from Hacker News

Vaccines against addictive drugs push forward despite past failures

by fern12 on 2/22/18, 9:52 PM with 37 comments

  • by RcouF1uZ4gsC on 2/23/18, 2:19 AM

    What is going to be an issue, is that opiods (like heroin, Fentanyl, morphine, oxycodone) actually have a clinical use apart from the abuse. So either the vaccine is very specific and just changing from say fentanyl to another of the many available opiods defeats the vaccine, or else it renders a whole class of drugs that may be legitimately used for pain management or anesthesia during surgery no longer able to be used for potentially the rest of the person's life.

  • by baxtr on 2/23/18, 8:37 AM

    Wait, so we we invent some great drugs for very specific use cases, prescribe them to the masses, just to find out that we created an epidemic and, then, instead of going back to prescribing it only rarely, invent a new drug against the abuse!? I don’t get it

  • by adventured on 2/23/18, 3:02 AM

    I've had a few friends that became addicted to opioids over the last ~20 years. It's terrifying to see what it can do to a person, how the addiction takes over. The only product I've seen work consistently to stop relapse and interrupt the craving, is Suboxone and the equivalent. It worked extremely well, returned them to a fully normal functioning state, but they couldn't stop taking it.

    The vaccination approach, even if it's unlikely to succeed, I certainly hope that it does, as every opioid addict I've known has ended up in a battle that never actually stops. It becomes a life-long struggle.

  • by CodeWriter23 on 2/23/18, 8:36 AM

    There must be a dose where the volume of heroin outstrips the body’s ability to generate antibodies, resulting in opiates passing into the brain. Addicts who have taken the vaccine will increase their chance of overdose when they relapse because they know just one balloon isn’t going to do the trick. And slam 5 balloons instead.

    Also, opiate receptors serve a purpose in pain relief and feeling pleasure when the brain secretes endorphins. The article doesn’t cover whether endorphins will trigger the immune response in people who have been modified by the vaccine.

  • by Animats on 2/23/18, 4:55 AM

    There have been previous attempts. There was "NicVax", which blocks nicotine somewhat. That made it to Phase III trials, but it wasn't very effective.

  • by tcj_phx on 2/23/18, 2:16 AM

    > Rather than activate the receptor, another drug called naltrexone blocks the receptor and can decrease cravings over time.

    Naltrexone is essentially a vaccine against both opioids and and alcohol. My recovered-alcoholic friend found that Naltrexone eliminated her ability to consume large amounts of alcohol. But she drank "to make it all go away", and Naltrexone didn't provide any relief for her emotional problems. She took herself off Naltrexone and drank herself into a 2-year prison sentence for her 3rd DUI. She tried to stay sober after getting released, but was unsuccessful because of her anger at her ex-husband (which I somewhat helped her release).

    Gabor Maté [0] says that virtually 100% of his most-hopeless drug addict patients had experienced "adverse childhood experiences".

    [0] https://news.ycombinator.com/item?id=16023802

    Last month I met "Henry" - our mutual friend said he was trying to get off "Black" (black tar heroin). A while later Henry tagged along with us... Mutual friend disappeared for a bit. Henry told me how scared he was of Black... That he'd once gone to Mexico with his family, thought he took enough to get him through the week, but started to go into withdrawal at the end of the trip.

    He also said how much he loves G (meth amphetamine), and that he'd tried to find some that day, but was unsuccessful. He then said, "A junky like me has to shoot something...", and said he'd used Black in the Taco Bell bathroom that afternoon, shortly before getting in my car.

    I told him I thought my friend (whom I've mentioned here before) was predisposed to addiction on account of her being adopted. Henry immediately said that he was adopted -- that he was found in a dumpster at 4 months old, screaming his little heart out.

    > But people struggling with addiction to cocaine or stimulants such as methamphetamine don’t have treatment options like these. They don’t exist.

    I've read some studies that found that Naltrexone is also helpful for reducing people's stimulant use, and that the anti-psychotics (anti-dopamine drugs) cause people to use more cocaine/amphetamine.

    Really there's no need for developing "vaccines" for "addictive drugs" - we have tools (naltrexone, the MAOIs, etc) that work well enough to address the reasons that people self-medicate with substances that cause long-term harm. Doctors just need to consider the full conditions of the person who can't limit their use of addictive substances to "recreation".

    It would also help to stop teaching addicts to be helpless in jail.

    This week I finally found the rest of a quote about 'feeling safe' that I've referenced for years [1]. Someone had asked about "ego" - the response was, "It's very important to develop an ego. When a person feels safe, the false-ego goes away."

    [1] https://news.ycombinator.com/item?id=15024780