Drug De Addiction: New Approach To Curb
Drug Seeking Behaviour
Breakthrough study shows that cocaine craving can be successfully reduced for effective de-addiction
Researchers have neutralized a protein molecule called granulocyte-colony stimulating factor stimulating factor (G-CSF) that is commonly seen among cocaine users (both new and repeat users) in their blood and brain. This protein is responsible for affecting the reward centres of the brain and thus neutralizing this protein or “turning it off” would reduce the craving among cocaine addicts. The study published in Nature Communications has been conducted on mice and is being suggested by medical professionals as the first step towards a potential medication to help people beat cocaine addiction.
The highly addictive cocaine
Cocaine is a very lethal drug and can cause serious health effects or even sudden death and it’s also the second most trafficked illegal drug in the world. Worldwide, around 15 - 19.3 million people (equivalent to 0.3% to 0.4% of the total population) use cocaine at least once in a year. Cocaine is highly addictive as it’s a powerful stimulant, and usually drug tolerance can form in just a few doses, with a rapid eventual drug dependence. Thus, cocaine creates a psychological dependence and affects the brain. Addiction to cocaine leads to long term damages to a person’s health including one’s physical, mental and emotional wellbeing. The young population (under 25 years of age) is the most vulnerable to cocaine because it causes temporary stimulation and euphoria and this age generally has higher propensity for addiction.
Cocaine drug addiction is a complex disease which involves not only changes in the brain of the user but also enormous changes in a wide range of social, familial, and other environmental factors. Thus, treatment of cocaine addiction is also complex as it must address all these changes alongside other co-occurring mental disorders that then require additional behavioural or medicinal interventions. The traditional approaches to treat cocaine deaddiction or seeking behaviour, generally include psychotherapy and “no medication-assisted therapy”. The ‘12-step programmes’ traditionally involve encouraging physiological principles such as courage, honesty and compassion and also psychotherapy done parallelly.However, most of such psychotherapy and behavioural interventions are subject to high failure rates and also increased occurrences of relapse. This study led by Dr. Drew Kiraly at Icahn School of Medicine at Mount Sinai, USA has been termed as “exciting” and “novel” because this is really the first time an alternative to regular de-addiction programs has been described. It’s a big step in a new direction to control and erase cocaine addiction in patients.
A novel approach to cocaine de addiction
The G-CSF protein is seen capable of producing a positive signal at the reward centres of the brain. Thus, the researchers expectedly found that when they directly injected this protein into the mice’s brain’s reward centres (called the “nucleus acumbens”), there was a significant increase in the cocaine seeking behaviour and also the overall cocaine consumption among the mice and they were seen to be basically craving. It is clear that targeting or neutralizing G-CSF can be a safe, alternative approach to curb this addiction. Interestingly, safe and tested treatments are already available for neutralizing G-CSF. These drugs are being routinely used to stimulate the production of white blood cells (infection fighting cells) after chemotherapy during treatment of cancer since chemotherapy typically suppresses the white blood cells. When these drugs were administered to neutralize the G-CSF, mice then lost all motivation and desire to seek out cocaine! Just like that this was a huge turnaround. Also, no other behaviour of the animal was altered in this process, whereas several clinical trials before have reflected unnecessary abuse potential of any kind of medication which has been tried for de addiction. This was a crucial find for researchers to be able to address cocaine addiction through these already tested and FDA approved drugs.
But is it feasible?
The authors point out that starting to use any kind of new medication is always laden with challenges which include possible side effects, routes of delivery, safety, feasibility and also the abuse potential. The authors insist that once more clarity is available in understanding how this protein can be best targeted to reduce addictive behaviour, higher possibilities of translating the results to trials with human participants will occur. Also, this has generated hope that for similar therapies that’s could be applied to other drugs as well like heroin, opium which are cheaper (in comparison to cocaine) and available to a larger population in middle income and low-income countries and are also illegally trafficked. Since most drugs have similar effects and target the overlapping regions of the brain, this therapy could be successful for them as well. Though at the time of publishing this study, the possible timeline for human trials is unclear, nevertheless, there are standard methods to overcome many of these challenges and this certainly is a potential new area of medications for de-addiction and could soon become a “reality”. This breakthrough study inches scientists a little closer to the finding the ultimate cure for cocaine (and similarly other drugs) addiction in humans without implicating any other behavioural changes or any side risks of developing other addiction.
Calipari, ES. et al. 2018, ‘Granulocyte-colony stimulating factor controls neural and behavioural plasticity in response to cocaine’, Nature Communications, vol. 9, DOI: https://doi.org/10.1038/s41467-017-01881-x