Novel treatments are desperately needed to treat substance abuse disorders (SAD), Kurt Rasmussen, director, division of therapeutics and medical consequences at the National Institute on Drug Abuse, said as he opened BIO 2020’s on-demand session, “Disruptive Thinking About Addiction Management.”
The session discussed three “out-of-the-box” innovations that apply to multiple types of addictions.
1. Mind Medicine has developed a non-hallucinogenic analog of the psychedelic drug ibogaine that targets opioid addiction and withdrawal without negative cardiac effects of the original compound. In proof of concept work, the drug appeared to confer a durable effect after a single dose. The drug, 18-MC, is in early trials. “We’re expecting the first patient clinical trials later this year in opioid abuse,” Stephen Hurst, co-founder, executive chairman and co-CEO Fahad Tamimi, said.
“18-MC works by regulating dopamine in the reward/pleasure centers of the mid-brain,” he explained. Dopamine drives the cravings and changes associated with the neuroplasticity phenomenon in the brain, which drives the desire for the pleasurable substance a person has been using. Eventually, the dysregulation doesn’t reset itself and the patient needs help.”
The most common medical approaches to treating addition, in contrast, are substitution therapies, Hurst said, in which a substance with a low health liability is substituted for one with a greater liability. Replacing a nicotine patch for tobacco is an example.
“This mechanism is common to all kinds of addictive and repetitive behavior,” he continued. “We have data on opioids, nicotine, alcohol, stimulants such as cocaine and meth-amphetamine, and compulsive eating disorders.” In what Hurst calls the “fat rat model,” administration of 18-MC caused the rats to favor a normal diet rather than one high in sucrose or fat. This offers a new approach to eating disorders and other additions.
Mind Medicine’s other programs investigate psychedelic compounds that have anecdotal data regarding anti-addictive effects.
In addition to novel therapeutics exploiting new pathways, addiction counselors also need ways to identify drug-to drug interactions, especially as a growing segment of their patients with substance abuse disorders are elderly with co-morbidities.
2. The Human-on-a-Chip system developed by Hesperos, Inc. models an overdose in a multi-organ system, testing drug efficacy of drugs and…