"Free yourself from cocaine": Inside Penn's Addiction Treatment Research Center

Maybe you’ve seen the sign on the El or BSL. Posted on the walls of various trains, it offers addicts the opportunity to “free yourself from cocaine,” and contains a phone number and the insignia of Penn’s Perelman School of Medicine.

Though the sign looks like something out of a ’90s Viagra commercial, the phone number ultimately leads to a place internationally renowned for discovering new ways to help drug addicts: The Charles O’Brien Addiction Treatment Research Center. This particular study aims to stop cocaine addiction with a treatment that sounds like a bit of a contradiction, using an oft-abused prescription drug, Adderall, and another pill prescribed for weight loss to stop people from abusing cocaine.

Dr. Kyle Kampman is running the study. His work on this particular study traces back more than a decade. His colleague at the Treatment Research Center, Anna Rose Childress, researched the effects of a drug called Baclofen on cocaine addicts in animal studies. Kampman thought of other similar drugs and came up with Topiramate. It’s generally used to treat seizures, migraines and has also been marketed as a weight-loss drug because it suppresses appetite.

“We want them not to get high,” Kampman said. “If you’re on Topiramate and do cocaine you wouldn’t feel it as much.”

He tested the Topiramate with success in a limited study and then researchers at Columbia did the same, adding another wrinkle: Adderall. The drug prescribed for Attention Deficit Disorder (and often abused by college students pulling all-nighters) worked in combination with the Topiramate. Now Kampman and Columbia are joining together to try and replicate the study.

Patients — about 40 right now at Penn, mostly middle-aged men — take Topiramate twice a day and Adderall once a day (they visit the clinic three times a week for therapy, counseling and testing, too). Kampman and the Columbia researchers believe it works because the Topiramate dulls the high and the Adderall, in addition to also dulling the high, can relieve withdrawal symptoms. Its repeated success would be a huge deal. Right now there are no medications for cocaine addiction approved by the FDA.

At the Center, doctors like Kampman with backgrounds in psychiatry, psychology, social work and various medical fields have been treating addicts since 1990. Whereas most treatments for people addicted to drugs focus on counseling and therapy, they work to introduce medicinal treatment, like the current study using Adderall. The Center’s goal? Treat and counsel patients — who often come because they lack insurance or because traditional treatments failed them — and come up with new ways to battle addiction. If the Center’s researchers can replicate success often enough for large enough groups, they could earn FDA approval or at least widespread recognition from doctors so their treatments could get used on a national level.

Even if you live near Penn, you probably haven’t noticed the Treatment Research Center. It is part of the 3900 Chestnut Building that includes a credit union, apartments and the now-closed Drinker’s West. Ironically, the Treatment Research Center is used to be atop a bar and is still across the street from a Cavanaugh’s and near a bar called Blarney West (the Center plans on moving to 3535 Market, where there are no nearby bars, in the future). But its relative anonymity in Philadelphia is belied by its reputation in medical circles. O’Brien, the founder, has won numerous international awards for his work in treating addiction. He was the first person to try treating alcoholism with a drug called Naltrexone, which had mainly been used for heroin addiction. O’Brien was successful. The FDA approved the treatment in 1992, and it is now one of the most widely-used treatments for alcoholics.

For the cocaine study, the researchers at Columbia and Penn want to test the treatment on about 100 more patients within the next year or two. If it’s successful, Kampman isn’t exactly sure what their next step will be. Going from an advertisement on the El to FDA approved isn’t easy, even for successful studies. Groundbreaking discoveries like O’Brien’s in the early 90s are the exception and getting help from drug companies for this particular treatment would be unlikely, Kampman said, because the drugs being used are already generic and wouldn’t be moneymakers.

Another goal would be the study getting enough recognition so doctors become aware of the treatment and start encouraging patients to follow it.

“We want these treatments to get out and get used,” Kampman said.