As a part of our Samsung Game Changers Series we explained how researchers are designing vaccines against drugs, including nicotine and cocaine. The man running these research programs, Dr. Ronald Crystal, of Weil Cornell Medical College, sat down to tell us why this approach to drug addiction is so innovative.Business Insider: Why do we need a new way to intervene with nicotine and cocaine addictions?
These are major problems for society and despite all the various strategies that have been used over many decades there are no very good ways to treat these addictions. And so those interested in addiction are constantly looking for new approaches that might be used on a platform strategy, one could be used for many different addictions, and which could be used to help people stop.
You have the problem of one prevention, that is getting people to not get addicted, and then the problem of how do you get people who are addicted to stop. These vaccines strategies are directed at both of those problems.
So why does vaccination make sense as a treatment for addiction?
The strategy in terms of developing addiction treatments is basically two approaches: One is can you develop drugs that might interfere with the brain pathways so that people will not get high. That has not been very successful.
The other strategy is to take one step back and prevent the addictive molecule from getting to the brain in the first place, so that’s the idea of the vaccines.
If you can develop immunity against the addictive drug, in the form of antibodies against the addicted drug, it would prevent the drug from reaching its receptors in the brain. So there would be no high or other effects associated with the addictive drug.
What types of addictions could we vaccinate against?
It could be used basically for any of the small molecule addictive drugs — nicotine, cocaine, heroin, methamphetamines, and oxycodone — all of the various small molecules that are well known.
It’s a broad strategy, and the challenge is being able to show that they in fact will work in humans. That’s the challenge.
So, they’ve been tested in animals; how long until these vaccines are tested in humans?
In the nicotine vaccine it will probably be in humans within a couple of years; and the cocaine vaccine will probably be in humans within the year.
That trial would be for drug addicts.
Yes, the first approach would be for people who are addicted and they want to stop. They stop and you vaccinate them and that hopefully will help them get past the recidivism.
Let’s say a vaccinated cocaine addict takes some cocaine, how would that person react?
They would not feel anything. In other words, if they took cocaine, they would just not have any effects of it. The vaccine is strategised to block the cocaine, or any of the other addictive molecules, from reaching the brain, so they wouldn’t get any of the addictive effects of the molecule, the high and other things associated with it.
But there are social and psychological aspects of addiction as well as the physical addiction, right?
The answer to that question is difficult and we won’t know until these are tested in humans of how much of the drive is addiction, which probably is the major drive, versus the social aspects of it. What often gets addicted people back, who stop, are the social things. People go to a party, someone offers them some cocaine, they take some, and then they are hooked again.
The social, psychological aspects of addiction are not trivial but hopefully if we can take away the physical aspects of the high and the other positive effects that people feel from the addiction, that will outweigh these other aspects of it.
You mentioned using these as a preventative — do you think we should vaccinate everyone against drug addiction?
The real issues with that are: One efficacy, and the second issue is safety. In all vaccines safety is an important concern, specifically if you begin using them in large numbers of people. So you have to be very careful when you move from treatment, people who are addicts, to prevention and using it in a widespread fashion.
Prevention is a very good idea, but that’s all in the future because of the issue of safety.
So, if the vaccines are safe and effective, is this something we could use to abolish the desire in people to even try drugs?
That would be wonderful wouldn’t it? That would be terrific.
Everything from smoking to cocaine to heroin, they have major impacts in society. They destroy lives, they kill people, there are all the financial and social behaviours associated with it. It would be wonderful if that could be done, but in fact that’s a long way in the future.
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