The Editor’s Desk: March 3, 2008:

Addiction knows no social or geographic boundaries: what John Cheever called “The Sorrows of Gin” are democratic in their destructiveness. I know few people who have not been affected in some way by addiction—in the world where I grew up, the drug of choice was usually alcohol, with a large side of nicotine—and I suspect the same is true for many of you.

It has long been unfashionable to think of addiction as a failure of character or of willpower. More than 50 years ago, in 1956, the American Medical Association recognized addiction as a disease, and we now speak of it in the vernacular of treatment and therapy. But only recently have scientists started making progress in understanding, and possibly treating, the underlying biological factors. When we began hearing about new advances in the search for pharmaceutical solutions for common addictions, we were curious. If addiction is in fact a disease, then could it be treated in the way, say, diabetes is with insulin?

The hunt for vaccines is not a quest for a cure-all—addiction is a chronic disease; like the conflict in the Middle East, it is something that can only be managed, not solved—but there is important work underway that may produce some pharmaceutical weapons in the struggle against addiction. In an essay, Mitchell Rosenthal, who founded Phoenix House, the national drug and alcohol treatment and prevention organization, notes that vaccines could well help, but are not magic bullets. As in cases of depression, pharmaceuticals work best in combination with other kinds of therapies. A change of heart, of mind or of spirit can be critical in the treatment of addiction; biology surely shapes us, but need not totally control us.

History has been unkind to hopes for a medicinal solution to addiction: opium and cocaine were introduced to the United States as cures for alcoholism in the late 1800s. Still, the National Institute on Drug Abuse is developing or testing more than 200 compounds that block the intoxicating effects of drugs, including vaccines that train the body’s own immune system to bar them from the brain.