The "High" Inhibitor

At 14, "B." was smoking marijuana and "chipping" (occasionally taking) heroin. By 17, he was up to regular "snorting" (inhaling) and "skin popping" (taking heroin by nonintravenous injection). Cold-turkey withdrawals in jail did not work, and he seemed condemned to the hopeless life of a full-fledged drug addict. But last year a family-guidance counselor referred him to Leon Brill, an associate of Dr. Jerome H. Jaffe at the Albert Einstein College of Medicine in New York City. That may have been the first piece of good luck in B.'s unhappy life. Jaffe and Brill asked him to join a pilot study on a new drug that seems to have the remarkable effect of inhibiting the "high" induced by heroin and other morphine-based narcotics.

Breaking Behavior. Called cyclazocine, the drug had been tested by Dr. William P. Martin in the federal Ad diction Research Center at Lexington, Ky. There, 15 addicts taking oral doses of cyclazocine twice a day found that six times their usual narcotic dose was required to give them any euphoric effect at all. Cyclazocine, which is itself nonaddictive, apparently has no serious side effects after tolerance is built up, and substantially reduces the physiological impact of morphine-based narcotics, probably by preventing the morphine from reaching receptor sites in the nervous system.

The physiological need for narcotics, however, is only one of the many things that hook a user. The two other major contributors are the user's psychological makeup and his conditioned behavioral pattern--the strong likelihood that a return to old haunts and old friends will ease the post-addict back into old habits. Cyclazocine has no psychological effects, but Jaffe and Brill wondered if it were not possible to use it to help break behavioral patterns. They decided to try it on outpatients on the theory that when an addict's surroundings led him to take dope, he would get no lift and thus might break the habit of resorting to narcotics when confronting difficult situations.

Further Testing. Test groups were too small for the doctors to draw any certain conclusions, but Jaffe and Brill report encouraging results. In the first issue of The International Journal of the Addictions, they say that of eleven male volunteers, only one so far did not work out; he decided to try methadone, a heroin replacement that also impedes highs but is itself addictive (TIME, Sept. 3). Among the other ten, preliminary results show varying signs of success. Most have reported a lessening of narcotic craving and say that they have tried large doses of their old drug once or twice with little or no effect. Said one: "I was never so relieved in my life."

"We are fully aware," concluded Jaffe and Brill, "that our enthusiasm may be playing an even larger role than cyclazocine." Whether that enthusiasm is a necessary ingredient, and whether it can be transmitted to patients "more typical of the antisocial urban heroin user," is something that can only be learned with further testing.

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