Addiction is a disease, it is often said. Since that’s the case, vaccines may be one way of preventing it.

That’s not just hyperbole. The idea isn’t that far-fetched. Researchers have been working on anti-addiction vaccines for decades. It involves immunopharmacology. President Donald J. Trump’s first secretary of Health and Human Services Tom Price touted the line of research in August 2017.

However, that also means they have been failing for decades, so don’t expect one on the market anytime soon.

Nevertheless, just this month, researchers from New Zealand’s Victoria University of Wellington received a $150,000 Explorer grant from the nation’s Health Research Council.

Project leader Benjamin Compton explains that molecules of addictive drugs bind themselves to receptors in the brain. Theoretically these molecules can be blocked to prevent a user getting high on the drug. The grant will fund the development of such a “synthetic vaccine platform”.

Although no anti-addiction vaccine has been successfully developed for humans yet, we do know several things about the possible eventual vaccine:

  • It won’t be one and done. Children will not receive a shot and thereafter be safe from addiction. It will require regular boosters, probably several a year.

  • It will be intended for people with a substance use disorder (SUD) who wish to recover.

  • It will be drug specific. For instance, a vaccine for heroin probably would not prevent a fentanyl high.

  • It will not be a total treatment in itself. The usual therapies – cognitive behavioral, holistic, aftercare, support – will still be required.

In the end, it will be mainly an alternative to existing medication-assisted treatments for opioid use disorder (OUD):

  • Methadone: An opioid drug itself, dispensed daily at a physician’s office or clinic to prevent diversion. It provides enough of an opioid kick to prevent withdrawal pains but no “high”, allowing the person with OUD to function normally.

  • Buprenorphine (Suboxone): Another opioid, usually dispensed as a tamper-resistant sublingual film. Like methadone, it provides a low dose that controls addiction without euphoria or withdrawal.

  • Naltrexone (Vivitrol): Most often given as a once-monthly shot, this prevents a “high” if the person with OUD tries to get high. It is the only non-opioid prescribed to prevent opioid misuse. Some politicians, physicians, and judges prefer it for that reason, saying that taking an opioid to stop using another opioid is simply trading one addiction for another. The other two drugs have a better overall success rate, however. 

The main difference (and an important one) is that the new anti-addiction vaccines should be adaptable to other drugs such as cocaine and methadone, not just opioids.

At about the time Price was praising the concept of anti-addiction vaccines, Opiant was working on a heroin vaccine  for the US Army that also could incorporate an HIV vaccine. Two years later, it is still only in the “pipeline”.

So, right now, anti-addiction vaccines are a nice dream, but if you need treatment for SUD now, don’t wait. Even if they should come to pass, they won’t be a panacea or put alcohol rehab or drug rehab treatment centers out of business. 

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