Curing Drug Abuse: Are Vaccines the Answer?
The use of vaccines to treat infectious disease in humans has a long beneficial history. Evidence exists that certain cultures used primitive forms of inoculation as early as 1000 CE. Contemporary forms of vaccination have been used for more than two hundred years, ever since Edward Jenner developed the smallpox vaccine in 1796.
Research in the modern era involves innovative techniques, including DNA technology and improved delivery methods, that are taking scientists in new directions. The targets for vaccines have also expanded, with some research beginning to focus on non-infectious conditions such as allergies and addiction.
Are Anti-Addiction Vaccines Possible?
The precise causes of addiction are varied and complex, involving both psychological and physical components, but it is a chronic disease involving brain reward, motivation, memory and related circuitry.
When someone repeatedly abuses a substance, dysfunction occurs in these brain circuits. This leads to biological, psychological and social manifestations. Once addicted, a person develops a pathology that involves pursuing reward and/or relief through continued substance use and other behaviors.
The medical rationale for anti-addiction vaccines is similar to ordinary vaccines, in that it seeks to inoculate someone from being affected by external factors (i.e. disease or drugs). Anti-addiction vaccinations would use special antibody serums as a treatment to reduce drug levels in the brain and to bind the drug before it enters the brain. This would make the drug ineffective in those who had been immunized, thus removing the reward and craving from taking the drug.
Other anti-addiction vaccination methods involve passive immunotherapy, which target the drugs themselves, rather than the drug’s site of action in the brain. The antibodies used with this approach can be used to treat drug overdose, reduce drug use relapse or protect certain at-risk populations.
Are Anti-Addiction Vaccines Currently Available?
At this time, the FDA has not approved any anti-addiction vaccines for human use. However, there are currently numerous vaccines under clinical trial and more are undergoing pre-clinical research evaluation.
A cocaine vaccine has undergone a successful placebo-controlled clinical trial and is currently being evaluated in an ongoing clinical trial. Based on the success of this vaccine in earlier trials, it shows promise to be one of the first anti-addiction vaccines approved by the FDA.
Smoking is acknowledged as a worldwide healthcare problem, causing more than five million tobacco-related deaths each year. This fact, combined with the substantial market for smoking cessation products, has produced much interest in anti-nicotine addiction vaccines. Three pharmaceutical companies have moved forward with developing nicotine vaccines, which are undergoing human studies.
The battle against opioid abuse is also at the forefront of anti-addiction vaccine development. Molecular Express, a small biotech company, is working on a promising solution that would inoculate against heroin. They are raising funding for clinical trials and hope to start tests in humans in the next two years.
What Does the Future Hold?
Technology and research will continue to make advances in the development, manufacturing and delivery systems that will improve future anti-addiction vaccines. But even if scientists developed an FDA-approved vaccine, it likely wouldn’t be a cure-all solution for addiction.
Individual variables and complex factors contributing to addiction make it unreasonable to expect that a vaccine would work for all patients. For example, vaccines would likely require booster shots over a period of time. Or, individuals could access different drugs for which they weren’t vaccinated.
Economics could also be a serious obstacle if the cost of such vaccines were prohibitive. Even social acceptance may play a role in the widespread use of anti-addiction vaccination. If families or recovery program staff view addictions as moral problems, they may have values that oppose medical solutions to addictive diseases.
Anti-addiction vaccines do hold promise and may become powerful tools for prevention of and recovery from addiction. Ultimately, however, even a highly effective vaccine would still need to be paired with behavioral therapy to adequately treat the psychological aspects of addiction.