Two Baylor College of Medicine scientists have developed a cocaine vaccine. It creates antibodies that attach themselves to the drug, and keep it from going to the brain. If cocaine does not go to the brain, it will not produce a high. If the vaccine makes it through regulatory hurdles, it would become the first drug approved to treat cocaine addiction.

The Baylor College of Medicine scientists have developed a cocaine vaccine, currently in clinical trials, that stimulates the immune system to attack the real thing when it's taken. As a result, cocaine no longer provides a kick."

Approval would mark a breakthrough in the treatment of cocaine addiction, which now mostly involves psychiatric counseling and 12-step programs. Over the years, Kosten notes, more than 50 pharmaceutical options have been investigated and found wanting.

The vaccine also could raise interesting ethical questions involving who should get inoculated and what happens if confidential information about those receiving it becomes known. Although developed for therapeutic purposes — the number of cocaine addicts in this country is estimated at more than 2 million — the vaccine eventually is expected to be used for prevention, as well.

The questions include whether parents would be allowed to have their children inoculated; whether it would amount to coercion to make it a condition for lighter criminal sentences; whether employers might happen upon such information and use it discriminatorily; and whether to use it on pregnant addicts to protect the fetuses.

The questions don't just reverberate about this vaccine: Tom Kosten also is at work on vaccines for methamphetamine, heroin and nicotine. Two other nicotine vaccines are being investigated by other scientists.

"It's a very clever idea," says David Eagleman, a Baylor neuroscientist. "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."

"Anti-drug vaccines may provide an important weapon against addiction," said Frank Vocci, director of treatment research and development at the National Institute of Drug Abuse, which funded much of the research. "We're starting to see progress. We just need to see more."

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