22 May Vaccines Against Drug Abuse: A Viable Treatment Option?
The idea of vaccinating against drug abuse is hailed by many to be the future of addiction treatment, but the concept has several downsides that may hold it back. The idea is simple: a vaccination would prevent the drug from having an effect if taken, which would therefore render taking drugs pretty much useless. It obviously has a huge potential benefit for removing the appeal of commonly-abused drugs, but critics point out that it could never become the sole treatment for addiction. Understanding the mechanism of the vaccines that have been developed and their limitations helps you see how they will fit into the future of addiction treatment.
How They Work
There are basically two approaches to vaccinating against drug abuse. The first has been tested on cocaine and works in the same way as an ordinary vaccine. Cocaine molecules are combined with an inactive portion of cholera, and when injected into the body, the substance is recognized by the immune system as a potential threat. This prompts it to create antibodies, the effects of which also extend to cocaine. This means that whenever the individual takes cocaine in the future, the body will fight it as if it were an infection, eliminating the substance before it reaches the brain.
The second method also works through antibodies, but stimulates the creation of them more directly through an interaction with the liver. The vaccine involves injecting a gene into the patient’s liver, which basically contains instructions for building an antibody. This approach has been successfully tested in mice and monkeys. The net result is the same as the first method, but it doesn’t involve any illicit substances.
A “Magic Bullet?”
The huge potential benefits of this approach lead many to assume that vaccinations could form some ultimate, infallible treatment for drug abuse. It has also been argued that the development of vaccines could legitimize addiction (particularly to stimulants) in the minds of doctors in the same way that Prozac did for depression. These assumptions are understandable, but unfortunately misguided. The idea that merely subverting the effects could stop addiction has received much criticism, largely because addiction isn’t merely a physical condition. The psychological grasp of addiction is the real issue, and it will not be removed if the body learns to nullify the effect of a substance. People take drugs in the belief that they will help with stress reduction, and it seems plausible that even if they were vaccinated against their previous drug of choice, they’d simply seek an alternative method of fulfilling their craving.
It’s clear that counseling or other psychological treatment would still remain a central part of any treatment program. Several psychological issues, such as problems with anger management, depression, or a poor self-image, usually accompany addiction. Like drug addiction, these issues would never be addressed solely through medication, and counseling would therefore still be required.
Issues With the Treatment
The treatment itself isn’t perfect. The main issue is that each one can only be effective for one chemical class of addictive substances. So, if a cocaine addict were given a vaccination for cocaine abuse, he or she could start abusing heroin and still achieve a high. This wouldn’t necessarily be the case (since users may not want to switch from the energetic and active effects of cocaine to the languid ones of heroin, for example), but it does present a potential issue, since vaccinating users against all drugs would be expensive and time-consuming.
Not all of the participants who were tested under the first method had a strong enough response to the vaccine to stop cocaine from having any effect. It worked for only 38 percent of those studied, and the researchers aren’t able to determine exactly why. Also, the effects of this type of immunization are temporary, which means users would need repeated, consistent dosing for it to be effective in the long term.
Finally, users might not actually want to take the treatment. This is especially problematic with the first approach, since after the effects wear off, they’d be expected to show up for follow-up appointments for subsequent vaccines. If they’re struggling with temptation, (which is particularly likely if they aren’t receiving counseling) they may not want to nullify the effects of their drug of choice.
The second method of immunization appears to be more promising, but the entire concept has overall issues that will hold it back. The fact that it does nothing to help with the psychological root causes of addiction means that cravings will still be a significant issue. As new “designer” drugs surface, new vaccinations will also need to be developed, which means it will be a constant battle. While immunizations could have a part to play in the future of addiction treatment, they are far from cure-all wonder-drugs. Instead, they’re likely to become another tool in the rehabilitation arsenal, and will probably only be used alongside existing treatment methods.
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