

"We think it's a promising approach," said Dr. Frank Vocci, director of
medications development at the National Institute of Drug Addiction, a
federal agency that has allocated $12 million across five years to fund the
research.

Human trials will continue for a minimum of four more years.

Some local drug treatment officials are excited about the vaccine.

"What Dr. Kosten is doing is very important, very important," said Mark
Kinzly, coordinator for the city of Bridgeport's needle exchange program.

But others are cautious with their optimism.

"We need to have some clear clinical documentation" before officials at The
Center, a drug treatment facility based in Bridgeport and Fairfield, will be
ready to cheer the vaccine, said director Sue Dalesandro.

"We heard the same kind of (claims) a couple of years ago," when acupuncture
was touted as a hot, new treatment for drug abusers," said Dalesandro.

"We reviewed that and found no proof," she added.

"Any (treatment) drug would be useful in cocaine relapse prevention," added
Dr. Steven Viani, vice president at Eagle Hill, a 56-bed substance abuse
treatment facility in Newtown.

The vaccine "would be useful in conjunction with traditional therapies,"
like counseling and the 12-step program made famous by Alcoholics Anonymous,
Viani said. "But the difficulty (in testing) is that if it changes the
effect of cocaine, the only way to know if it works is to try cocaine," said
Viani.

"And it has been our experience," he added, "that there's usually not just
one drug people use." The vaccine, for example, would not affect the two
drugs usually taken with cocaine -- alcohol or heroin.

Kosten is quick to agree the vaccine is not meant to be a panacea, and
stresses it will be an aide for people truly committed to forsaking cocaine.

Back at Daytop, Pasquale says he "had second thoughts (about) shooting
something unknown into my veins" when he was offered the chance to be a
vaccine test subject.

But the New Haven County resident he said he weighed that against how
addiction has affected his life. He started dealing marijuana at age 14,
encouraged by the sight of his parents doing the same. He tried cocaine not
long after finding his mother's stash of the white stuff in their home. He
began smoking crack cocaine at age 17.

"After that, I went right downhill, robbing, lying and stealing to get it,"
he explains.

And he was in jail when the baby girl he fathered was born.

"I wanted to be there," Pasquale says, an urgency in his eyes. "I want to be
there for her now, be a father."

Sam talks about growing up the son of a church official and a schoolteacher.
"I was brought up well," he assures.

Sam first tried smoking pot, and later snorted cocaine, as a high-schooler
"hanging out with friends."

It was "not that big of a step" when he sank to smoking crack cocaine, he added.

"My family didn't know," he said.

Sam lost both of his jobs after stealing from work sites to support his
habit. He lost his apartment for nonpayment of rent. Ultimately, he was
arrested for larceny and burglary.

"I let myself down. I let my family down. I turned into scum," Sam says.

"Hopefully," he says, "now I have the emotional growth and the vaccine to
handle it in the right way if someone offers me cocaine again."