Sola Ogundipe
6 January 2009
interview
Lagos — SHE is one of a kind. While her contemporaries in the scientific arena are more engaged in pursuing research into areas with potential commercial profit, she is primarily involved in breaking frontiers that would primarily be of social benefit to mankind.
Such is the mien of Nigerian physician Dr. Ajibike Salako- Akande, a primary health care physician and substance abuse rehabilitation specialist who recently patented a cost effective drug for substance abuse. The drug is Combamino (combined amino acid) is a revolutionary nutritional formulation reputed to have potential to emerge as cure for drug and substance abuse such as marijuana, cocaine and alcohol.
After she graduated from the University of Lagos 30 years ago, followed by a 20-year stint in the USA, working on addiction and rehabilitation and the healthcare process including mental health, Salako-Akande who's invention is currently undergoing further studies with the Food & Drug Administration (FDA) of America speaks about her invention and her exploits in research into drug addiction.
Excerpts:
Essence of the research
What prompted me was worry that Nigeria has too much curruption problem and that if we add addiction, our country would be wiped out of relevance,
also as a physician, I am trained to provide comfort for patients. When I see the way people react to addicts or cringe, it gave me the instance to contribute to humanity by providing comfort for them, and that is why I chose this.
I also noticed physicians were not interested in this field at that time and I felt that as a physician myself, if I understood the basis of the problem, I would be able to train others and makle a difference. Addiction is a multi-professional problem that we cannot leave it for the social worker alone. We all have a role to play.
In Nigeria , at least one in 10 people is affected by alcohol/drug addiction problems. The conventional method which is being used to treat substance abuse uses chemicals which are also addictive in its treatment such as valium and barbiturates, but this has not provided much success particularly in the area of relapse and harm reduction.
I was worried to see that people use drugs meant for anaesthesia. In medical school we learned that pethidine is an anaesthetic, also in this class of drugs is morphine, the opiates. People are strung on it and also get addicted to cocaine, marijuana and alcohol. So I decided to understand why people get addicted and cannot stop.
For almost 10 years when I was in Baltimore , Maryland in the US, I decided to learn as a physician how to take care of this problem. I first went for a Masters Degree in Rehabilitation Counseling and specialised in substance abuse and because I'm a physician, the State allowed me to be licenced to operate a general medical clinic and run mental health in a primary healthcare system.
Discovery
While I was treating these mentally ill patients, I found out that the medication they had been using such as valium and barbiturates were not working and they had severe withdrawal symptoms. The reason is because there are usually severe nutritional deficiencies associated with drug use, resulting in the disruption of the brain chemistry because the addictive chemicals cannot address these deficiencies.
So I decided to look for alternatives and for another seven years I was attending the National Institute of Health conferences on neuro-physiology and chemistry and other divisions and I was able to understand the problem of addiction and the brain and how people get addicted and how we can use the alternative methods to take care of addiction.
Science of addiction
Experience and follow-up also shows that when nutritional supplements are ingested, the brain uses them to produce neuro-transmitters that are needed
for basic body functions and emotional responses plus replenishing the chemicals that the brain lacks as a result of addictive drug use. Our study showed that the supplements can improve neural conduction in those subjects with severe addiction (particularly addiction to heroin or marijuana) and those who have lost their memory. The supplements also reduce the rate of return to treatment and improve both the nutritional and general well being of the addict. Once craving is dimiished and the individual is able to function, he or she is less socially disruptive and can become a productive citizen.
Patent
I have patented my formulation in Nigeria and also in the US and we are actually in the last leg of approval because once it has been published, it takes another year to give you the licence. The drug has been tried in the US and there have been observational studies in Nigeria and in Jamaica at the University of West Indies, we have done animal studies. We have to wait until these results are published. We are currently doing case studies in Nigeria at Yaba Psychiatric Hospital and it is showing positive results.
When you are working with nutritional supplements there is no need for too much research because since the 19th century, nutritional supplements have been used for various diseases and have been shown to be effective but it is because I want to contribute to science I am going through all this research. The next stage is that of clinical trials.
The formulation
Nutritional supplements are basic amino acids and vitamins. What I did was combine different amino acids. In understanding the chemistry of addiction, we know that there are different neuro-chemical compounds that create neurotransmitters for the brain to function.
There is acetylcholin, tyrosine, serotonin, etc, so since I understood that nutrients can be used to create a chemical, I just picked and used them in different doses, so I was now able to know the basic amount that was effective. I was able to pick what methods could be used to create a chemical and mix in different doses to treat patients.
After the initial treatment cycle, the individuals can find their own levels to the supplement. There is no fear of overdose because it is safe and even in the light of the high dose utilised, it is about one-third of the clinical amount one can be worried about.
What it does
The formulation is a multi-component programme involving the use of optimal nutritional products - amino acids, vitamins, minerals, and fish oils. The technique provides a combination of the amino acid caps, multi-vitamins, and fish oil that will replenish the brain chemistry that is lacking and make withdrawal and craving manageable even in an outpatient setting; hence making rehabilitation possible. It helps in cocaine treatment.
What I have done is to formulate dosage in three phases of treatment. I formulated for cocaine, and marijuana and blended them together and also for alcohol and for opiods. In Nigeria we have discovered that what the addicts use is codiene, this is the opiod aspect and people drink it so copiously that it gives them the high. I have not seen much of heroin use in Nigeria. So what I have done is to formulate a therapy for a group depending on the physiology. There are four main drugs of addiction that I formulated for. If it is a stimulant, opiate, marijuana or hallucinogen, the appropriate one can be picked.
Is it a cure?
It is God that cures, I cannot say I cure, but remembering other factors, we noticed that if we take care of other factors, over time, people stop their addiction. Addiction has two major problems which are short term and long term. The short term is the physiological response which is four months so the effect is immediate. The long term is another six months of lower dose of treatment.
Some improve within the first four weeks, others do so in the second phase of eight weeks, others still may have to continue. If you now have mental illness or other complication then that they may need to use it longer. But usually those that we have been treating now tend to improve in two months. We are still looking for the long term cure.
Cost
The drug is not free. I want to help Nigerians by bringing solution. Eventually once it is well known, we hope the drug will be free but not immediately. The drug is made in the US by two plants with who I have an understanding. The NDLEA has shown interest in the drug and is willing to work with me.
They advised the drug should continue to be made overseas becaude of the problem of faking here. The FDA has accepted my package and transferred me to the drug abuse office in America.
I am apperealing to the NAFDAC and government to consider that we are inventors. In the US, the FDA would not charge a cent because they know we are we have to partner with a pharmaceutical company. Also they have created what is known as an individual new drug owner. They do not charge you when you present your package, they first give you a pre registration number. With that, you can sell it and do research.
I'm glad that ther requirements in America and in Nigeria are similar except that we are charged heavily for registration here. I'm not saying it should be free, but what I'm asking is that NAFDAC should give a waiver or moratorium and also create this individual drug ownership so that one would not have to be a big organisation before you can help people.
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