Academic Exchange Describe
your research that may help addicted people resist craving.
Michael Kuhar In the late 1980s, my group identified
a cocaine receptor in the brain. A drug receptor is the molecular
site where a drug interacts to produce an effect. Its like
a button that the drug pushes. I started working with chemists,
in particular Ivy Carroll at the Research Triangle Institute. He
makes cocaine analogues, and I test them. We have produced and characterized
about five hundred analogues.
are substances like cocaine?
like cocaine but also different. Thats key. The idea is to
give a chemical analogue to someone with reduced controlan
addictto reduce craving. These analogues get into the brain
slowly and leave the brain slowly. Most substances with a high abuse
liability get in and out of the brain quickly. The pharmacokinetics
are different. Since the analogues are more selective and potent,
they are less toxic. Theyre more like medications.
The idea is someone coming to treatment could be given something
that would reduce out-of-control behavior. Unless an addict can
get some control, she is just going to become demoralized and relapse.
Would users always need to take the analogue, as heroin addicts
dont know. Its possible that some people may need to
take it for a long time. Our intention is to use the analogue as
a first-stage treatment to let the physician get control over the
patient to make further treatment possible. The addict would have
to come to the physician, as opposed to the drug dealer, to get
the cocaine analogue. Since hes not going to the drug dealer
that cuts out a whole host of illegal behaviors.
Do the cocaine analogues cause a high?
never been given to people, so we have no idea. Theyre still
in development. We formed a company, Addiction Therapies, Incorporated,
develop these compounds for use in humans.
would you say to critics who might charge that this is just substituting
a drug for a drug?
that so terrible if youre giving people their lives back?
Drugsmedicationsare used to treat many things. The evidence
is very clear that people who are on methadone for a long time have
improved lives. The lives of people around them are better; the
community functions better.
That question also assumes that there is something wrong with chronic
medication. But people take lipid-lowering drugs chronically. Mentally
ill people take drugs like lithium and antidepressants for long
Its time to realize that treating addicts is not a bad thing.
Certainly, from an economic point of view, treatment is much better
than incarceration or trying to interdict drugs coming across the
borders, although that has its place, as well.
One of the most important developments in drug addiction in the
last fifteen years is the realization of many that this is a disordered
state worthy of treatment.
Did addicts do something wrong,
take a wrong step, do something self-destructive? Yes. You cannot
absolve people of personal responsibility. They decided to take
a drug and repeat it. Then they reached a point where they had less
We need to ask if this is any different from people who refuse to
control their weight and have diabetes or refuse to change their
diet and sedentary lifestyle and suffer heart disease. Of course,
there is the added problem that drugs are illegal. All this just
shows that addiction, just like heart disease or any other complex
disease, requires many different kinds of medication, treatments,
and interventions. Theres not going to be a single, magic
obligation do you feel to see that your work reaches public policy
MK We are in an area where our work can and should affect policy.
And it can and should affect peoples attitudes about each
other. A lot of the things that are done and said about addiction
and addicts are not science-based. Theyre just not based on
facts. And the public has a right to know, particularly since many
diseases such as cancer and mental illness may carry a stigma. Fortunately,
that is lessening.
I think you can do a lot in the lab, but people live in their skin,
and thats where they hurt. Thats where they are wounded
and feel the judgments. Thats where we try to help in the
lab and elsewhere.
specializes in neuro-anatomy and molecular biology.