Some researchers believe that vaccines could be a powerful new tool for fighting substance use disorder and overdose, but some experts are expressing caution about the idea.
Columbia University neurobiology professor Sandra Comer is one of the leaders of a project developing drug-specific vaccines to produce antibodies that target specific drugs.
His team is in the early stages of human trials for the oxycodone vaccine.
“If the person ends up using oxycodone after receiving the vaccine, the antibody will bind to that chemical structure … and block it from getting to the brain,” Comer said.
“The person will not experience the euphoric effects or high that oxycodone will produce.”
Marco Pravetoni, an associate professor of pharmacology and medicine at the University of Minnesota, said a fentanyl vaccine has shown promising results for preventing overdose in animal trials.
“Mice and rats vaccinated against fentanyl or carfentanyl will not show respiratory depressant effects of these compounds,” Pravetoni said.
“It can prevent or reduce the potential for fatal overdoses.”
Researchers believe that these vaccines, if successful, could offer new approaches to substance use disorder treatment.
The response from substance use experts in BC has ranged from cautious interest to downright skepticism.
early stages
The researchers said the two-dose vaccine is expected to be effective in a patient for six to 12 months.
By targeting specific drugs, Pravetoni said, the idea is not to neutralize drugs with medical use — for example, anesthesia or opioid recovery treatments. However, the researchers also want to develop vaccines that can target a range of illegal street drugs, which often have an unpredictable formulation.
“If you take fentanyl analogs, there are hundreds of them,” Pravetoni said. “We want to cover all these bases.”
Comer said their vaccine development is in the early stages.
The first goal is to make sure the vaccines are safe for human use, she said. Then the question will become whether they work or not.
Addiction Ministry Good for Thought
Cheyenne Johnson, executive director of the BC Center on Substance Use, said the project is interesting, but she worries about how well vaccines will work on illicit drug supplies.
“We know this is completely unpredictable,” Johnson said, adding patient choice needs to be considered.
“There’s a lot of evidence that … when we mandate treatment for people in terms of correctional facilities, in terms of youth, in terms of other health professions, there are really not very good outcomes.”
The Ministry of Mental Health and Addictions said it was monitoring the work.
“We welcome new research and initiatives that help provide treatment and recovery options for people with addictions,” a spokesperson wrote in an email.
“Right now, our government is focused on making proven treatment and support more accessible for people with opioid use disorder.”
Those treatments and supports include recovery programs, a secure supply program and de-criminalisation, the ministry said.
main cause
Guy Felicella, a peer clinical advisor at the B.C. Center on Substance Use who has lived with addiction himself, said a vaccine to purportedly cure addiction may not solve the root causes of addiction.
“In trauma, especially childhood trauma, and even in my own life, I was trying to numb that pain,” Felicella said. “I quit drugs. My life didn’t get better. You know, it got worse.
“I think it’s a scapegoat to target the trauma and the real issues of poverty and homelessness, and to punish people for using substances, instead of targeting them.”
Garth Mullins with the Vancouver Area Network of Drug Users worries that drug-specific vaccines will only prompt people with addictions to change their habits or to change their drug supply.
“People will be moved to the next thing,” Mullins said. “It would just encourage the kind of arms race that we see happening in the drug supply.”
He says that if the goal is to prevent overdose deaths, a regulated supply of pharmaceutical opioids is an easy solution.
