CalixCoca

Blog Credit: Trupti Thakur

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CalixCoca- A Brazilian Vaccine

Scientists in Brazil have developed a groundbreaking treatment for cocaine and crack addiction in the form of a vaccine named “Calixcoca.” This innovative vaccine aims to disrupt the effects of cocaine by triggering an immune response in the body, preventing the drug from reaching the brain and providing the pleasurable “high” associated with its use.

How Calixcoca Works

Calixcoca functions by inducing an immune response that generates antibodies capable of binding to cocaine molecules in the bloodstream. This binding process results in the enlargement of cocaine molecules, rendering them too large to pass into the brain’s “reward center” or mesolimbic system. This area of the brain is typically stimulated by cocaine to release dopamine, the pleasure-inducing neurotransmitter. Consequently, individuals who receive the vaccine will not experience the desired euphoric effects of cocaine, potentially assisting them in breaking the cycle of addiction.

Promising Animal Testing Results

The vaccine has undergone successful testing on animals, demonstrating the production of significant levels of antibodies against cocaine. Minimal side effects were observed during these trials, and notably, the vaccine provided protection to rat fetuses against the harmful effects of cocaine. This protective aspect could have significant implications for pregnant addicts and their unborn children.

Transition to Human Trials

Following encouraging results in animal trials, Calixcoca is poised to enter the next phase of development, which involves human trials. This critical step will assess the vaccine’s safety and efficacy in a human population.

Historical Context of Cocaine Addiction Treatment

While the development of a cocaine vaccine may seem novel, similar research efforts were conducted in the United States, the world’s leading consumer of cocaine, as per the United Nations Office on Drugs and Crime. However, these studies faced setbacks when clinical trials failed to yield sufficient results.

Complementary Treatment for Recovering Addicts

The vaccine is not intended as a standalone solution. Instead, it is envisioned as a supplementary treatment alongside existing approaches such as psychological counseling, social assistance, and rehabilitation. Calixcoca is designed for recovering addicts who have already discontinued cocaine use and seek assistance in maintaining their sobriety.

More about it

Scientists in Brazil, the world’s second-biggest consumer of cocaine, have announced the development of an innovative new treatment for addiction to the drug and its powerful derivative crack: a vaccine.

Dubbed “Calixcoca,” the test vaccine, which has shown promising results in trials on animals, triggers an immune response that blocks cocaine and crack from reaching the brain, which researchers hope will help users break the cycle of addiction.

Put simply, addicts would no longer get high from the drug.

If the treatment gets regulatory approval, it would be the first time cocaine addiction is treated using a vaccine, said psychiatrist Frederico Garcia, coordinator of the team that developed the treatment at the Federal University of Minas Gerais.

The project won top prize last week — 500,000 euros ($530,000) — at the Euro Health Innovation awards for Latin American medicine, sponsored by pharmaceutical firm Europharma.

The vaccine works by triggering patients’ immune systems to produce antibodies that bind to cocaine molecules in the bloodstream, making them too large to pass into the brain’s mesolimbic system, or “reward center,” where the drug normally stimulates high levels of pleasure-inducing dopamine.

Similar studies have been carried out in the United States — the world’s top cocaine consumer, according to the United Nations Office on Drugs and Crime. But they stalled when clinical trials did not demonstrate sufficient results, among other reasons, Garcia says.

CalixCoca has so far proven effective in testing on animals, producing significant levels of antibodies against cocaine and few side effects.

It also protected rat fetuses against cocaine, researchers found, suggesting it could be used in humans to protect the unborn babies of pregnant addicts.

The vaccine is now set to enter the final stage of trials: testing on humans.

Garcia says CalixCoca could reshape addiction treatment.

“There’s no specific registered treatment for cocaine and crack addiction. We currently use a combination of psychological counseling, social assistance and rehabilitation, when necessary,” he says.

Calixcoca could add an important tool to that regimen, helping patients at critical stages of recovery, such as when they leave rehab, he says.

The vaccine is made with chemical compounds designed in the lab, rather than biological ingredients, meaning it would be less expensive to produce than many vaccines and would not have to be stored at cold temperatures.

But it won’t be a “panacea” that can be administered to anyone, Garcia says.

The exact target group will depend on the outcome of clinical trials, but is theoretically meant to be recovering addicts “who are off (cocaine) and want to stay that way,” he says.

The goal is to change what Garcia calls a “sad statistic”: according to the US National Institute on Drug Abuse, one in four regular cocaine users becomes addicted.

And just one in four addicts manages to quit after five years of treatment.

Given the stakes, anticipation around the vaccine is high. More than 3,000 people have contacted Garcia’s team to volunteer to take part in the clinical trials.

Practical issues

Speaking with researchers and organisations on the ground in Brazil, there are multiple concerns about how a crack/cocaine vaccine would be used.

TalkingDrugs and Youth RISE spoke to the Community Centre, an organisation that houses and advocates for people who use drugs, as well as distributes harm reduction materials in São Paulo. Their Research Coordinator, Karin di Monteiro, did not seem surprised by the news, saying that it’s common to hear about such vaccines being proposed.

“A vaccine is a technology for epidemics, but in this case, it is a matter of behavioural control. It would be a ‘treatment’ that controls, or aims to control, the behaviour of a person or a certain group of people in society”, she said.

It’s still unclear how the vaccine would work on humans and how it would be used by the public health system. “[Calixcoca] isn’t clear in its effects and dosage: a person in treatment would have to re-dose the vaccine every two months.”, said Monteiro.

The vaccine’s blocking effect also means that abstinence would be the only model of cocaine recovery. “There are, in practice, many ethical implications. The lack of debate about how people use substances, who they are and how they would react to the introduction of such a technology are important issues to understand when talking about a vaccine,” she added.

“A vaccine is a technology for epidemics, but in this case, it is a matter of behavioural control. It would be a ‘treatment’ that controls, or aims to control, the behaviour of a person or a certain group of people in society”

Karin di Monteiro, CC é de Lei

It is also unclear what would happen in the case of relapse for those vaccinated with calixcoca. People could still consume large amounts of cocaine or crack to feel its psychoactive effects again.

“A drug cannot simply be neutralised; you’re just strengthening the blood-brain barrier. The drug is still acting within your body and may cause other non-psychoactive effects on other parts, such as your digestive or cardiovascular system.” While the vaccine would block the psychoactive effects of the drug, side-effects, such as cardiac arrests or blood pressure increases, may still occur, even if you’re not feeling high.

What the calixcoca development project seemed to miss is the potential displacement of drug use: people may simply use other non-cocaine-based stimulants, like methamphetamine or MDMA, to simulate the intended psychoactive effects.

“Either you develop a vaccine for all stimulants, or this technology will not work in practice,” Monteiro commented.

A weapon of social control

There are serious concerns with pathologizing problematic crack use and implementing a technology-led health approach to respond to a phenomenon that is very much a societal failure. “I’m left thinking about how this vaccine could be used as a weapon of social control. Will people have to use it if they’re in treatment?” asked Felipe Neis Araujo, Lecturer at the Criminology Department at the University of Manchester.

There were already some egregious incidents of human rights abuses of people who use drugs, done in the name of health. In 2018, a woman experiencing homelessness and drug addiction in Mococa, a small city in São Paulo state, was forcefully sterilised after receiving a sentence for drug possession.

“The Government of São Paulo promotes the idea of crack and cocaine as a pathology to be ‘cured’ with a vaccine when we know that when people are using drugs problematically, they’re using them for several social and psychological issues – things that a vaccine won’t cure,” Araujo added.

“What if this vaccine is used by ‘therapeutic communities’, which are highly problematic organisations… how will we know they will use the vaccine ethically if they choose to adopt it?” Araujo said.

Faith-based rehabilitation clinics have long been used in Brazil to “treat” drug dependency, often punishing people through forced labour or physical assault. Drug treatment centres are fuelled by Bolsonaro-era policies which facilitated the forced internment of people who use drugs and funnelled significant amounts of drug treatment funds to these evangelical and Christian institutions.

The vaccine’s support from São Paulo’s Health Secretary comes at a time when the city’s administration has systematically dismantled local harm reduction resources that provided more holistic responses to the health needs of people using drugs problematically. Calixcoca would address the surface issue of drug use but not impact the conditions that lead to problematic drug use, such as the lack of housing, community support or psychological care.

To Araujo, São Paulo’s vaccine funding announcement is an attempt to veil the city’s current criminal justice approach to drug use as a health intervention. “If a health approach is really intended, why doesn’t the government support harm reduction organisations that have experience working with these target populations?”.

“It would not be at all unrealistic for me to predict a scenario in which people who are charged with drug possession are given two options – either you are going to get the vaccine treatment, or you are going to be framed and arrested. Ultimately, there is the risk that the vaccine becomes a legal weapon, another form of violence against people’s freedom and sovereignty,” said Araujo.

“The Government of São Paulo promotes the idea of crack and cocaine as a pathology to be ‘cured’ with a vaccine when we know that when people are using drugs problematically, they’re using them for several social and psychological issues – things that a vaccine won’t cure.”

 

 

 

Blog By: Trupti Thakur