The Addiction Vaccine
It’s not infrequent that we hear of a celebrity overdosing: Michael Jackson, Elvis Presley, River Phoenix, Whitney Houston, and most recently, Prince. However, addiction may impact more lives than you imagine. In 2011, 20.6 million Americans over the age of 12 had an addiction, excluding tobacco!8 And, that number excludes all of those affected second handedly, all the family and friends severely impacted by watching someone suffer from this disease, worrying, and not always knowing how to help. Chances are, you know at least one person who has an addiction.
There are two ways drugs work in the brain. Some drugs, like marijuana and heroin, imitate naturally occurring neurotransmitters. When they bind to receptors, however, they act differently from normal neurotransmitters, and wreak havoc in the brain and body. The second way drugs, such as cocaine and methamphetamine, affect the brain is through direct the stimulation of nerve cells.
All drugs affect the pleasure centers of the brain. They all cause this “reward center” to release floods of dopamine, creating the “highs” of intense happiness and pleasure. This onslaught disrupts the natural cycle of dopamine, which explains why users experience high highs on the drug, and low lows when not on the drug.1 Because our brains are programmed to seek what brings us pleasure, it is easy to imagine that it will keep bringing a drug user back to the drug.1 This can lead to addiction.
Addiction is defined as “a chronic brain disease that is manifested by compulsive substance use despite harmful consequence.”6 Anyone can use a drug, but there is a difference between using a drug once, and becoming addicted. The core of the distinction lies in the fact that addicts cannot simply “stop.” Drug addiction is not a will power issue, it’s a disease. It’s not that an addict chooses to do the drug every time, they can’t control it. Normal brains can control urges, but addicts cannot. Dr. Nora Volkow, director of the National Institute on Drug Abuse, describes addiction like this: You are driving on a downhill road and a cat is standing in the middle of it. You don’t want to hit the cat, so you press the brakes, but the brakes are broken. No matter how much you want to stop the car, you cannot. You will inevitably run over the cat.3 This phenomenon even continues after the brain adapts and builds tolerance, and no longer has as high highs. Just the memory can create intense cravings.9
Heroin users may soon have a new tool to aid in their recovery. A lab group under Dr. Kim Janda of the Scripps Research Institute is in the process of developing a heroin “vaccine.” As the drug enters the body, the vaccine would cause the immune system to attack the drug by binding to it, recognizing it as a foreign body. This prevents the drug from crossing the brain-body barrier, and therefore also a high from ever occurring. This worked so well in rat experiments, that no rat relapsed to heroin addiction.4
In a panel titled “The Craving Brain: The Neuroscience of Uncontrollable Urges” from the 2014 World Science Festival, Dr. Janda mentioned the primary uses for such a vaccine being to help prevent relapses and to reduce use in third world countries, where needle sharing and therefore HIV are prevalent.3 Unfortunately, this is not an attractive package for drug companies. Although currently substance abuse costs our national healthcare system $600 billion per year,7 a low monetary return on an inexpensively produced drug is not a “good” investment for companies. Yet, the project still needs a lot of funding to support drug trials, and ultimately, FDA approval.3
Fortunately, in November of 2015, the National Institute for Drug Abuse gave $1.6 million to the project.5 In a phone interview, graduate student Paul Bremer descried that the lab was able to move on from rat trials, and is currently performing monkey trials. So far, they have not seen any side effects whatsoever. Bremer anticipates a patient would need three injections spaced about a month apart, although so far, it seems the more vaccine they inject, the better the response.2
Although the Janda Lab is one step closer to developing a vaccine for heroin, a lot more funding is needed to do clinical trials. Just recently, a few investors have expressed interest in the project. Bremer hopes that the lab will be able to pair with clinicians and perform the trials so that the vaccine can become available to consumers. Hopefully one day, we can be in a place where we really know how to help addicts, and have powerful tools to do so. From there, we can work on destigmatizing the disease of addiction in our society and healthcare system, so we can all overcome it once and for all.
Works Cited
"Brain and Addiction." National Institute for Drug Abuse for Teens, National Institutes for Health, teens.drugabuse.gov/drug-facts/brain-and-addiction. Accessed 29 Nov. 2016.
Bremer, Paul. Telephone interview. 21 Nov. 2016.
"The Craving Brain: The Neuroscience Of Uncontrollable Urges." The Kavli Foundation, www.kavlifoundation.org/science-spotlights/craving-brain-neuroscience-uncontrollable-urges#.WDtvofkrLif. Accessed 29 Nov. 2016.
Dinker, Bill. "Heroin Vaccine - Why Pharmaceutical Companies Just Say No." Discovery Place, www.discoveryplace.info/heroin-vaccine. Accessed 29 Nov. 2016.
Fikes, Bradley. "Heroin vaccine project gets $1.6M." The San Diego Union-Tribune, 19 Nov. 2015, www.sandiegouniontribune.com/business/biotech/sdut-heroin-vaccine-janda-tsri-2015nov19-story.html. Accessed 29 Nov. 2016.
Parekh, Ranna, editor. "What Is Addiction?" American Psychiatric Association, July 2015, www.psychiatry.org/patients-families/addiction/what-is-addiction. Accessed 29 Nov. 2016.
"Principles of Drug Addiction Treatment: A Research-Based Guide." National Institute on Drug Abuse, 3rd ed., National Institutes of Health, Dec. 2012, www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/drug-addiction-treatment-worth-its-cost. Accessed 29 Nov. 2016.
Smith, Kayla. "Addiction Statistics." Addiction Center, 21 Jan. 2016, www.addictioncenter.com/addiction/addiction-statistics/. Accessed 29 Nov. 2016.
"Understanding Addiction: How Addiction Hijacks the Brain." Help Guide, www.helpguide.org/harvard/how-addiction-hijacks-the-brain.htm. Accessed 29 Nov. 2016.
