Would you vaccinate against drug abuse?

January 31, 2008

Recruiting the body’s immune system in the fight against drug abuse is a hot topic. A recent piece highlights progress on cocaine vaccines:

The vaccine works by getting the body’s immune system to recognize the drug as foreign and attack it in the blood stream.
It does so by injecting an altered version of the drug into the body which has been attached to a protein that the body will recognize as a threat.

Doesn’t this sound great? Inoculation against drug abuse? Wouldn’t any parent of a pre-teen ask “Where do I sign my kid up?”

I’ll plan to get into the science of the “vaccine for drug abuse” in later posts because today I want to touch on the ethical implications a bit. Nevertheless, we need to understand a little bit about the mechanism of action.
Most readers will have a passing acquaintance with the way the body’s immune systems work and what typical vaccination against disease is doing. In very brief overview, your immune system learns to recognize foreign and potentially harmful proteins floating around your bloodstream or within your tissues. Typically, said proteins are integral parts hanging off the exteriors of nasty microbes such as bacteria and viruses. Once it recognizes nasty bits, your immune systems can then mount a series of strategies to attack these foreign nasties, degrade them to harmless components and excrete the whole mess.
This process is, most assuredly, a battle. One in which there can be winners, losers and occasionally detente, truces and/or standoffs. Oftimes the outcome is dictated by speed and strength wherein the immune system that can respond more quickly and forcefully than the microbe can gain a foothold in your body wins the day. The trick of vaccination is that your immune systems have a tendency to respond more quickly and forcefully the second (or third or fourth) time they’ve seen a given nasty compared with the first time. So if you are exposed to an artificially crippled version of the nasty, that still contains the appropriate proteins for immune “recognition”, you can avoid the dicey outcome of the first-exposure to that particular bug and skip right to a powered-up and prepared state.
So why don’t you get an immune reaction to cocaine, methamphetamine, heroin and other “foreign” drugs? Because they are too small for your immune system to recognize under “normal” circumstances. So scientists have taken to linking drug molecules, such as cocaine, nicotine or methamphetamine, to molecules that will engender an immune response. Then, after immunization with these tandem molecules, the immune system is able to recognize the drug molecule alone. So when an immunized person takes cocaine, for example:

“The vaccine slowly decreases the amount of cocaine that reaches the brain,” said Thomas Kosten, a professor of psychiatry and neuroscience at Baylor College of Medicine in Houston, who has been working on the vaccine since 1995.

Okay, now we get to the fun part. (Apart from busting Kosten’s chops for saying it is the “vaccine” that does the work. It is the immune system, not the vaccine itself.) How would you countenance use of anti-recreational drug immunizations?
Would you recommend it broad-spectrum for all children much like MMR?
Would you recommend parents be permitted to subject their drug abusing teen against his or her will?
Allow the courts to mandate inoculation?
Suppose it were made a condition of employment?

13 Responses to “Would you vaccinate against drug abuse?”

  1. Dunc Says:

    But aren’t a lot of “abused” drugs simply homologues of existing neurotransmitters and the like? So wouldn’t this sort of treatment risk making you allergic (or worse) to your own neurochemistry?
    Personally, I’m of the opinion that there is nothing intrinsically wrong with the use of recreational drugs, so the whole question is very iffy. If people suffering from addiction or other problematic usage patterns want it as a treatment, fine. Otherwise, no. The sooner I can have my Culture-style genofixed drug-glands, the better.


  2. Dave Briggs Says:

    Would you recommend it broad-spectrum for all children much like MMR?
    Would you recommend parents be permitted to subject their drug abusing teen against his or her will?
    Allow the courts to mandate inoculation?
    Suppose it were made a condition of employment?
    An interesting topic for sure! If you are going in further it seems likely there will be a lot of pragmatism and ethics. I look forward to what you and everyone else has to say! Personally I see this as another breakthrough that is going to see mixed revue.
    Dave Briggs :~)


  3. writerdd Says:

    Is all drug “use” to be considered “abuse”? I think this is an incredibly intrusive idea and a dumb one to boot.


  4. speedwell Says:

    If the body is fighting a drug “infection,” is it less able to devote its resources to fighting bacterial and viral infections?


  5. hibob Says:

    1. The vaccine effectively increases tolerance for drugs, so that users have to take more to get the same effect. Does this sound risky to anyone else? If an addict’s usually high immune response to a drug drops one day and they don’t compensate with a lower dose wouldn’t they overdose? Remember to run an ELISA and calculate your titer before you shoot up.
    2.Drugs that are snorted, like cocaine, often go directly from the nasal passages to the brain, skipping the circulatory system for the most part. Antibodies on the other hand can’t cross the blood brain barrier, and are excluded from the brain. Won’t most of the cocaine be hitting receptors in the brain well before antibodies have a crack at it?


  6. phisrow Says:

    I would be very, very, reluctant to see such a vaccine used in any situation other than a voluntary treatment program(Minors are a slightly tricky issue. Children are incapable of making independent decisions due to age in many cases; but I imagine that drug use is largely confined to the mid and late teens who ought to be able to make decisions, particularly in the case of a treatment that will have a longterm effect.)
    Now I have no doubt that we’ll start to see: “But the only reason you would oppose the vaccine is if you were going to use illegal drugs!” style arguments popping up with unpleasant frequency; and, while your employer might not require the vaccine they may well advise you that one injection is just a whole lot easier than weekly drug tests.
    I would also hope that due caution is being exercised around the possibility of unintentional reduction in efficacy of anesthetics(or worse endorphins and similar). I assume that the scientists working on this one have probably thought of that well before I, the random internet commentator, did; but it does leap immediately to mind as a potential issue.


  7. 1) Pardon me, but inhaled cocaine must pass through the bloodstream to get to the brain. Cocaine is highly permeable to the blood/brain barrier. However, intranasal application (see here for more information) results in slower arrival at the brain, so in fact it would spend more time in the bloodstream.
    2) I would imagine that in effect this would be unusable for narcotics of most sorts- if one is ever in a situation to be given morphine, well, that could end badly.
    Plus, that whole personal-freedom thing… drug use is not communicable in the same way as measles, so I can’t see how it can be the same magnitude of public health concern.


  8. hibob Says:

    Jenny F. Scientist: pardoned, but inhaled cocaine is absorbed through the lungs and then the blood. A fraction of intranasal cocaine (and other intranasally applied drugs) goes straight from the nasal mucosa to CSF without ever touching the blood stream. Pharma research has been chasing this idea for quite a while.
    It turns out there’s an answer to my question: creating the immune response in the nasal mucosa.
    “Induction of Protective and Specific Antibodies against Cocaine by Intranasal Immunisation Using a Glyceride Adjuvant”.


  9. pelio Says:

    Could this cause an increase in cocaine use?
    If people could use cocaine without the slippery slope of addiction would more people try the drug? In other words, if there is an easy ‘cure’ for a cocaine problem there is much less incentive to avoid developing one.
    Neat biology, neat treatment option, but definitely not a good idea for broad public vaccination – thats my opinion.


  10. lydia Says:

    I believe that some of the most serious societal problems of drug abuse stem from people committing robbery/theft to get the money to buy a fix. If this vaccine increases the amount one needs to get high, won’t this just encourage addicts to steal more to buy more drug?


  11. pissed wife Says:

    my husband is a junkie ,crack head, pill snorter shooter eater would eat shit if it wouldget him high we have three children he needs to grow up if i could give it to him while he was a sleep i would need help i should leave but just wont i know im the idiot for putting up with this but cant find the strength to leave


  12. Anonymous Says:

    nobody even visits this sight can it work i am very much like the above my husband is a addict and would also eat shit if it got him high nobody matters kids me rest of family only where the next drug is i would


  13. DrugMonkey Says:

    nobody even visits this sight
    Well, this is a blog and this particular entry was written some time ago. We do not focus entirely on drug abuse issues by any means and only occasionally on treatment-related things. There are many, many resources out there which may be of greater use to you in figuring out how to deal with an addicted family member.
    I would suggest you start looking at your local county pages for health and human services or similar. Should be online or at the least in the telephone directory. There will almost certainly be resources you can contact which can help you start figuring out your next steps. Whether that be leaving a spouse or getting him/her into some sort of treatment, your local resources are the best.


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